When and how you can change your Medicare coverage

You can switch Medicare plans during Open Enrollment for Medicare, which runs from October 15 to December 7 each year. During this window, you can change from Original Medicare to a Medicare Advantage plan, switch between Medicare Advantage plans, add or drop prescription drug coverage, or move to a Medigap policy. Changes take effect January 1 of the following year.

Outside of Open Enrollment, you can only switch plans if you have a may have access to life event — such as losing employer coverage, moving to a new state, or becoming newly may be able to access for Medicaid. Even then, you typically have 60 days from the event to make changes.

The process itself is straightforward: you contact the plan you want to join, provide your Medicare number and personal information, and submit your request. The plan handles the paperwork with Medicare. You do not need to contact Medicare directly to switch.

Key Takeaways

  • Open Enrollment runs October 15 through December 7 each year, and any changes you make take effect January 1.
  • You can switch plans only during Open Enrollment unless you have a may have access to life event such as moving or losing employer coverage.
  • Contact the new plan directly — by phone, online, or in person — to request a switch; the plan files the change with Medicare for you.
  • Review your current plan's coverage and costs against other options before switching, because you cannot change plans again until the next Open Enrollment period.
  • If you miss the important date, you are locked into your current plan for the full year unless a may have access to event occurs.

The three types of switches and what each requires

Switching from Original Medicare to Medicare Advantage means moving from the federal program (Part A and Part B) to a private insurance plan. You keep your Medicare coverage but get it through a private company instead. You will need to drop any Medigap policy you have, because Medigap and Medicare Advantage cannot be held at the same time. If you have a prescription drug plan (Part D), it ends when your Medicare Advantage coverage begins, since Medicare Advantage plans include drug coverage.

Switching between Medicare Advantage plans is the most common type of switch. You might do this because your current plan's costs are rising, your doctor is no longer in the network, or you want different coverage. You can switch to a different Medicare Advantage plan or back to Original Medicare. If you switch back to Original Medicare, you can then enroll in a standalone Part D plan and a Medigap policy if you want them.

Switching from Medicare Advantage to Original Medicare requires you to act during Open Enrollment. Once you are back on Original Medicare, you have a one-time right to enroll in a Medigap policy without medical underwriting — meaning the insurance company cannot deny you or charge you more based on your health. This right lasts 63 days from the date your Medicare Advantage coverage ends. After that window closes, you may face higher premiums or denial if you explore for Medigap later.

Step-by-step: how to request a plan change

Step 1: Gather your information. Have your Medicare number ready (it is on your Medicare card), your current plan name and member ID, and a list of the doctors and medications you want to keep covered. If you are switching to a specific plan, have that plan's name and contact information.

Step 2: Contact the new plan directly. Call the plan's customer service number, visit their website, or visit a local enrollment event. You do not call Medicare. The plan will ask for your Medicare number, date of birth, and address. They will confirm your may be able to access and walk you through the switch. Many plans also work with brokers or agents who can help at no cost to you.

Step 3: Confirm the effective date. Ask the representative when your new coverage begins and when your old coverage ends. Write down the date and any confirmation number they give you. Request written confirmation by mail or email.

Step 4: Notify your current plan (optional but recommended). You do not have to, but calling your current plan to tell them you are switching can prevent billing confusion. They will receive notice from Medicare automatically, but a quick call can speed up the process.

Step 5: Update your doctors and pharmacy. Once your new plan is active, contact your doctor's office and pharmacy to confirm they accept your new coverage. Bring your new insurance card to your next appointment.

What to check before you switch

Before you submit a switch request, compare your current plan against the one you are considering. Check whether your regular doctors, specialists, and hospital are in the new plan's network. Call the plan or use their online directory to verify. If your doctor is not in the network, ask whether they accept out-of-network patients and what you would pay out of pocket.

Review the prescription drugs you take and confirm they are covered by the new plan at the same cost tier. A drug that costs $10 a month on your current plan might cost $50 on another plan, even if both are Medicare plans. Use the plan's formulary (drug list) or call their pharmacy line to check.

Compare the total yearly cost: premiums, deductibles, copays, and coinsurance. A plan with a lower premium might have higher copays that cost you more overall. Medicare provides a comparison tool at Medicare.gov, and many plans offer side-by-side comparisons on their websites.

Check whether the plan covers services you use regularly — such as dental, vision, hearing aids, or physical therapy. Original Medicare does not cover these, but some Medicare Advantage plans do. If you switch from a plan that covers these services to one that does not, you lose that coverage.

Missing the important date: what happens and your options

If Open Enrollment ends on December 7 and you have not switched, you are locked into your current plan for the full calendar year. You cannot switch again until the next Open Enrollment period in October, unless a may have access to life event occurs.

may have access to events include losing employer coverage, moving to a new state or service area, becoming newly may be able to access for Medicaid or Extra Help, getting married or divorced, having a baby or adopting a child, or experiencing a death in your household. You have 60 days from the event to request a change. Contact your current plan or Medicare at 1-800-MEDICARE to report the event and request a Special Enrollment Period.

If you missed the important date and do not have a may have access to event, you have limited options. Some people choose to wait until the next Open Enrollment period. Others contact a broker or agent to discuss whether any exceptions might explore to their situation, though exceptions are rare.

Switching from employer coverage to Medicare

If you are retiring and losing employer health insurance, you have a 60-day window to enroll in a Medicare plan without penalty. This counts as a may have access to event. Contact your employer's benefits office to confirm your coverage end date, then contact Medicare or a plan directly to enroll.

If you delay enrolling in Medicare after employer coverage ends, you may face a permanent penalty on your premiums. The penalty is 1% of the national average Part B premium for each month you were not enrolled, and it stays on your account for life. The same penalty applies to Part D (prescription drug coverage).

If your employer has 20 or more employees, you may be able to stay on the employer plan past age 65 without enrolling in Medicare. Check with your benefits office about whether this option is available and what it means for your Medicare enrollment important date.

Frequently Asked Questions

Can I switch plans more than once during Open Enrollment?

Yes. You can make multiple changes during the Open Enrollment period as long as each change is submitted before December 7. However, only your final request will take effect on January 1. If you submit a request to switch to Plan A and then change your mind and request Plan B, Plan B is what you will have on January 1.

What happens to my current plan's benefits on January 1?

Your old plan's coverage ends on December 31, and your new plan's coverage begins on January 1. There is no gap in coverage if you switch during Open Enrollment. You will receive a new insurance card from your new plan before January 1.

Do I lose my Medigap coverage if I switch to Medicare Advantage?

Yes. Medigap and Medicare Advantage cannot be held at the same time. When your Medicare Advantage coverage begins, your Medigap policy automatically ends. If you later switch back to Original Medicare, you have 63 days to enroll in a new Medigap policy without medical underwriting.

What if my doctor leaves my new plan's network after I switch?

If your doctor leaves the network after your coverage begins, you may be able to request a mid-year plan change, though this is not may provide. Contact your plan when ready to ask about your options. You can also wait until the next Open Enrollment period to switch to a different plan.

Can I switch plans if I am on Medicare Advantage and unhappy with my coverage?

Yes, during Open Enrollment you can switch to a different Medicare Advantage plan, back to Original Medicare, or to a Medigap policy. You cannot switch mid-year unless you have a may have access to life event. If you are unhappy with a coverage decision your plan made, you can file an appeal with the plan instead of switching.