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Medicare Advantage Enrollment Periods Explained

There’s more than just the annual Medicare Advantage enrollment periodClock Approaching 12:00

If you ask most people on Medicare when they can enroll in, switch or drop a Medicare Advantage plan they will be quick to tell you.

The annual enrollment period is from October 15th through December 7th. New plans become effective on January 1st.

But don’t look for specific information on next years plans until October 1st. Insurance companies approved to offer Advantage plans are not allowed to publicly publish and distribute plan information until that date.

Over the years since Medicare Advantage plans were introduced there have been some changes in enrollment periods. One notable change was the elimination of the enrollment period from January 1st to March 31st.

There are other important enrollment periods and dates that you should be familiar with.

Annual Dis-enrollment Period

You are able to dis-enroll from a Medicare Advantage Plan beginning January 1st through February 14th. Your only option is to return to original Medicare. You can purchase a stand-alone Part D Plan or a Part D Plan and a Medicare supplement (underwriting may apply).

If you enrolled in a Part D Plan during the AEP and would like to switch, you are in most cases, out of luck. You must keep the plan through the end of the year.

Enroll when you become eligible for Medicare

If you are new to Medicare you have a 7 month window where you can join a Medicare Advantage Plan. The period begins 3 months prior to the month you turn 65, the month you turn 65 and 3 months after the month you turn 65.

At this time you have enrollment periods for both Medicare Advantage and Medigap. The open enrollment period for Medigap is the best time to choose that type of policy.

Special enrollment period for five star Medicare Advantage plans

You may be able to take advantage of a special enrollment Period that will allow you to change plans anytime (one time per year) and enroll in an Advantage plan rated five stars on the medicare.gov website.

If you are enrolled in a plan with less than five stars you can move to a five star plan. This enrollment period is designed to encourage companies offering these plans to get their quality scores up. That’s the good news. the bad news is that there are very few five star plans.

There are other Special Enrollment Periods that allow you to change plans as well.

  • If you qualify for extra help due to low income you are entitled to a Special Enrollment Period.
  • If you live in an institution such as a nursing home you also qualify for a special Enrollment Period.
  • Losing your employer group health coverage also qualifies.
  • If you move out of your plan’s service area you are entitled to a Special Enrollment Period.



Other reasons you may be able to switch plans outside of the Annual Enrollment Period includes misrepresentation or a plan defaulting on their

obligation to provide coverage.

If you are enrolled in a Medicare Advantage Plan it’s important to keep in mind that your plan is an annual plan and can change from year to year. Because of this you should mark these Medicare Advantage enrollment periods on your calendar and compare plans at the appropriate time.

 

2 comments

  1. I have aarp medicarecomplete with united healthcare,its a ppo ,I can not find a hematoligist in vero where I live ,why do I have to drive so far to see a specialist the insurance does not cover drs close by,i will have to look for another insurance company.

  2. Carol, I endorse PlanPrescriber as a good resource to compare all available plans with the help of a licensed agent. You can shop PlanPrescriber online or call them at (888) 310-0376. They have helped hundreds of my readers and subscribers.

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