Savvy Senior: When can I change my Medicare coverage?

Savvy Senior

QUESTION: Is it possible to make changes to my Medicare coverage now? I know we've passed the fall open enrollment period, but I've heard that there are other times of the year when beneficiaries can make changes. What can you tell me?

ANSWER: Yes. The annual Medicare open enrollment period isn't your only chance to swap out Medicare coverage. There are other opportunities, but when you can make those changes depends on your specific circumstances and the kind of Medicare coverage you have. Here's what you should know.

<span style="text-decoration: underline;">Medicare Advantage change</span>

If you're enrolled in a Medicare Advantage Plan, you might be able to use the Medicare Advantage open enrollment period, which occurs each year from Jan. 1 through March 31.

During this period, you can switch from your current Medicare Advantage Plan to another Medicare Advantage Plan or to original Medicare with or without a prescription drug plan. You can make only one change during this period, and it will be effective the first of the next month after you make the change.

<span style="text-decoration: underline;">Special enrollment</span>

Depending on your circumstances, you might also qualify for a special enrollment period to change your Medicare health and drug coverage.

There are a number of circumstances in which you might have a special enrollment period, such as if you moved outside of your plan's service area, your Medicare Advantage Plan terminated a significant amount of its network providers, or you are enrolled in a State Pharmaceutical Assistance Program.

Those with Extra Help - the federal program that helps pay for drug costs - also have a special enrollment period in which to enroll in a Part D plan, or switch between plans once per quarter in the first three quarters of the year.

If you need to make changes to your coverage but aren't sure whether you qualify for a special enrollment period, contact your State Health Insurance Assistance Program, which provides free Medicare counseling. To find a SHIP counselor in your area, visit ShipHelp.org or call (877) 839-2675.

Also, if you're enrolled in a Medicare plan by mistake or because of misleading information, you might be able to disenroll and change plans.

Typically, you have the right to change plans if you joined unintentionally, joined based on incorrect or misleading information or, through no fault of your own, were kept in a plan you did not want.

To get help, call Medicare at (800) 633-4227 and explain to a customer service representative how you joined the plan by mistake and to request retroactive disenrollment or a special enrollment period.

<span style="text-decoration: underline;">Fall open enrollment</span>

There's also the fall open enrollment period that allows all Medicare beneficiaries - those with original Medicare and Medicare Advantage plans - to make changes.

That period occurs each year from Oct. 15 through Dec. 7. During this time, you can join a new Medicare Advantage Plan or stand-alone prescription drug plan (Part D). You can also switch between original Medicare with or without a Part D plan and Medicare Advantage.

You can make as many changes as you need during this period, and your last coverage choice will take effect Jan. 1.

Jim Miller is editor of the Savvy Senior. Send your senior questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org.<!--p:footer-->