Changing Your Medicare Insurance Plan in 2023

Understanding Medicare Insurance Plans and Your Options

Even after enrolling and getting started, there are many times when someone might want to consider making changes to their Medicare Insurance Coverage. If you’ve decided now is the time to change Medicare plans, it’s important to next figure out how to make these changes — and when switching Medicare coverage is allowed. In this article you will find everything you need to know about how to change Medicare Insurance Plan. 

There are specific periods of time to make some of these changes, and there are important rules to know about to make sure your coverage changes go into effect in time. The Health Plus Life team is dedicated to breaking down these crucial steps to changing Medicare health plans or switching Medicare coverage, and we’re ready to help you find the best coverage for your personal needs. Before we dive into the topic at hand, let’s quickly revisit the basic types of Medicare:

• Medicare Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare services.
• Medicare Part B (Medical Insurance): Covers medical services and supplies not covered by Part A, including doctor visits, preventive services, and outpatient care.
• Medicare Part C (Medicare Advantage): Offers an alternative to Original Medicare, providing all benefits of Part A and Part B, often with additional coverage such as vision and dental.
• Medicare Part D (Prescription Drug Coverage): Helps pay for prescription medications and is available to those with Original Medicare or Medicare Advantage plans that do not include drug coverage.

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Why Might You Want to Change Medicare Insurance Plan?

Every person has a unique healthcare history and current needs, though there are some common reasons that might prompt someone to decide it’s time to seriously consider switching Medicare insurance plans. Here are some of the most common reasons for changing Medicare health plans:

 

• Health changes: If your health situation has changed significantly, whether it’s the need for more coverage due to chronic disease or less demand for coverage because of improved health, it could be time to change Medicare plans.

• Financial changes: A drastic shift in your income or budget might be another reason to consider switching Medicare insurance plans to either save money on premiums or buy more comprehensive coverage.

• Plan network changes: A switch can make sense if your preferred doctor or healthcare provider is no longer a part of your plan’s network.

• Your plan is no longer available: If your Medicare Advantage or Part D plan is discontinued or no longer available in your area, it’s time to choose a new plan.

• Dissatisfaction with your current plan: If you haven’t been happy with the service or coverage of your current plan, it’s worth considering making a change.

• Changes to your prescription needs: It can be worthwhile to consider other plans if a medication you need is no longer covered or falls under a higher pricing tier by a Medicare Part D or Medicare Advantage plan that includes drug coverage.

• Relocation: Moving to a new area might mean your current plan isn’t available there. Even if you can remain on your current plan, there are times after a move when different plans are available to you that might better suit your needs and budget.

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How to Change Your Medicare Insurance Plan:

 

• Review: Start by understanding your current Medicare plan coverage and assess if it’s meeting your healthcare needs. Remember to consider things like premiums, deductibles, co-payments, and your medications and doctors.
• Consider your needs: It could be time to make a change if your healthcare needs have changed over the past year. Consider things like a new diagnosis or changes in your prescription needs.

• Research: Compare your current plan to other Medicare plans available in your area.

• Consider eligibility periods: Changes typically need to happen during certain enrollment periods, such as the Annual Election Period or Open Enrollment from October 15 to December 7 when you can switch between Medicare Advantage and Original Medicare or change your Medicare Advantage or Part D plans.

• Apply: After choosing a new plan, you’ll need to apply online, over the phone, or with a paper application. The new plan will automatically disenroll you from your former plan once it takes effect.

• Review: Once enrolled, look over the packet of information you’ll receive about your new plan, paying particular attention to benefits, costs, and rules.

• Use your benefits: Start using your new plan for all your healthcare needs and services, and keep track of your usage and costs. This quick check can help you decide if this plan is worth sticking with or if you’ll want to consider switching Medicare coverage again during the next enrollment period.

 

 

When can I change my Medicare health insurance plan?
Read our blog for more information on the importance of Enrollment periods: https://t.co/lQbmQUSq7y#medicareforall #medicareadvantage #healthcaretips #medicalcare #AEP #openenrollment pic.twitter.com/fxckORqZk9

— HealthPlusLife (@healthplus_life) August 2, 2023

Evaluating Your Current Medicare Coverage

It’s important to continuously evaluate your Medicare coverage because plans, rules, networks, and options are always changing. Here are some things to consider:

 

• Costs: Take a close look at all of your healthcare costs, including your premium, deductible, co-payments, coinsurance, and out-of-pocket maximums.
• Network: For those who have a Medicare Advantage (Part C) plan, check if your plan’s network includes your preferred doctor, hospital, or pharmacy. A provider out of your network could require you to pay more.
• Prescription coverage: Assess your Part D or Medicare Advantage plan’s formulary, or list of covered drugs, to ensure the prescriptions you need are covered and learn what they will cost you. This is also a good time to learn the rules of your plan, such as prior authorization or quantity limits that apply to medications.
• Quality ratings: Check your Part D or Medicare Advantage plan’s star rating as provided by Medicare.
• Healthcare needs: Changes to your healthcare needs since enrolling in your current plan could make it time to change Medicare plans.

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Selecting a New Medicare Plan

If you’ve decided it’s the right time to change Medicare plans, you’ll next want to select your new plan, considering those same important factors such as costs, provider networks, and coverage for prescription medications.

There will likely be several options available for you, and each could represent potential advantages and drawbacks in terms of costs, coverages, and other benefits. Take your time really considering everything you think you’ll want and need in the next year, as well as your realistic budget constraints and what you truly need from your health insurance.

There’s a lot to consider when it comes to out of state HMO vs PPO plans, but it’s important to remember that you don’t have to do this alone. The Health Plus Life team is here to help you consider all of your options, including out of state HMO vs PPO plans, and determine if better coverage is available in your location and current health needs. We can demystify this complex process and make the decision to change Medicare plans, including out of state HMO vs PPO plans, a simple, seamless change that can help your budget and your healthcare coverage.

Things to Know When Switching to a New Medicare Plan

When preparing for or even just considering any kind of change to a Medicare plan or switching Medicare insurance plans, a crucial thing to keep in mind is when you can actually make these changes — and for most of us, that will be during the Medicare open enrollment period, which runs from October 15 through December 7 each year. 

Other than that narrow window of time to make changes in order to have new coverage in place for the following year, you’ll want to be prepared for what these changes will mean in your personal situation. Will your preferred doctor be in the network, or is it time to find a new provider? Will your new plan details reduce your monthly premiums or lower monthly and annual out-of-pocket costs? And are there any particular rules to follow for the new plan, such as quantity limits on prescription medications?

The best advice is to be prepared and arm yourself with a good plan that will best fit your budget, healthcare needs, and future goals. That’s where the Health Plus Life team comes in.

Our licensed agents can help you navigate all of your best Medicare Insurance options and ensure the coverage you have is exactly what you need. There are many times that better coverage is available to those who decide to change Medicare plans. If you’re ready to consider your options, give our team a call today.

FAQs About How to Change Medicare Insurance Plan

 

What are the different Medicare plans I can switch to?

There are several different Medicare plans you can switch to, depending on your individual needs, circumstances, and eligibility. Here’s a closer look at the different options:

• Original Medicare: This is a fee-for-service plan managed by the federal government and includes two parts, Part A (Hospital Insurance) and Part B (Medical Insurance). Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctor’s services, outpatient care, medical supplies, and preventive services.
• Medicare Advantage Plans (Part C): These are a type of Medicare health plan offered by private insurance companies contracted with Medicare. They include all the benefits and services covered under Part A and Part B and usually include prescription drug coverage (Part D). Some may offer additional coverage for vision, hearing, dental, and/or health and wellness programs.
• Medicare Prescription Drug Plans (Part D): These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans. They’re offered by insurance companies and other private companies approved by Medicare.
• Medicare Supplement Insurance (Medigap) Plans: Medigap policies help pay some of the healthcare costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. They don’t work with Medicare Advantage Plans, so you would need to switch back to Original Medicare if you want to buy a Medigap policy.

When can I change my Medicare health insurance plan?

There are specific times during the year when you can change your Medicare health plan, which includes the Annual Enrollment Period (AEP), running from October 15 to December 7 every year. Additionally, if you’re enrolled in a Medicare Advantage Plan, you can change plans during the Medicare Advantage Open Enrollment Period from January 1 to March 31. Special Enrollment Periods may also apply based on certain situations like moving out of your plan’s service area or losing your current coverage.

What factors should I consider before deciding to change my Medicare plan?

When considering a plan change, you should take into account factors such as your health needs, the doctors and hospitals included in the plan’s network, prescription drug coverage, out-of-pocket costs, and the quality of care offered by the plan. Also, consider if the new plan covers the services you need and if your current doctors are in-network.

Are there any penalties for switching my Medicare insurance plan?

There are generally no penalties for changing Medicare plans during designated enrollment periods. However, if you decide to switch from Original Medicare to a Medicare Advantage Plan or vice versa, or if you decide to add or drop a Medicare Prescription Drug Plan, you may face late enrollment penalties if you don’t enroll when you’re first eligible.

Can I revert back to my previous plan if I’m not satisfied with the new one?

Yes, you can switch back to your previous plan, but only during specific times. For instance, during the Medicare Advantage Open Enrollment Period (January 1 to March 31), you can switch back to Original Medicare or change to a different Medicare Advantage Plan. Outside of these periods, you must qualify for a Special Enrollment Period to change your plan.

How long does the process of switching Medicare plans take?

The process of switching Medicare insurance plans usually takes a few weeks. If you enroll or make changes to your plan during an enrollment period, your new coverage generally starts on the first day of the following month.

Can I switch from a Medicare Advantage plan to Original Medicare or vice versa?

Yes, you can switch from a Medicare Advantage Plan back to Original Medicare during the Medicare Advantage Open Enrollment Period (January 1 to March 31) or during the Annual Enrollment Period (October 15 to December 7). Similarly, you can switch from Original Medicare to a Medicare Advantage Plan during the Annual Enrollment Period. Outside of these periods, you may qualify for a Special Enrollment Period due to certain life changes or circumstances.