If you're in a Medicare Advantage Plan, the Medicare Advantage Open Enrollment Period lets you make one change between January 1 and March 31. You can switch to a different Medicare Advantage Plan, or drop your plan and go back to Original Medicare, with the option to join a separate drug plan. The change starts the first day of the month after the new plan gets your request.
Who can use the Medicare Advantage Open Enrollment Period?
Medicare.gov says this period is for people who are already in a Medicare Advantage Plan on January 1. It runs from January 1 to March 31 each year.
There's also a version for people who are new to Medicare. If you joined a Medicare Advantage Plan when you first got Medicare, your window runs from the first month you have both Part A and Part B until the last day of the third month you have both.
People with Original Medicare and a stand-alone drug plan can't use this window.
What change can I make?
You can make one of these changes:
- Switch to a different Medicare Advantage Plan, with or without drug coverage.
- Drop your Medicare Advantage Plan and go back to Original Medicare. If you do, you can also join a separate Medicare drug plan.
Medicare.gov says you can only make one change during this period each year, so check your doctors and drugs before you use it.
What can't I do during this period?
According to Medicare.gov, during the Medicare Advantage Open Enrollment Period you can't:
- Switch from Original Medicare to a Medicare Advantage Plan.
- Join a Medicare drug plan if you're in Original Medicare.
- Switch from one Medicare drug plan to another if you're in Original Medicare.
Those changes belong to the fall Open Enrollment, October 15 to December 7, unless you qualify for a Special Enrollment Period. See how to compare Part D plans during open enrollment.
When does the change take effect?
Changes start the first day of the month after the plan gets your request. For example, if a new plan gets your request on February 10, your new coverage generally starts March 1. Until then, your old plan's rules and network still apply, so keep using in-network providers.
Why do people use this window?
Maybe your cardiologist turned out to be out of network. Or your inhaler cost more at the pharmacy in January than the plan's estimate. Other people run into prior authorization problems (see Medicare Advantage prior authorization denials) or out-of-network bills (see Medicare Advantage out-of-network bills).
Check whether the problem is the plan or the bill. A wrong bill may be fixed with one phone call, and switching plans won't change a bill you already got.
What should I check before I switch?
At Medicare.gov/plan-compare, add your doctors and see whether they're in each plan's network, then call each office to confirm. Enter your exact drugs and pharmacy too.
A new plan may start you over on its deductible and out-of-pocket maximum, so ask how it handles what you've already paid this year. If you're in the middle of treatment, ask the new plan whether it needs prior authorization.
If I go back to Original Medicare, can I get Medigap?
Ask this before you leave a Medicare Advantage Plan. Medicare.gov says that after your Medigap Open Enrollment Period ends, insurance companies in most states don't have to sell you a Medigap policy unless you have a guaranteed issue right. They may also look at your health.
Some people have a "trial right." Medicare & You says that if you dropped a Medigap policy to join a Medicare Advantage Plan for the first time, or joined one when you were first eligible at 65, you may be able to buy Medigap if you leave within 12 months. State rules vary. Your State Health Insurance Assistance Program (SHIP) can tell you what applies where you live. Find yours at shiphelp.org.
Without Medigap, Original Medicare generally leaves you paying 20% coinsurance for most Part B services, with no yearly cap. See Medigap plans: what they pay.
How do I make the change?
- To switch Medicare Advantage Plans: enroll in the new plan through Medicare.gov/plan-compare, by calling the plan, or by calling 1-800-MEDICARE (1-800-633-4227). Joining the new plan generally ends the old one.
- To go back to Original Medicare: call 1-800-MEDICARE or contact your plan. If you want drug coverage, join a stand-alone drug plan at the same time.
What to say when you call 1-800-MEDICARE:
"I'm in a Medicare Advantage Plan, and I'd like to use the Medicare Advantage Open Enrollment Period to [switch to (plan name) / go back to Original Medicare and join (drug plan name)]. Can you tell me the date my new coverage will start? And can you give me a confirmation number?"
Write down the date, the name of the person, and the confirmation number.
What if I miss March 31?
After March 31, you'll usually wait until the fall Open Enrollment, unless you qualify for a Special Enrollment Period. Medicare.gov lists situations that can qualify, such as moving out of your plan's service area or moving into or out of a nursing home. Ask your SHIP or 1-800-MEDICARE if your situation counts.
Frequently asked questions
When is the Medicare Advantage Open Enrollment Period?
January 1 to March 31, for people already in a Medicare Advantage Plan. People new to Medicare have a window in their first three months with both Part A and Part B.
How many changes can I make?
One. Medicare.gov says you can only make one change during this period each year.
Can I switch from Original Medicare to Medicare Advantage in this window?
No. That change belongs to the fall Open Enrollment, unless you qualify for a Special Enrollment Period.
When does my new coverage start?
The first day of the month after the plan gets your request.
Check the bill before you switch
Bill Review Coach is a monthly medical bill review service for seniors and their families. Upload your first bill free, no card needed. Snap a photo of the bill and your plan's Explanation of Benefits, and you'll get back a plain-English summary of what may be wrong and what to ask your plan. Refer a friend and you both get a free month once they join the paid plan. You make the calls and write the emails; we help you know what to say.
General information, not legal advice. Check your own bill and notices.