Updated: May 29
I made changes to my Medicare coverage during Fall Open Enrollment without doing much research about my options, and now I am not sure if I have the Medicare coverage that is best for me. What opportunities do I have to change my coverage in 2019?
-Sophia (Minneapolis, MN)
There are several situations in which you may be able to change your Medicare coverage in 2019. Some of these situations include:
If you have a Medicare Advantage Plan
The Medicare Advantage Open Enrollment Period (MA OEP) occurs each year from January 1 through March 31.
During the MA OEP, you can switch from your Medicare Advantage Plan to another Medicare Advantage Plan or to Original Medicare with or without a stand-alone prescription drug plan. Remember, you can only use this enrollment period if you have a Medicare Advantage Plan.
Before making any changes, make sure you know how changing your health and drug coverage will affect you.
Changes made during the MA OEP are effective the first of the following month. For example, if you switch from a Medicare Advantage Plan to Original Medicare and a stand-alone Part D plan on February 10, your new coverage will begin March 1.
If you have Extra Help
Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. If you have Extra Help in 2019, you have a Special Enrollment Period (SEP) to enroll in a Part D plan or switch between plans.
This SEP is available once per calendar quarter for the first three quarters of the year (January-March, April-June, and July-September). If you use the Extra Help SEP to change your coverage, the change will become effective the first of the month when you make the change. For example, if you use the Extra Help SEP to choose a new Part D prescription drug plan in March, that plan will become effective April 1.
This is a change to the Extra Help SEP, which previously could be used once per month. If you have Extra Help, these new limits may mean that you are locked into a drug plan at certain times of the year.
If you qualify for another Special Enrollment Period (SEP):
There are several circumstances in which you may be able to make changes to your Medicare health or drug coverage, like if you move outside of your plan’s service area, if your Medicare Advantage Plan terminated a significant amount of its providers, or if you enroll in certain State Pharmaceutical Assistance Programs (SPAPs).
If you need to make changes to your coverage but you are not sure whether you qualify for an SEP, call your State Health Insurance Assistance Program (SHIP) to learn more. To contact your SHIP, call 877-839-2675 or visit www.shiptacenter.org
Each year, there are changes to Medicare costs and coverage options. Starting in 2019, there are also several important changes to Medicare that will affect enrollment, Medicare Advantage Plans, and prescription drug coverage. Visit Medicare Interactive to download the free “Medicare in 2019” guide, and find out what you can expect for Medicare Parts A, B, D, and Medicare Advantage in 2019. Download the guide.
Article Submitted by:
Stephanie Kirk, Owner JC Madison Inc
18887 HWY 305, Suite #300, Poulsbo