The Medicare Advantage Open Enrollment Period (Jan 1 – Mar 31)

Picked a Medicare Advantage plan in the fall and it's not working out? You may get one more chance.

From January 1 to March 31, people already in a Medicare Advantage plan can make one change. It's called the Medicare Advantage Open Enrollment Period.

It's not a second fall Open Enrollment. It's narrower. Let's go over exactly who can use it and what you can do.

The mental model: one do-over, not a free-for-all

The fall Open Enrollment (October 15 to December 7) is wide open. Almost anyone with Medicare can switch almost anything.

The January-to-March window is a single do-over, only for people in Medicare Advantage. You get one move. Make it count.

The analogy: the restaurant that lets you send back one dish

Picture a restaurant with a nice policy. If you order an entrée and don't like it, you can send it back once and order something else. Or skip the entrée and order from the regular menu instead.

But you can only send back one dish. And if you didn't order an entrée in the first place, the policy doesn't apply.

That's the Medicare Advantage Open Enrollment Period.

Who can use it

You can use it if, on January 1, you're enrolled in a Medicare Advantage plan, with or without drug coverage.

There's also a version for people new to Medicare. If you joined a Medicare Advantage plan when you first got Medicare, you can make one change within your first 3 months of having Medicare.

Who can't use it: - People in Original Medicare who want to join Medicare Advantage. That's a fall Open Enrollment move. - People in Original Medicare who just want to switch Part D drug plans. This window doesn't cover that.

What you can do (pick one)

1. Switch to a different Medicare Advantage plan, with or without drug coverage.
2. Drop your Medicare Advantage plan and go back to Original Medicare. If you do, you can also join a standalone Part D drug plan.

Your new coverage starts the first of the month after the plan gets your request. Switch in February, and it usually starts March 1.

Why folks use it

From what I see each January, it usually comes down to a few things:

• A doctor isn't in the network like they thought.
• A drug costs more than expected, or needs prior authorization.
• The plan just isn't a fit once they start using it.

These are exactly the things worth checking in the fall. But if something slipped past, this window helps.

Going back to Original Medicare? Read this first

If you drop Medicare Advantage for Original Medicare, think about the gap a supplement would normally fill.

Here's the catch. Outside of certain situations, buying a Medicare Supplement later usually means answering health questions. The company can say no.

Exceptions exist. Say you joined Medicare Advantage when you were first eligible at 65. If you switch back within the first year, you have a federal trial right to buy certain supplements. And if you dropped a supplement to try Medicare Advantage for the first time, you have a 12-month window to go back.

If you don't have one of those rights, line up the supplement before you drop your plan. Don't drop first and hope.

My piece on Medicare Supplement vs. Medicare Advantage goes deeper on switching back.

Don't forget drug coverage

If you go back to Original Medicare, pick up a Part D plan at the same time. Original Medicare alone doesn't cover most outpatient prescriptions. And going without creditable drug coverage for 63 days or more can lead to a Part D late penalty.

Our Medicare plan finder can estimate yearly drug costs for plans in your county.

Other windows that might apply

You might have a different, more flexible option if:

• You get Extra Help or have Medicaid. You can change drug coverage once a calendar month.
• You moved. Moving can open its own Special Enrollment Period. See moving and Medicare.
• You lost other coverage. That can open a window too.

Things I'd do (and never do)

1. I'd use the first few weeks of January to test my plan. Call my doctors' offices. Fill my prescriptions.
2. I'd act early in the window so my new coverage starts sooner.
3. I'd line up a supplement before dropping Medicare Advantage, unless I have a trial right.
4. I'd never forget Part D if I go back to Original Medicare.
5. I'd never waste my one change on a guess. Check doctors and drugs on the new plan first.

Not happy with your plan?

Tell us what's not working. We'll check whether another plan fits better and whether you have the rights you need to make the move safely.

Call (417) 633-7200, or visit our Springfield office or Wildwood office.

One do-over. Let's make it a good one.

— Matt

Frequently asked questions

What is the Medicare Advantage Open Enrollment Period?

It runs January 1 to March 31 each year. If you're in a Medicare Advantage plan, you can make one change. Switch to another Medicare Advantage plan, or go back to Original Medicare and join a Part D plan.

Can I switch from Original Medicare to Medicare Advantage from January to March?

No. This window is only for people already in Medicare Advantage. Moving from Original Medicare to Medicare Advantage is generally done in fall Open Enrollment, October 15 to December 7.

How many changes can I make between January 1 and March 31?

One. After that, you generally wait for the next enrollment period. The exception is if you qualify for a Special Enrollment Period.

When does my new plan start if I switch in this window?

The first of the month after the new plan gets your request.

Can I switch Part D plans from January to March if I have Original Medicare?

Not through this window. It's only for people in Medicare Advantage. You may qualify for another window if you get Extra Help or have a qualifying life event.