Do you need a Medicare health or drug plan
Are you in need of a medicare drug plan as you near retirement or become medicare eligible? We have great news, we have listed a vast amount of information that can support you in your understanding of Medicare and what options you have regarding enrollment options.
Special circumstances (Special Enrollment Periods)SEP
Changing Medicare Advantage and Medicare prescription drug coverage when certain events happen, during Special Enrollment Periods (SEPs).
5-star special enrollment period
How Medicare uses member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans.
- During the five-star enrollment period (December 8 – November 30), people who live in an area with a five-star Medicare Part D or Medicare Advantage plan can switch to that plan if they choose to do so.
Special enrollment periods if you get Extra Help
Learn about special enrollment periods for Medicare Advantage Plan or Medicare prescription drug coverage.
When can I join, switch, or drop a plan?
Your are not obligated to change your medicare/medicare advantage health plan at all during these times as most pans will automatically renew year after year. However, during this times listed below you can join, switch, or drop a Medicare Health Plan or a Medicare Advantage Plan (Part C) with or without drug coverage during these times:
- Initial Enrollment Period. When you first become eligible for Medicare, you can join a plan.
- Open Enrollment Period. From October 15 – December 7 each year, you can join, switch, or drop a plan. Your coverage will begin on January 1 (as long as the plan gets your request by December 7).
- Medicare Advantage Open Enrollment Period. From January 1 – March 31 each year, if you’re enrolled in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this time.
During this annual window, Medicare plan enrollees can reevaluate their coverage – whether it’s Medicare with supplemental drug coverage, or Medicare Advantage – and make changes or purchase new policies if they want to do so.
What plan changes can I make during the Medicare open enrollment period?
During the Medicare open enrollment period, you can:
- Switch from Original Medicare to Medicare Advantage (as long as you’re enrolled in both Medicare Part A and Part B, and you live in the Medicare Advantage plan’s service area).
- Switch from Medicare Advantage to Original Medicare (plus a Medicare Part D plan, and possibly a Medigap plan).
- Switch from one Medicare Advantage plan to another.
- Switch from one Medicare Part D prescription drug plan to another.
- Enroll in a Medicare Part D prescription plan if you didn’t enroll when you were first eligible for Medicare. If you haven’t maintained other creditable coverage, a late-enrollment penalty may apply.
*Note: Prior to 2021, patients with end-stage renal disease were unable to enroll in Medicare Advantage plans unless there was a Medicare Special Needs plan available in their area for ESRD patients. But that changed as of 2021, under the terms of the 21st Century Cures Act. People with ESRD gained the option to enroll in Medicare Advantage as of 2021, and CMS expected more than 40,000 to do so. This can be particularly advantageous for beneficiaries with ESRD who are under age 65 and living in states that don’t guarantee access to Medigap plans for people under the age of 65.
Learn more below about enrollment periods below.