Switching to another Medicare plan
Q: I recently signed up for a Medicare Advantage plan and started to use it, but I discovered that some of my doctors weren’t included. Can I switch to another Medicare Advantage plan or switch back to traditional Medicare?
A: You generally can’t switch to another Medicare Advantage plan until open enrollment in the fall, which runs from Oct. 15 to Dec. 7 for 2018 coverage. There are a few exceptions, however. You can switch plans if you qualify for a special enrollment period, such as if you move to an address that isn’t in your plan’s service area.
You can also switch anytime during the year to a Medicare Advantage plan with a five-star quality rating. But in 2017, there are only 17 five-star Medicare Advantage plans in the U.S., including just 14 with prescription-drug coverage, so you may not have a five-star plan in your area. You can check by looking up “Medicare health plans” for your zip code using the Medicare Plan Finder (www.medicare.gov/ find-a-plan). You can also see a list of five-star plans at the Centers for Medicare and Medicaid Services’ website (www.cms.gov).
Switching from Medicare Advantage back to traditional Medicare is even trickier. The Medicare Advantage disenrollment period runs from Jan. 1 through Feb. 14 every year. At that time, you’ll also be able to sign up for Medicare Part D. But there’s no guarantee that you will be able to get a medigap policy to help cover the gaps in Medicare’s coverage, such as deductibles and co-payments. You can get any medigap policy within six months of first enrolling in Medicare Part B (whether you had coverage through traditional Medicare or Medicare Advantage), but after that insurers can generally reject you or charge more because of preexisting conditions.
There is another special rule, however, that could help you qualify for a Medigap policy: If you switch out of a Medicare Advantage plan within 12 months of first signing up, you can buy a Medigap policy within 63 days of making this change, says Mitchell Clark of the Medicare Rights Center. For more information, see the Medicare Rights Center’s “Protected Times to Buy a Medigap” fact sheet.
Your state may have other opportunities to sign up for a medigap policy regardless of any preexisting conditions. New York and Connecticut, for example, let you enroll in a Medigap plan at any time regardless of your health. Contact your State Health Insurance Assistance Program (www.shiptacenter.org) to learn more about the options in your area.