When Am I Allowed to Switch out of a Medicare Part C Health Plan?

1 answer | Last updated: Oct 29, 2016
A fellow caregiver asked...

When am I allowed to switch from one Medicare Part C health plan to another, or back to regular Medicare?


Expert Answers

Choosing a Medicare Part C Medicare Advantage health plan doesn't mean you're stuck forever with that particular plan. If you later find a different plan you'd prefer, or you'd rather return to traditional Medicare Part A and Part B coverage, you can switch -- as long as you follow Medicare's enrollment rules. There are also rules that cover what happens if your Medicare Part C health plan drops all coverage where you live, or if you move to someplace where your health plan doesn't provide coverage.

The times and rules for switching Medicare Part C health coverage are:

  • During open enrollment for a new Part C plan. You can switch from one plan to another once a year, during what's called the "open enrollment" period, regardless of your medical history. Every Medicare Part C Medicare Advantage health plan designates at least one month a year for open enrollment (if the plan's accepting any new enrollees at all). Most plans pick November for open enrollment, with coverage beginning the following January 1. Some plans have open enrollment for more than one month. All you have to do is enroll in the new plan and give your current plan 30 days' written notice of the date you'll be dropping its coverage.

  • If you're dropped by your Part C plan. Medicare Advantage plans sometimes drop out of specific geographic areas. If your plan drops out of your area, it will notify you by October 1, effective the following January 1. If that happens to you, you can join any other Medicare Part C health plan that operates where you live (unless it's not accepting new enrollees). You can enroll in the new plan any time between October 1 through December 31. Or you can rejoin traditional Medicare Part A and Medicare Part B instead. If you do, you're also guaranteed the right to buy a medigap supplemental insurance policy to fill gaps in Medicare coverage.

  • If you move out of your health plan's service area. Medicare Part C health plans operate within specific geographic areas. A plan isn't required to continue covering you if you move out of its service area. However, if you do move out of the plan's service area, you can enroll in any Medicare Part C Medicare Advantage plan operating in your new location. You can enroll in the new plan during that plan's yearly open enrollment period. However, if there's a gap in time between when you move and the open enrollment period for the new plan you want to join, you'll have to enroll in traditional Medicare Part A and Part B in the meantime.

  • If you want to switch back to Medicare Part A and Part B. You can leave your Medicare Part C Medicare Advantage plan and return to traditional Medicare Part A and Part B, without having to give any reason and regardless of your medical condition. The only restriction is that you may only leave during your health plan's open enrollment period, giving the plan 30 days' written notice that you're dropping your coverage.