Many Medicare beneficiaries ask: “Can I change my Medicare Advantage plan after open enrollment?” The answer is yes, through specific enrollment periods and qualifying events.
We at Dave Silver Insurance see clients navigate these changes successfully throughout the year. Understanding your options helps you switch plans when your healthcare needs change or life circumstances shift.
When Can You Change Medicare Advantage Plans
Special Enrollment Periods allow Medicare Advantage plan changes throughout the year when specific life events occur. The Centers for Medicare & Medicaid Services permits these changes when qualifying events occur, with coverage that starts the first day of the month after your plan receives the enrollment request. Moving outside your current plan’s service area creates an immediate two-month window to switch plans or return to Original Medicare. This window extends to three months if you notify your plan before the move occurs.
Major Life Changes That Qualify
Loss of employer-sponsored health coverage creates a two-month Special Enrollment Period for Medicare Advantage plan enrollment or switches. Marriage, divorce, or the addition of a family member through birth or adoption also qualify as events that trigger enrollment opportunities. Income changes that affect your eligibility for Extra Help or Medicaid open enrollment opportunities within specific timeframes. Loss of Medicaid eligibility provides a three-month window to join or switch Medicare Advantage coverage, while citizenship acquisition or release from incarceration allows enrollment up to 12 months after the qualifying event.
Coverage Transitions and Facility Moves
Moves into or out of nursing homes, assisted living facilities, or other long-term care institutions provide a two-month Special Enrollment Period for Medicare plan changes. Return to the United States after residence abroad creates a two-month enrollment window for Medicare Advantage or Part D coverage. Loss of creditable prescription drug coverage requires action within two months of the loss or notification that coverage no longer meets creditable standards. Plan contract non-renewals or involuntary plan terminations automatically qualify beneficiaries for Special Enrollment Periods to select new coverage options.
Monthly Change Options for Dual-Eligible Beneficiaries
Beneficiaries who receive both Medicare and Medicaid (dual-eligible status) can change their Medicare Advantage or Part D plans once per calendar month. These monthly changes take effect the first day of the following month after enrollment. Residents of certain institutions like nursing homes also qualify for monthly plan changes while they remain in these facilities. This flexibility helps dual-eligible individuals adjust their coverage as their health needs change throughout the year.
The Medicare Advantage Disenrollment Period offers another pathway for plan changes with specific timing and options that differ from Special Enrollment Periods.
What Happens During the Medicare Advantage Disenrollment Period
The Medicare Advantage Disenrollment Period runs from January 1 through February 14 each year and gives you a second chance to change your coverage after the annual open enrollment ends. This 45-day window specifically allows Medicare Advantage members to drop their current plan and return to Original Medicare with the option to add a standalone Part D prescription drug plan. According to the Centers for Medicare & Medicaid Services, approximately 28 million Americans were enrolled in Medicare Advantage plans as of 2023, which makes this disenrollment period a significant opportunity for those who want to switch back to traditional Medicare coverage.
How to Switch Back to Original Medicare
You drop your Medicare Advantage plan during this period and automatically return to Original Medicare Parts A and B coverage. Your new coverage starts the first day of the month after your plan receives your disenrollment request, which means a February 10 request would activate Original Medicare coverage on March 1. The process requires you to contact your current Medicare Advantage plan directly to request disenrollment rather than enroll in a new plan. Once you return to Original Medicare, you regain the freedom to see any doctor or specialist who accepts Medicare without network restrictions or referral requirements.
Part D Enrollment After Disenrollment
After you return to Original Medicare, you have until February 14 to enroll in a standalone Part D prescription drug plan if you want prescription coverage. This timeline is critical because you could face late enrollment penalties that increase your Part D premiums permanently if you miss this window. The penalty equals 1% of the national base beneficiary premium multiplied by the number of months you went without creditable prescription drug coverage after your Initial Enrollment Period ended. Compare Part D plans immediately after disenrollment since prescription drug needs often differ significantly from the coverage that Medicare Advantage plans provided.
Important Restrictions During This Period
You cannot switch from one Medicare Advantage plan to another during the disenrollment period (January 1-February 14). The period only allows you to drop your current Medicare Advantage plan and return to Original Medicare. You also cannot join a new Medicare Advantage plan during this time unless you qualify for a Special Enrollment Period due to a life event. These restrictions help prevent plan hopping while still providing an escape route for beneficiaries who want traditional Medicare coverage.
The process of actually changing your Medicare Advantage plan requires careful research and specific steps to avoid coverage gaps.
How Do You Actually Switch Medicare Advantage Plans
Use the Medicare Plan Finder tool at Medicare.gov to find Medicare health and drug plans in your area and compare costs. The tool displays current data that shows average Medicare Advantage premiums range from $18 to $158 monthly (depending on your location and plan features). Focus your search on plans that include your current doctors and specialists in their networks, since out-of-network providers can increase your costs by 40-60% according to recent Medicare data. Check each plan’s formulary to confirm your prescription medications remain covered at the same cost tier, as drug coverage varies significantly between plans even from the same insurance company.
Compare Total Annual Costs Beyond Monthly Premiums
Calculate your total yearly expenses with premiums, deductibles, copays, and coinsurance rather than monthly plan costs alone. A plan with a $0 premium might cost you $3,000 more annually through higher copays and deductibles compared to a plan with a $50 monthly premium. Request a Summary of Benefits from your top three plan choices and compare costs for your specific medications and expected medical services. Medicare Advantage plans with Star Ratings of 4 or 5 stars typically offer better customer service and clinical outcomes, though they may cost 15-20% more in premiums.
Submit Applications Within Required Timeframes
Contact your new plan directly or work with a licensed agent to submit your enrollment application, which automatically cancels your previous Medicare Advantage coverage. Your new coverage starts the first day of the month after your enrollment request, so a January 15 application activates February 1 coverage. Never cancel your current plan before you confirm acceptance into your new plan to avoid coverage gaps that could leave you responsible for 100% of medical costs. Keep documentation of your enrollment confirmation and plan cancellation notices for at least two years as proof of continuous coverage.
Final Thoughts
Special Enrollment Periods provide 60-day windows after life events occur, while the Medicare Advantage Disenrollment Period runs exactly 45 days from January 1 to February 14. You must act within these timeframes or wait until the next Annual Open Enrollment Period from October 15 to December 7. Missing deadlines leaves you locked into your current coverage for months.
Complex situations with multiple coverage types or dual eligibility status require professional guidance to navigate successfully. We at Dave Silver Insurance help clients understand their Medicare options and make informed decisions about their healthcare coverage. Our team works with you to find solutions that match your health needs and budget constraints (without the confusion of trying to decode Medicare rules alone).
The answer to “Can I change my Medicare Advantage plan after open enrollment?” remains yes through specific events and periods. You need research, proper timing, and often expert support to make these changes work in your favor. Contact Dave Silver Insurance to get personalized guidance on your Medicare choices and avoid costly mistakes in your coverage decisions.