Medicare Advantage FAQs

The primary times to enroll for Medicare Advantage, Medicare Advantage Prescription Drug, or Medicare Part D prescription drug plans are:

• During your Initial Coverage Enrollment Period which is usually the seven-month period beginning three months before and ending three months after your 65th birthday month. Medicare is always effective the first of the month. If your birthday is the first of the month, your birth month is considered to be the first day of the preceding month. (Most Medicare Supplements are also effective the first of the month, but a few carriers make plans effective upon the date enrollment is approved.); or
• During the Annual Election Period (AEP) which starts October 15 and ends December 7. The effective date of enrollment is the following January 1. This is the time to review your present plans and coverages and decide if you want to make any changes. Unless you have a Special Election Period, this is the only other time (see the following note for the exception) you can enroll in or change to a different Medicare Advantage, Medicare Advantage Prescription Drug, or Part D Prescription drug plan.

NOTE: see the answer to FAQ 2 following that describes the Open Enrollment Period. Members who have previously enrolled in a Medicare Advantage or Medicare Advantage Prescription Drug Plan can change to a different Medicare Advantage or Medicare Advantage Prescription Drug Plan on a one-time basis between January 1 and March 31. Those who have enrolled in a Medicare Advantage or Medicare Advantage Plan during their Initial Coverage Election Period (as defined above) have a three-month period starting with the Part A and B effective dates after the effective date of enrollment to switch to a different Medicare Advantage or Medicare Advantage Prescription Drug Plan.

The Open Enrollment Period runs from January 1 through March 31. During this period, a person enrolled in a Medicare Advantage or Medicare Advantage Prescription Drug plan can elect to return to Original Medicare and may also select a Medicare Supplement Plan and/or separate Medicare drug coverage (Part D) OR make a one-time change to a different Medicare Advantage or Medicare Advantage Prescription Drug plan.

A beneficiary who elects a Medicare Advantage or Medicare Advantage Plan during his Initial Coverage Election Period (see FAQ 1 for definition) can also choose a different Medicare Advantage or Medicare Advantage Prescription Drug Plan -- or switch back to “Original Medicare” (Parts A and B) -- for up to three months after his or her Part A and B effective dates with or without a Medicare Supplement Plan and/or Medicare drug coverage (Part D).

One of the reasons for making this change in enrollment periods is that some members find that the network for their Medicare Advantage plan is inadequate or that their primary or specialist doctor(s) may have left the network. The Open Enrollment Period provides these members an opportunity to change to a plan that corrects this problem.

An individual with a Medicare Supplement or with "Original Medicare" (only) cannot make an election during this period, nor can an individual with a stand-alone Prescription Drug Plan switch to another stand-alone Prescription Drug Plan.

These individuals are eligible for Special Election Periods that permit them to enroll in a Medicare Advantage plan throughout the year:

• *Medicaid beneficiaries.
• *Individuals on low-income subsidy ("extra help" in paying for prescription drugs);
• People with chronic conditions like diabetes, chronic heart failure, COPD, and dementia (if a plan specializing in their condition exists in their service area);
• People moving out of a plan’s service area; and
• Those affected by other situations (including plan termination or insolvency).

* Medicaid and "extra help" (also called “low-income subsidy”) beneficiaries (who formerly could change plans at any time with an effective date the first of the following month) can now change plans once per calendar quarter for the first three calendar quarters. Any change is effective the first of the following month. A change can also be made during the Annual Election Period (i.e., between October 15 and December 7) to be effective the following January 1.

Five new Special Election Periods were added beginning in 2023:

1. Individuals impacted by an emergency or disaster,
2. Individuals who experience a health plan or employer error,
3. Formerly incarcerated individuals,
4. Individuals who lose Medicaid coverage, and
5. Other exceptional conditions

Please call us at 877-734-3884 (TTY: 711) for additional details including eligibility, available enrollment dates and help in enrolling.

A Special Enrollment Period permits eligible beneficiaries to enroll in a five-star plan at any time of the year between December 8 of the current year and November 30th of the following year for a first of the following month effective date. LEARN MORE.

For a complete listing of plans available in your service area please contact 1-800-Medicare or go to the Medicare Plan Finder at www.medicare.gov (TTY users should call 877-486-2048).

Your copy of Medicare & You 2024 also contains a generalized listing of the plans available in your area for 2024, but these listings do not contain complete details. You should consult the Summary of Benefits or Evidence of Coverage for each plan for more information.

Call us at 877-734-3884 (TTY: 711) for more information and help in enrolling in a plan.