If you find yourself in a Medicare Advantage plan you do not like, you have an escape hatch to another plan. The Medicare Advantage Open Enrollment Period is a short period of time when you can escape from your current enrollment, switch to another Medicare Advantage plan, or return to Original Medicare with a Part D prescription drug plan.
Each year, thousands of people are renewed into Medicare Advantage plans that they suddenly realize they don’t want. It’s not that the plans are bad, it’s just that plans may have changed and they no longer meet the health care needs of the Medicare beneficiary. The question becomes, “Why didn’t the person change plans when they had the opportunity?”
The time to change your Medicare Advantage plan is during the Annual Enrollment Period from October 15th through December 7th. The changes become effective January 1 of the new year. However, this is a busy period for many people. There are vacations, holidays, and family events.
It is also during this time that the Annual Notice of Change (ANOC) letters are sent to Medicare Advantage Members. The ANOC outlines the changes to the plan you might be enrolled in. There could be changes to the drug formulary, copays, and network providers such as doctors and hospitals.
Because people are busy during the Annual Enrollment Period (AEP), they may not focus to closely on the ANOC. Then, come January, when the plan member goes to use the Medicare Advantage plan, they find it has changed and no longer fits how they want their health care services delivered or it has become too expensive to use. For years, Medicare Advantage members who had not switched plans during the AEP were stuck with a health plan they did not like for the rest of the year.
There is now an escape hatch to get out of the plan. The Medicare Advantage Open Enrollment Period (MAOEP) begins January 1 and runs through March 31. Individuals in a Medicare Advantage plan they are unhappy with can switch to a different plan or return to Original Medicare and add a Part D prescription drug plan.
This open enrollment period is only for Medicare beneficiaries enrolled in a Medicare Advantage plan. Individuals with only a Part D prescription drug plan cannot enroll in a Medicare Advantage under the MAOEP.
When the individual elects a new Medicare Advantage or Part D plan, the old plan will be terminated and the new plan will become effective the 1st of the next month. For example, you decided to change Medicare Advantage plans on March 8th. The old plan will continue until the end of March and the new plan will be effective April 1.
The Medicare Advantage Open Enrollment Period is not limited to enrollments or renewals during the Annual Enrollment Period. A Medicare beneficiary who enrolls in the middle of the year will also have the 3-month MAOEP.
For instance, Mary turned 65 on June 15th. Her Medicare eligibility was effective June 1st. Mary enrolled in a Medicare Advantage in May for an effective date of June 1st. In July, Mary determined that the Medicare Advantage plan – as wonderful as it was – was just not going to work because she needed to see some doctors who were not in the plan’s network.
Mary’s Medicare Advantage Open Enrollment Period started June 1st. She has through the end of August to switch Medicare Advantage plans, or drop the plan, return to Original Medicare and add a Part D prescription drug plan.
https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
If you determine that your current Medicare Advantage is not working for you AND you are in the Medicare Advantage Open Enrollment Period, contact the agent who enrolled you or the plan. Confirm with them that the deficiencies you perceive with the plan are real and unavoidable. There are times when you may not have to change plans. Some issues may be easily corrected. You may only have to change your Primary Care Physician to gain access to specialists you need to see in another medical group. You can also contact Medicare directly for guidance and assistance.