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When can you switch Medicare plans

Published by Mike Lovell on

A common question I hear is “When can I switch Medicare plans if I do want to make a change?”  Unfortunately there isn’t an easy answer.  Because different types of Medicare plans follow different types of rules the answer for you could be different than the answer for your neighbor.

In order to find out when you can change, we first need to figure out what type of plan you have. Let’s start with Medicare Advantage

Medicare Advantage

Medicare Advantage plans typically lock in for a calendar year.  So if you are already in an Advantage plan you may need to wait until one of the scenarios below.

AEP

AEP is the Annual Enrollment Period which happens every year from October 15th through December 7th.  If you decide to make a change during this time period then it’ll take effect January 1st of the following year.

OEP

OEP is the Open Enrollment period which was new for 2019.  It lasts from January 1st to March 31st.  There are a few key differences between OEP and AEP.

First off you can only make one change during this window.  Unlike AEP where you could submit as many applications as you desired.  (Although I might not recommend this.)

The second is that you are more limited in your options depending on your current plan.  Now if you have a Medicare Advantage then this shouldn’t be an issue but if you had a Prescription Drug Plan then it would have an impact.

Any applications submitted during OEP would take effect the 1st of the following month.

SEP

SEP is a Special Enrollment Period that gives you a window of time to make a change.  This could be due to a reason like moving out of the area or you qualify for extra help financially.  There are around 40 SEP types that all have different rules so it’s good to talk to an agent to see if you qualify for an SEP.

Medicare Supplements

Medicare Supplements don’t have any type of annual enrollment period.  What that means for you is that you can potentially switch at any time of the year.  This helps because you don’t have to wait until the following calendar year for a plan change to take effect.

The potential downside is that you may need to qualify through underwriting.  This is where a good agent is key because each carrier handles their underwriting a little bit different.  An agent would be able to tell you if a lower rate is available and help you navigate through the different carriers to find one based on your medical history.

Guaranteed Issue

Now usually you need to go through underwriting to switch Medicare supplement plans.  But some occasions cause what is  known as a Guaranteed Issue scenario.  This means that no matter your health history, you cannot be denied.

Guaranteed Issue typically have limited windows when you can apply for coverage.  So it’s important whenever a big change is happening to your current coverage to make a decision in that window.

Prescription Drug Plans

Prescription drug plans follow similar rules to Medicare Advantage.  Similar but not identical.

AEP

AEP is the Annual Enrollment Period which happens every year from October 15th through December 7th.  If you decide to make a change during this time period then it’ll take effect January 1st of the following year.

During this time you could submit an application but if you change your mind you can simply submit a new application and it will override the prior application.

SEP

SEP is a Special Enrollment Period that gives you a window of time to make a change.  This could be due to a reason like moving out of the area or you qualify for extra help financially.  There are around 40 SEP types that all have different rules so it’s good to talk to an agent to see if you qualify for an SEP.

If you have specific questions please don’t hesitate to contact me.

Mike Lovell

608-571-4461

mike@askmedicaremike.com

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