What Changes Can I Make to My Medicare Advantage Plan During Open Enrollment?

Medicare’s Open Enrollment Period gives anyone currently enrolled in a Medicare Advantage Plan — or those considering one — an opportunity to evaluate their current coverage, change their current coverage, or enroll in a Medicare Advantage plan.

While this valuable time period allows individuals enrolled in Medicare Part D (Prescription Drug Coverage) to update their prescription coverage, this article focuses primarily on the changes Medicare Advantage beneficiaries can make during OEP, which lasts from Oct. 15 through Dec. 7. 

This article breaks down four main scenarios:

1. I am enrolled in Original Medicare (Parts A & B)
2. I am enrolled in a Medicare Advantage Plan
3. I am enrolled in a Medicare Supplement Plan
4. I am enrolled in a health coverage provided by another institution

I am enrolled in Original Medicare (Parts A & B)

If you are currently enrolled in Original Medicare, you can use the Open Enrollment Period to enroll in a Medicare Advantage plan. During this time, it’s important to evaluate the benefits Medicare Advantage Plans can provide you, ensure your current providers are in-network while maintaining creditable prescription drug coverage either through a stand-alone Medicare Part D plan, or choosing a Medicare Advantage Plan with prescription drug coverage (MA-PD).

I am enrolled in a Medicare Advantage plan

If you’re currently enrolled in a Medicare Advantage Plan, you can remain in your current coverage, shop for a new Medicare Advantage Plan and, if it’s time to update your coverage you can enroll in a new Medicare Advantage plan. If you enroll in a new plan during Open Enrollment, your coverage takes effect on Jan. 1 of the following year. 

Additionally, you opt for coverage through Original Medicare alone. However, it’s important you retain creditable drug coverage should you choose this route, you must have health insurance coverage from your employer or your spouse’s employer of 20 or more employees to have what’s known as creditable coverage. Losing creditable coverage can result in penalties. 

Whether you choose to switch Medicare Advantage Plans or not, the Open Enrollment Period provides you a valuable opportunity to evaluate your current coverage and options available to ensure your coverage is keeping pace with your health and financial needs. 

LEARN MORE: What To Know About Switching Medicare Plans

I am enrolled in a Medicare Supplement Plan

If you’re enrolled in a Medicare Supplement (also called Medigap) Plan, you can switch to a Medicare Advantage Plan during the Open Enrollment Period. 

Medigap and Medicare Advantage Plans are two different ways to supplement your Original Medicare coverage, but they function differently.

Medigap is a supplemental insurance policy that helps cover costs not paid by Original Medicare, such as deductibles, coinsurances, and copayments. It offers flexibility and choice by expanding your network. However, it does not offer additional benefits like routine dental, vision, hearing services, or fitness programs. 

Medicare Advantage includes Original Medicare Parts A and B, plus some plans can include extra benefits like routine dental, vision, hearing, and fitness programs. It may also have an out-of-pocket maximum to protect you from large bills. However, it can become costly if you’re sick due to uncovered copays and may offer only a limited network of doctors. T

Choosing between the two depends on your specific health needs, financial situation, and preference for flexibility versus additional benefits. It’s best to carefully review each plan before making a decision. A SmartMatch Licensed Insurance Agent can help you evaluate all your options to help you make an informed, confident decision.

I am enrolled in health care coverage provided by another institution

In this example, you might be covered by your employer or union’s health care, but you could be losing coverage or just want to see if there’s coverage available that better meets your health and financial needs. During Open Enrollment, you can shop and switch to a Medicare Advantage Plan. However, you need to first be enrolled in Original Medicare (Parts A & B) to be eligible to make that change.

Key Takeaway

The Open Enrollment Period most commonly applies to individuals currently enrolled in a Medicare Advantage  or Prescription Drug Plan, or individuals who are considering switching to a Medicare Advantage Plan or a Prescription Drug Plan. Any changes you make during AEP will take effect Jan. 1 of the following year.