If you want to switch between Medicare Advantage plans,

Perhaps you have watched a commercial, called, and enrolled in a plan over the phone (I don’t think this is a very good idea on a single call, there are too many moving parts when considering your most-fitting Medicare setup). Anyways, the message throughout Maximize Your Medicare is that there are powerful consumer rights, if you know what you are doing.

You have a single time to change, beginning January 1, ending March 31. The sooner the better, and the reason is that any progress towards the out of pocket maximum will reset if you are moving to a new plan (there can be exceptions, but this is a conservative path).

  • You can switch OUTSIDE this window, if:

    • You are switching INTO a 5-star plan as determined by the CMS. Once, between Jan 1 – Sep 30, and again during the Annual Election Period.

    • You qualify for Extra Help, which is the federal program that assists with pharmaceutical costs. Once a quarter, you can change.

    • You qualify or are disqualified for Medicaid in your state.

    • Your plan is discontinued.

If you have switched from Medigap to Medicare Advantage, and want to switch back,

  • January 1 – March 31: you can cancel your Medicare Advantage and enroll in a Part D plan. BUT remember that you CANNOT switch back to Medicare Advantage for the rest of the year. That means that you need to make sure that you are accepted by the Medigap carrier FIRST. Doing this out of order could be a huge mistake, which is easily avoided by FIRST getting accepted by a Medigap carrier. Note that this is trickier than it may seem, because the Medigap carrier may require additional information or have questions that everyday people can find very difficult to answer correctly.

  • There are other ways to do this (12-Month Trial Right), but it requires expertise in the rules, and on top of that, it may require evidence to prove that you are following those rules.