The Medicare Advantage Open Enrollment Period (OEP) is a crucial time for individuals enrolled in a Medicare Advantage (Part C) plan to make changes to their coverage. This period occurs annually from January 1 to March 31 and allows beneficiaries to adjust their healthcare plans based on their evolving needs.
Who Can Use the Medicare Advantage Open Enrollment Period?
This period is only available to individuals who are already enrolled in a Medicare Advantage plan as of January 1. If you are enrolled, you have the opportunity to make adjustments that better fit your healthcare requirements.
What Can You Do During the Medicare Advantage Open Enrollment Period?
If you are enrolled in a Medicare Advantage plan, you can:
- Switch to a different Medicare Advantage plan (with or without prescription drug coverage)
- Drop your Medicare Advantage Plan and return to Original Medicare
- Apply for a Medicare Supplement (Medigap) plan if you return to original Medicare.
- Enroll in a stand-alone Medicare Part D prescription Drug Plan (only if you return to Original Medicare)
What Are You NOT Allowed to Do During the OEP?
During this period, you cannot:
- Switch from Original Medicare (Parts A & B) to a Medicare Advantage plan.
- Enroll in a Medicare Part D Prescription Drug Plan if you are on Original Medicare (unless you disenroll from Medicare Advantage first).
- Switch from one Medicare Part D plan to another while on Original Medicare.
Important Considerations Before Changing Plans
The Medicare Advantage Open Enrollment Period is designed to allow adjustments for those who are already enrolled in a Medicare Advantage plan. If you decide to return to Original Medicare, you should be prepared for:
- The potential loss of extra benefits (e.g., dental, vision, hearing, and wellness programs) that some Medicare Advantage plans offer.
- Increased out-of-pocket costs if you do not enroll in a Medicare Supplement (Medigap) plan.
- The importance of enrolling in a stand-alone Medicare Part D plan to maintain prescription drug coverage if you leave Medicare Advantage.
If you plan to leave Medicare Advantage and switch to Original Medicare, we highly recommend exploring Medicare Supplement (Medigap) plans to help cover gaps in your healthcare expenses. Applying early is advised to avoid gaps in coverage.
Why Consider Switching from Medicare Advantage to a Medicare Supplement (Medigap) Plan?
- More Predictable Costs – Medigap plans are budget-friendly and provide predictable monthly costs with minimal surprise expenses.
- Greater Flexibility – Unlike Medicare Advantage, Medigap plans do not require network restrictions, allowing you to see any doctor who accepts Medicare.
- Year-Round Enrollment (With Medical Underwriting) – You can apply for a Medicare Supplement plan at any time of the year, but medical underwriting may apply unless you qualify for a guaranteed issue right.
⚠ Important: If you do not have a guaranteed issue right, insurers may use medical underwriting when reviewing your Medigap application. This could mean higher premiums or denial of coverage, depending on your health conditions.
Your State Health Insurance Assistance Program (SHIP) can provide guidance on whether medical underwriting applies in your situation.
When Do Changes Take Effect?
Any changes made during the Medicare Advantage Open Enrollment Period will take effect on the first day of the month following your request.
For example, if you submit a request on February 10, your new coverage will begin on March 1.
For expert guidance on navigating your Medicare choices, give us a call at 877-413-1556 or click below to compare plans.