Are you currently enrolled in a Medicare Advantage plan and wondering about your options to switch to a different plan? Whether you’re considering a change due to rising costs or network changes, or you’re relocating to a new area, this comprehensive guide will walk you through everything you need to know about how to change Medicare Advantage plans efficiently and effectively.
Medicare Advantage plans (also known as Medicare Part C) are offered by private insurance companies approved by Medicare to provide your Medicare benefits. While these plans can offer excellent coverage, circumstances change, and what worked well for you last year might not be the best option for the coming year.
Let’s explore when and how you can make changes to ensure you always have the most suitable coverage for your healthcare needs.
Understanding the Annual Notice of Change (ANOC)
If you’re currently enrolled in a Medicare Advantage plan, you’ll receive an Annual Notice of Change (ANOC) document around October 1st each year. This isn’t just another piece of mail to file away—it’s a crucial document that deserves your immediate attention.
By law, every Medicare Advantage provider must send an ANOC before the Annual Enrollment Period begins. This document outlines all the changes that will affect your plan in the upcoming year. Since private insurance companies have the authority to modify virtually any aspect of their plans annually, the coverage you rely on today might look quite different next year.
Unfortunately, many beneficiaries overlook this important document, leaving them unaware of significant changes until they’ve already taken effect. This oversight can be costly, as failing to switch plans during the Annual Enrollment Period (October 15th through December 7th) means you’ll be locked into your current plan until the following year’s enrollment period.
When reviewing your ANOC, pay special attention to these key areas:
Premium Adjustments
Has your monthly premium increased? If so, by how much? Consider whether this new amount fits comfortably within your budget. Even small increases can add up to hundreds of dollars over the course of a year.
Cost-Sharing Changes
Check for modifications to copayments and coinsurance amounts. For example, a doctor visit that previously cost you $10 might increase to $20 or even $50. Some plans may switch from fixed copayments to percentage-based coinsurance, which could significantly impact your out-of-pocket expenses depending on the services you use.
Network Modifications
Medicare Advantage plans operate with specific provider networks. Always verify that your current doctors, specialists, and preferred healthcare facilities remain in-network for the upcoming year. A change in network status could mean substantially higher costs for seeing your preferred providers or even having to find new healthcare providers altogether.
Prescription Medicare Drug Coverage
Medication costs can be one of the largest healthcare expenses for many seniors. Carefully review any changes to the plan’s formulary (list of covered drugs) to ensure your prescriptions will still be covered and at what tier level. A drug moving to a higher tier or being removed from coverage entirely could dramatically increase your costs.
Additional Benefits
Many Medicare Advantage plans provide additional benefits not covered by Original Medicare. The specific benefits vary by plan and location.
If, after reviewing your ANOC, you’re satisfied with your current plan and the upcoming changes, you don’t need to take any action. Your enrollment will automatically continue into the next calendar year. However, if the changes are concerning or you believe there might be better options available, it’s time to explore how to switch Medicare Advantage plans during the enrollment period.
When Can You Switch Medicare Advantage Plans?
There are several periods throughout the year when you can change your Medicare Advantage plan.
Annual Enrollment Period
Running from October 15th through December 7th each year, this is the primary time when you can switch Medicare Advantage plans. Any changes you make during this period will take effect on January 1st of the following year.
Medicare Advantage Open Enrollment Period
From January 1st through March 31st each year, if you’re already enrolled in a Medicare Advantage plan, you can:
- Switch to a different Medicare Advantage plan
- Drop your Medicare Advantage plan and return to Original Medicare
- Join a Medicare Prescription Drug Plan if you return to Original Medicare
Changes made during this period typically take effect on the first day of the month following your request.
Special Enrollment Periods
Certain qualifying life events trigger Special Enrollment Periods that allow you to make changes outside the standard enrollment windows. One common scenario is changing Medicare Advantage plans when moving to a new location. Other qualifying events include:
- Moving out of your plan’s service area
- Moving to an area with new plan options (even if you remain within your current plan’s service area)
- Losing employer or union coverage
- Being eligible for both Medicare and Medicaid
- Qualifying for Extra Help with Medicare prescription drug costs
- Moving into, residing in, or leaving a long-term care facility
How to Switch Medicare Advantage Plans: Step-by-Step Guide
When you’re ready to explore your options and potentially switch Medicare Advantage plans, follow these steps to ensure a smooth transition:
Step 1: Research Available Plans
Visit Medicare.gov or MedicareSchool.com/AEP to compare plans available in your area. Both sites provide access to the same information, but MedicareSchool.com offers free enrollment assistance if you need help navigating the process.
Step 2: Create an Account or Sign In
If you’re using these online tools for the first time, you’ll need to create an account using your personal information, including your Medicare number. If you’ve used these services before, simply sign in with your existing credentials.
Step 3: Enter Your Current Medications and Preferred Pharmacy
For accurate cost comparisons, input all your current prescriptions and select your preferred pharmacy. If you’re considering changing pharmacies, you can explore that option as well. The system will calculate your estimated drug costs under each available plan.
Step 4: Compare Plans and Check Provider Networks
The platform will display all available Medicare Advantage plans in your area, typically ranking them based on your estimated total costs. For each plan that interests you:
- Verify that your medications are covered
- Check the estimated annual costs, including premiums, deductibles, and out-of-pocket expenses
- Most importantly, confirm that your preferred healthcare providers are in-network. Medicare Advantage plans generally require members to use in-network providers except for urgently needed or emergently needed care.
Don’t simply select the plan with the lowest premium—the true cost of a plan includes your total out-of-pocket expenses based on your specific healthcare needs.
Step 5: Enroll in Your Chosen Plan
Once you’ve identified the right plan for your needs, you can enroll directly through the Medicare.gov website or with assistance from a Medicare School Guide. When you can switch Medicare Advantage plans online, the process typically takes just 15-30 minutes.
Step 6: Confirm Your Enrollment
After submitting your application, you should receive a confirmation number. Within a few weeks, you’ll receive welcome materials from your new plan provider, including your member ID card. Be sure to keep your current coverage active until your new plan takes effect.
Special Considerations When Changing Medicare Advantage Plans When Moving
Relocating to a new area requires special attention to your Medicare coverage. Here’s what you need to know about changing Medicare Advantage plans when moving:
Timing Is Critical
If you’re planning a move, it’s important to understand the timing for making changes to your Medicare coverage:
- You can make changes up to one month before your move date
- You have up to two months after your move to select a new plan
- If you miss this window, you may have to wait until the next Annual Enrollment Period
Service Area Verification
Medicare Advantage plans have defined service areas, typically by county or state. When you move:
- Check if your current plan serves your new location
- If not, you’ll need to select a new plan to avoid coverage gaps
- Even if your current plan is available in your new location, the network, costs, and benefits may differ significantly
Network Considerations
When you move, even if your plan is available in your new area, the provider network will likely be different. Before deciding to keep your current plan:
- Research the available healthcare providers in your new location
- Check if the specialists you need are included in the network
- Verify that nearby hospitals and urgent care facilities are covered
Prescription Drug Coverage
Different regions may have different formularies (covered drug lists) or pharmacy networks, even within the same insurance company. When considering a plan in your new location:
- Verify that your medications are covered
- Check the tier levels and associated costs
- Confirm that convenient pharmacies are in-network
Can You Switch Medicare Advantage Plans Mid-Year?
While the Annual Enrollment Period is the primary time for making changes, you might wonder: can you switch Medicare Advantage plans at other times? The answer is yes, under certain circumstances:
- During the Medicare Advantage Open Enrollment Period (January 1st – March 31st)
- If you qualify for a Special Enrollment Period due to qualifying life events
- If you’re eligible for both Medicare and Medicaid, you may qualify to change plans once per quarter during the first nine months of the year
Working with Medicare Assistance Programs
If you find the process of comparing and selecting plans overwhelming, free assistance is available:
Medicare School Guides
Our trained professionals can help you navigate the complexities of Medicare Advantage plans and find the best option for your specific situation. They’re familiar with hundreds of different plans and can provide personalized guidance at no cost to you.
Medicare Customer Service
You can call Medicare directly at 1-800-MEDICARE (1-800-633-4227) for assistance with comparing plans and enrolling in a new one.
Get Help from Medicare School
Remember, your Medicare coverage should adapt to your changing healthcare needs and circumstances. Reviewing your options annually and knowing how and when to switch Medicare Advantage plans ensures you’ll always have the most appropriate coverage for your situation.
Click here to make an appointment online with one of our guides, or call 800.864.8890 for immediate assistance from someone who can walk you through the whole process.
FAQs About Switching Medicare Advantage Plans
How do I change Medicare Advantage plans during the Annual Enrollment Period?
Visit Medicare.gov or MedicareSchool.com/AEP, create an account, enter your medications and preferred pharmacy, compare available plans in your area, verify that your providers are in-network, and complete the enrollment process online or with assistance from a Medicare guide.
What should I do when changing Medicare Advantage plans when moving to a new state?
Contact Medicare or your current plan within one month before or up to two months after your move. Verify if your current plan is available in your new location, compare local provider networks, and enroll in a new plan if necessary to avoid coverage gaps.
Can you switch Medicare Advantage plans outside of the Annual Enrollment Period?
Yes, you can switch Medicare Advantage plans during the Medicare Advantage Open Enrollment Period (January 1-March 31) or if you qualify for a Special Enrollment Period due to qualifying life events such as moving, losing other coverage, or qualifying for Medicaid.
Will I have a gap in coverage when I switch Medicare Advantage plans?
No, when you switch Medicare Advantage plans properly during enrollment periods, your new coverage begins immediately after your old coverage ends, typically on January 1st following the Annual Enrollment Period or the first of the month after you enroll during other periods.
What happens to my prescriptions when I change to a new Medicare Advantage plan?
Your new plan may have different prescription drug coverage, including formulary, tiers, and pharmacy networks. Before switching, verify that your medications are covered under the new plan and check the associated costs to avoid unexpected expenses.