Healthcare Educators


Second Chances: What If You Don’t Like Your Medicare Plan?

by | Sep 16, 2021

In a recent article, we looked at the Medicare enrollment periods. We saw that most people enroll when they turn 65, but some people might delay enrollment without paying a late enrollment fee if they have eligible insurance from current employment. What we didn’t cover is what comes next. What happens after you enroll?

Hopefully, you like your plan, and there are no issues. If you enroll in a Medicare Advantage plan and decide you don’t like it, however, you may have a second chance.

Changing Your Mind After the Initial Enrollment Period

Let’s say you select a Medicare Advantage plan during your Initial Enrollment Period. The plan looks great on paper, and you think you’ll be happy with it. It goes into effect, and you start using it – but there are problems. Maybe your doctor has dropped out of the network. Maybe you don’t qualify for the extra benefits you found so attractive. Maybe you just don’t like it. For whatever reason, you want out.

Well, the good news is that you can get out. During the first three months in your plan, you can decide to switch to another Medicare Advantage plan. You can also decide to go back to Original Medicare.

Changing Your Mind After the Annual Election Period

Every year, between October 15 and December 7, Medicare beneficiaries can review their coverage and make plan selections for the coming year. The plan you select during this time will go into effect on January 1.

If you select a Medicare Advantage plan and decide you don’t like it, you can switch to another plan during the Medicare Advantage Open Enrollment Period, which occurs between January 1 and March 31 each year. During this time, you can switch to a different Medicare Advantage plan, or you can return to Original Medicare.

Using Your Open Enrollment Periods Wisely

Having a second chance is great, but you still need to be careful. Here are a few warnings to help you make the most of your options.

  • If you’re in Original Medicare, you might be stuck. The Open Enrollment Periods let you change your mind if you’ve selected a Medicare Advantage plan. If you’ve elected to use Original Medicare, you won’t be able to switch plans during the three-month Open Enrollment Period.
  • You might be stuck with your drug plan, too. Original Medicare doesn’t include prescription drug coverage, so enrollees select a separate prescription drug plan. During the three-month open enrollment period, you cannot switch from one separate drug plan to another. If you decide to switch from Medicare Advantage to Original Medicare, you will be able to enroll in a Medicare prescription drug plan.
  • You only get one second chance. During the open enrollment period, you get one more chance to change your enrollment selection. The changes you make will go into effect the first day of the month after your plan receives your request.

You Won’t Be Stuck Forever

There are a few reasons you might not be able to take advantage of the open enrollment period. Maybe you’re in Original Medicare. Maybe you’ve already made one change but still aren’t happy. Maybe you missed the three-month window. This means you might be stuck in your plan, but don’t worry – you won’t be stuck forever.

The Annual Election Period runs from October 15 to December 7 every year. During this time, all Medicare beneficiaries will have a chance to change their plan selections. You may also qualify for Special Enrollment Periods at other times of the year, for example, if you move out of your plan’s area.