Each year during the fall, Medicare participants are given an opportunity to make changes to their coverage during the program's annual open enrollment program. If you signed up for a new Medicare Part D drug plan or a new Medicare Advantage plan in late 2023, then hopefully, that new coverage is working out well so far.
But what if it isn't?
Maybe you went to make an appointment with your pulmonologist only to realize they're not considered in network based on your new Medicare Advantage plan. Or maybe you were just prescribed a daily pill based on recent test results, and the costs under your current Part D drug plan are exorbitant.
If you're not happy with your existing Medicare plan, you may, unfortunately, be stuck with it for the remainder of 2024. But that's not necessary the case.
When you're not thrilled with your Part D coverage
If you signed up for a Medicare Part D plan you're not happy with, you may have to stick with it for the remainder of the year. However, there can be exceptions to this rule. For example, in some cases, if you move to a new location, you may be eligible to switch your Part D drug plan in the middle of the year.
If that's not an option, talk to your providers about ways to lower your prescription costs under your current plan. That could mean switching medications or moving over to generics.
When you're not thrilled with your Medicare Advantage plan
Maybe you signed up for Medicare Advantage for the first time late last year. Or maybe you switched to an Advantage plan you thought would be a better fit than a former one but isn't.
If you don't like your Medicare Advantage plan, you're actually in luck, because you're allowed to make a one-time change to your coverage between now and March 31. You don't need to qualify for a special circumstance, such as a change of location. You can opt to sign up for a different Advantage plan, or you can move over to original Medicare (Parts A and B) and then sign up for a Part D drug plan to go along with it.
Now one thing you should know is that if you decide to drop Medicare Advantage and get coverage under original Medicare instead, you may not be able to get a Medigap policy. It's common for enrollees in original Medicare to get supplemental insurance via Medigap to help cover out-of-pocket costs like deductibles. But if your current Medicare Advantage plan is truly a poor fit, then you may want to make a change regardless of this potential drawback.
Be careful with open enrollment
It's unfortunate to land in a situation where you're not satisfied with the Medicare coverage you've chosen. One way to potentially avoid a repeat scenario is to take plenty of time to research your plan choices during open enrollment the next time it comes around. With any luck, your next attempt at putting Medicare coverage in place will yield much more favorable results.