How to switch Medicare plans — and why you might want to

Medicare open enrollment is starting soon, but 7 in 10 Medicare beneficiaries say they are not comparing Medicare plans during this timeframe, according to a 2021 analysis by KFF, a nonprofit health policy organization.

That’s not great, since Medicare Advantage plans — which work much like private insurance you might have had through an employer — change from year to year. One of your doctors may have dropped out of the network, or your prescription drug prices may have gone up. And those on Original Medicare should compare their Part D prescription drug coverage.

Here’s how to switch Medicare plans.

Use the registration deadlines

If you have a Medicare plan, the October 15-December 7 open Medicare enrollment is your opportunity to change coverage. You can switch from Original Medicare to Medicare Advantage or vice versa, or enroll in or change Medicare Part D prescription drug plans.

If you have Medicare Advantage, you can use Medicare Advantage open enrollment to switch plans each year from January 1 through March 31, or return to Original Medicare and enroll in a Medicare Part D drug plan.

Consider prescription medications

If you take prescription medications, you should be aware of how your current plan will cover them in 2023 and whether another plan might be cheaper.

“It can be as simple as entering your medications into Medicare.gov,” said Scott Maibor, a Boston-based Medicare consultant. “They should at least check that ‘this is the plan I have, this is the plan they recommend, what are the savings?'”

That’s because Part D prescription drug plans — whether you’re on Original Medicare or receive coverage through a Medicare Advantage plan — can change every year. You may find that one of your prescriptions will cost more in 2023, or that your plan will no longer cover it. Or maybe you’ve started a new medication and find a plan that charges you less for it.

Don’t forget to browse your medication plan’s favorite pharmacies. “Sometimes it’s not even just a question of cost, it’s a question of location,” said Karen Schechter, director and assistant professor of the health management and health administration programs at Maryville University. “If I’m a person who needs to refill a prescription once a month, I might not want to go somewhere far away.”

Think carefully before abandoning your Medigap plan

You are first eligible for Medicare Supplement Insurance or Medigap once you are 65 years of age or older and have Medicare Part B. This six-month Medigap enrollment period only happens once, and you can take out any policy you want. regardless of your health. After that, you may not be able to get a Medigap plan — or it may cost more.

Medigap pays many of the expenses of Original Medicare. If you have a serious or chronic medical condition, this can result in significant cost savings. Some people switch to Medicare Advantage plans during open enrollment, unaware that they may not be able to switch to a Medigap plan later.

“Our clients are sitting at home, they’re watching these commercials on TV talking about free gym memberships, no rewards, and they’re going ahead and making changes themselves,” said Emily Gang, owner of The Medicare Coach. “They realize early in the year that they made a mistake and we can’t go back.”

Complete the process

To enroll in a new plan, you will need your Medicare number and the date your Part A and/or Part B coverage began. (All of this information is on your Medicare card.)

You may be able to sign up online, but you may also need to make a phone call or two:

— If you switch from one Medicare Advantage plan to another, you will be automatically unenrolled from your previous plan once your new coverage begins.

— If you are switching from Medicare Advantage to Original Medicare, call 800-MEDICARE to make the change or call your plan provider to opt out. Don’t forget to enroll in Prescription Drug Coverage (Part D) to avoid paying a penalty.

— If you switch from Original Medicare to Medicare Advantage, your new plan transfers your benefits from Medicare. However, you must opt ​​out of any Part D plan you may have.

— If you switch Part D medication plans, your old coverage will end when your new coverage begins.

— If you stick to your current plan, do nothing. Your insurance cover is automatically extended.

This article was provided to The Associated Press by personal finance site NerdWallet. Kate Ashford is a writer at NerdWallet.