Whether you have a Medicare Supplement Policy (aka Medigap), or a Medicare Advantage Plan, you may qualify to switch your plan any time of year!
- Accepted by any doctor or hospital that accepts Medicare
- Monthly premiums are usually more than $100
- Most popular plans are F, G, and N.
- Usually $0 monthly premium
- Typically includes a drug plan
- Requires a doctor and hospital network with copay and coinsurance
Chances are, if you are reading this page it is because you are either new to Medicare, or there is something about your current plan you are not happy about.
It may be the new rate increase, it may be an increase in benefits you weren’t aware of, or an expensive drug that isn’t covered.
There are very specific ways to switch your plan mid-year, and these will be discussed below, starting with Medigap Plans.
Switching your Medigap Policy any time of year
The number one reason people switch Medicare Supplement carriers is rate increases. There will always be rate increases. So why not “re-set” the rate increases from a new lower rate, and start saving now, while you qualify?
The Annual Enrollment period for Medicare Plans ONLY applies to Medicare Advantage plans and Part D drug plans. This does not apply to Medigap plans at all, and does NOT give you guaranteed acceptance to switch your Medigap Plan.
To switch your Medigap Plan to a new lower rate with a different carrier, you must qualify based on health. Don’t let this scare you away yet. It’s not as difficult as you might think.
Every carrier application has their own set of health questions, and they vary. You may qualify with one carrier, but not another. While certain conditions can disqualify you, such as cancer, heart attack, stroke, COPD, or hospitalizations within the past few years, the average senior may easily pass medical underwriting. It is worth checking into. Most seniors are overpaying, and can save $20-$80 per month!
Keep in mind that a Plan F with one carrier is exactly the same as a Plan F with another carrier. All plans are standardized and approved by Medicare, but allowed to charge different premiums for the exact same benefits.
Different insurance companies may charge different premiums for the exact same policy. -Page 92 of the 2015 Medicare & You Handbook
Switching your Medicare Advantage Plan any time of year
5 Star Special Enrollment Period
Medicare gives “star ratings” to rate the overall performance of Medicare Advantage Plans. This can help you compare plans based on quality and performance. Plans can get an overall rating between 1 and 5 stars.
You can switch to a Medicare Advantage Plan or Medicare Cost Plan that has 5 stars for it’s overall star rating from December 8, 2014 – November 30, 2015. – Page 87 of the 2015 Medicare & You Handbook
You can only use this special enrollment period if there is a 5-star Medicare Advantage Plan, or Medicare Cost Plan, in your county, and only switch one time.
To find out if your county has a 5-star plan, contact a local independent agent that represents multiple plans, call Medicare, or visit the Medicare website.
Special Needs Plans
If you have Medicare and you develop certain severe or disabling conditions, or enter a nursing home… You can join a Medicare SNP (Special Needs Plan) designed to serve people with those conditions at any time, but once you join a plan this special enrollment period ends. – Page 15 of “Your Guide to Special Needs Plans,” A CMS (Centers for Medicare & Medicaid Services) Publication
Some examples of severe and disabling conditions are chronic heart failure, diabetes mellitus, and chronic lung disorders.
What If I’m on a Medicare Advantage Plan and would like to switch to a Supplement (Medigap)?
If you are still within your first year ever on a Medicare Advantage Plan, there is a Medicare rule (Trial Right) that allows you to dis-enroll from that plan and enroll in a Medigap policy. -Page 23 of 2015 Choosing A Medigap Policy, A CMS (Centers for Medicare & Medicaid Services) Publication
Other enrollment circumstances that allow you to join, switch, or drop a Medicare Advantage Plan:
- Moving out of your plan’s service area
- You have Medicaid
- You qualify for Extra Help (A Medicare program to help people with limited income pay for prescription drugs)