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What do I need to know if I want to change my Medicare plan this year?

Everyone who is signed up for Medicare has the opportunity to change their plan in the fall open enrollment period. Here are some things to keep in mind.

What to know before changing your Medicare plan

As time passes, needs can change from where you live, how you get around to what you eat. The healthcare coverage you have is no different. Once a year, during the nine weeks of Open Enrollment for Medicare all those who are signed up can make changes to their plan for healthcare and prescription drugs for the next year.

But you don’t have to wait until 15 October when Open Enrollment starts to get going on the foot work of considering a different plan. You can get a head start by taking into account what your needs are and checking those with your current coverage. Then you can use the Medicare online tool to compare plans before you make a switch.

Also see:

Important first steps when considering a change to your Medicare coverage

First and foremost, you will want to check that your plan covers the services you need. Also, whether you have other types of health or prescription drug coverage through your current or former employer. Keep in mind that you will want to know if that coverage works with Medicare or is affected by it.

You can get the necessary information by consulting any materials you have from your insurer or plan. Better yet, you may want to call so the benefits administrator can walk you through the details. You’ll want to check the fine print thoroughly before making any changes or dropping your coverage, it could be a one-way street.

You will want to crunch the numbers as well. If you are retired, you’ll most likely be living on a fixed income from your retirement savings. You should pay attention to your plan’s premiums, deductibles, and other costs. Look into how much your out-of-pocket costs will be for doctor visits, hospital stays and other services as well as having prescriptions filled.

Many people make plans for their golden years to do the things that they didn’t have the time to do while they were a slave to the grind. A big dream for many is getting out to see the world, but you’ll want to make sure you are covered in another state or country.

Other factors to help judge if you should change your Medicare plan

The relationship between a doctor and patient can impact the outcome of treatments and even help to nip a developing problem in the bud before it becomes a serious issue. Getting the treatment you want from the professional you want may not be covered under certain plans. You will want to check which doctors or healthcare providers are covered under each plan you are considering.

Likewise, you should keep in mind the convenience of the services you are seeking including the location of the hospitals and doctors’ offices covered in the plan. Which pharmacies you can use and whether you can have your prescriptions sent to you by mail should also be considered.

Whether you choose to use Original Medicare or Medicare Advantage, during the Open Enrollment period you can switch from one to the other, whichever has the best fit for you and your budget.

Important dates for Medicare

September & October

You will want to review your current plan as it may have changed and compare other plans that are available to see if they better meet your needs.

15 October

Open Enrollment begins, when everyone with Medicare can switch their health and drug plans for the next year.

7 December

Open Enrollment ends and your enrollment request must be received by the plan that you have chosen. For most this is the last day that you can change your Medicare coverage.

1 January

If you’ve chosen to switch your Medicare plan, the new coverage begins 1 January. If you don’t switch plans, any changes to coverage, benefits, or costs that have been announced will take effect at the start of the year.

Between 1 January and 31 March

For those in a Medicare Advantage Plan, you have the option to switch to another Medicare Advantage Plan or to Original Medicare during this period. Your Medicare Advantage Plan can be with or without drug coverage. For those who opt to change to Original Medicare, you’ll also have the option to join a Medicare drug plan.

The new coverage will begin the first day of the month after your enrollment form is received by the plan.

Special Enrollment Period

In certain cases, if you qualify, you may be able to make other changes in a Special Enrollment Period.


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