Just being “unhappy” with a Medicare Advantage plan doesn’t give you the right to switch plans, but there are certainly several time periods when you can legitimately change to another plan.
These include:
- Annual open enrollment period (Oct. 15 to Dec. 7): You have many options to change your coverage during this time frame: from a Medicare Advantage plan to original Medicare and vice versa; from one Medicare Advantage plan to another; from one Part D drug plan to another. Coverage in the new plan begins Jan. 1.
- Annual disenrollment period (Jan. 1 to Feb. 14): This specifically gives you the opportunity to switch from a Medicare Advantage plan to the original Medicare (but not to a different Advantage plan). If you drop your plan in January, coverage in original Medicare begins Feb. 1; if you drop it in the first two weeks of February, coverage begins March 1.
- Your first year in a Medicare Advantage plan: This counts as a trial period in two circumstances. You can drop out of the plan and return to original Medicare, with the right to buy Medigap supplemental insurance, at any time during those first 12 months — if you joined the plan straight away when you enrolled in Medicare at age 65, or if you dropped a Medigap policy to join the Advantage plan and this is the first Advantage plan you have ever been enrolled in.
- At any time in certain circumstances: You can switch to another type of coverage (a different Medicare Advantage plan or original Medicare) if:
• You receive Extra Help (the low-cost Part D prescription drug program for people with incomes under a certain level)
• You enter or leave a nursing home or other long-term care facility
• You lose coverage from Medicaid or a state program that pays your Medicare premiums
• You switch to a Medicare Advantage plan that has earned Medicare’s highest quality rating (five stars) if there is one in your area (you can switch any time of the year except for the first week of December)
• You move out of the plan’s service area
• The plan withdraws service from your area, leaves Medicare entirely, or closes down
• Medicare agrees with your complaint that the plan violated its contract with you, or that you were misled into joining the plan through fraud or erroneous or incomplete information
• Medicare agrees that a federal employee made a mistake when processing your enrollment in this plan.
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