Most Americans enroll for Medicare at their earliest opportunity, because the program provides affordable and extensive coverage for a wide array of healthcare costs. After you've enrolled in Medicare, you have the option each year to make changes to your coverage during the Medicare open enrollment period. That period is less than eight weeks long, though, and it's easy for people to miss it in the year-end bustle of the holidays. If you're one of the many Medicare enrollees who missed open enrollment, which ended on Dec. 7, there are some options available to you if you still want to make changes to your coverage.
Switching from Medicare Advantage to original Medicare
If you're currently enrolled in a Medicare Advantage plan and are looking to switch to original Medicare, you'll have another opportunity to do so in the near future. The Medicare program offers what it calls the Medicare Advantage Disenrollment Period each year, which starts on Jan. 1 and ends on Feb. 14.
During the period, you're allowed to move from a Medicare Advantage plan to regular Medicare coverage. When you do so, you can also enroll in a Part D prescription drug program, since many Medicare Advantage offerings integrate prescription drug coverage into their plans.
However, the Medicare Advantage Disenrollment Period is a lot more limited than the regular open enrollment period. You're not allowed to switch from one Medicare Advantage plan to another Medicare Advantage plan during the period, nor are you allowed to go from original Medicare to a new Medicare Advantage plan. Those who already have Part D prescription drug coverage aren't permitted to switch to a new plan during the period, either. Finally, certain special Medicare Medical Savings Account-based plans aren't eligible for the disenrollment period.
If you do qualify, any changes take effect as of the first of the following month. The sooner you act once the New Year begins, the sooner your replacement Medicare coverage will apply to future expenses.
Special enrollment periods
In addition to open enrollment, Medicare allows people to make coverage changes under special circumstances. These special enrollment periods give participants an opportunity to ensure that they'll have appropriate healthcare coverage.
A host of different situations can trigger eligibility for a special enrollment period, and your options differ in each one. For instance, if you move outside your existing Medicare Advantage or Part D plan's service area, you can replace it with new coverage of the same type. If you move into or out of a skilled nursing facility, you can make a wider range of changes, including not only joining Medicare Advantage or a Part D plan but also switching to other plans or returning to original Medicare within a two-month period. Losing coverage from Medicaid also allows you to sign up for Medicare Advantage, Part D, or return to original Medicare.
Often, if you become eligible for new coverage, then you'll be allowed to drop your existing Medicare coverage. For instance, new offerings from an employer or union can open the door to dropping Medicare coverage, and those who become eligible for Medicaid can make changes to their Medicare options at any time.
Finally, some plan changes can give you an option to make special enrollment decisions. Sanctions against your plan provider can allow you to change plans, as can a decision from Medicare not to renew a provider's contract with the insurer that's offering you coverage.
This is just a short overview of special enrollment periods, but you can get more complete information from the Medicare website. Using that information as a resource will help you understand what all of your options are.
Know what your rights are with Medicare enrollment
Annual open enrollment is over, but that doesn't mean that you're stuck with your current Medicare choice for good. Look to see if the disenrollment period or a special enrollment period might apply to your situation and then take action as you see fit to make the most of your healthcare coverage options.
Medicare open enrollment is a time you can use to get the most out of your healthcare coverage. Be ready next week to look at your options and find the one that fits your needs the best.