Medicare Advantage Open Enrollment Period: Round 2

You may be familiar with Medicare’s open enrollment period (OEP) which occurs each fall. From October 15 until December 7 of each year, Medicare beneficiaries can enroll in a Medicare Advantage or Part D plan of their choice. This includes enrolling in a plan for the first time or changing to a new plan.

But did you know there is a second OEP specific to Medicare Advantage plans?

This is something new for 2019 and future years. It replaces the Medicare Advantage disenrollment period that was in place in previous years. Now, from January 1 until March 31, anyone who is enrolled in a Medicare Advantage plan can make a one-time change to their coverage. Permissible changes include, but are not limited to the following:

Changing from a Medicare Advantage plan without Part D coverage to a Medicare Advantage plan that includes Part D coverage (or vice versa)

• Changing from a Medicare Advantage plan with an HMO network to a Medicare Advantage plan with a PPO network (or vice versa)
• Changing to another Medicare Advantage plan offered by the same insurance company
• Changing to another Medicare Advantage plan offered by a different insurance company
• Canceling the Medicare Advantage plan and returning to Original Medicare; a stand-alone Part D plan can also be obtained in this scenario

Changes will generally be effective on the 1st of the month after the request is made. For example, if an application to change Medicare Advantage plans was submitted on January 20, the change will be effective on February 1.

It should also be noted that this OEP does not apply to individuals who are currently enrolled in a stand-alone Part D plan. No changes are permitted to stand-alone Part D plans until the fall open enrollment period, unless there is a qualifying event which makes a person eligible for a midyear special enrollment period.

The special enrollment period is for people who qualify to enroll due to a special circumstance or situation, such as: 

• Moving into or out of a plan service area
• Gaining or losing eligibility for Medicaid financial assistance
• Qualifying for extra help for prescription drug coverage
• Losing employer-sponsored insurance coverage
• Terminating current plan
• Turning 65 while already on Medicare disability