Can I change my Medicare coverage?

Emily WhicheloeDear Marci0 Comments

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Dear Marci,

Last November, during Fall Open Enrollment, I switched into a new Medicare Advantage Plan. I have since realized that I do not want to be a part of this plan. Can I change my Medicare coverage?

Faisal (Madison, WI)

 

Dear Faisal,

Depending on the kind of change you want to make to your Medicare coverage, you may be able to make a change now. Before you make any changes, make sure you know how changing your health and drug coverage will affect you. In particular, make sure that with the new coverage you choose, you will be able to see your usual doctors and continue to have your medications covered.

If you want to disenroll from your Medicare Advantage Plan and use Original Medicare and a stand-alone Part D plan, you can make that change during the Medicare Advantage Disenrollment Period (MADP). The MADP runs from January 1 to February 14 of each year. During this time, you can switch from a Medicare Advantage Plan to Original Medicare and a Part D drug plan. This is the only kind of change you can make during the MADP. You cannot enroll in another Medicare Advantage Plan or make any changes to Original Medicare coverage. Changes made during the MAPD are effective the first of the following month, so any changes you make before the end of January will be effective February 1, while any changes you make between February 1 and February 14 will be effective March 1.

Note: If you disenroll from your Medicare Advantage Plan federal law does not usually give you the right to buy a Medigap plan. The laws in your state might give you more rights. Medigap plans are supplemental polices that help pay for Original Medicare deductibles and coinsurances. You should check with your State Health Insurance Assistance Program to find out if and when you can enroll in a Medigap plan in your state. To find your SHIP, you can go to www.shiptacenter.org or call 877-839-2675.

If you want to make other kinds of changes, or if you miss the MADP, you might be able to change your coverage if you meet the requirements for a Special Enrollment Period. There are several reasons that you might qualify for a Special Enrollment Period to disenroll from your Medicare Advantage Plan and enroll in different coverage. For example, people who have Medicaid or the Medicare Savings Program have the option to join, disenroll from, or switch Medicare Advantage Plans or Part D drug plans once every month. You may also have an SEP if you move, if your Medicare Advantage Plan stops contracting with many of its providers, or if you want to enroll in a plan that has a 5-star rating, among other reasons.

If you initially joined your plan because you were misled in some way, you could be entitled to a special enrollment period to change coverage. If you think you experienced misleading marketing, or if you were enrolled in your plan without your consent, you should report this to 1-800-MEDICARE or your local Senior Medicare Patrol (SMP). To contact your local SMP, visit www.smpresource.org or call 877-808-2468. A representative can help you understand what happened and report any violations to the correct authorities. They can also help you contact your SHIP, who will be able to assist you with changing your Medicare coverage.

-Marci

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