Opportunities to Change Medicare Plans after January 1st

Although most people on Medicare can only change their health and drug plans during the Annual Open Enrollment Period (October 15th through December 7th), there are some enrollment opportunities that people can use to make changes to their Medicare coverage next year if needed. 

Medicare Advantage Open Enrollment Period

One option for making an enrollment change after January 1st is the Medicare Advantage Open Enrollment period, which runs from January 1st through March 31st.  This enrollment period allows people who are enrolled in a Medicare Advantage plan on January 1st to switch to another Medicare Advantage plan (with or without drug coverage) or disenroll from their Medicare Advantage plan and return to Original Medicare.  Anyone choosing to return to Original Medicare during this period will be able to join a stand-alone prescription drug plan for Part D coverage.  Only one change may be made during this period.  Any change made during this period will become effective the first day of the next month.

Special Enrollment Period for Dual Eligibles and people with Extra Help

Dual eligibles (those eligible for both Medicare and Medicaid) and other individuals who are eligible for Extra Help with their Part D costs have a special enrollment period to change their Medicare health or drug plan once a quarter during each of the first three quarters in a calendar year. Changes made during this period will start the first of the next month. 

Other Special Enrollment Periods (SEPs)

There are several other SEPs that exist for various circumstances that people can use to make coverage changes during the year.  Common ones include when people move, when people lose Medicaid coverage, or when people lose other prescription coverage and need to enroll in Part D. 

A special enrollment period may be available for those who received inaccurate or misleading information while using the Medicare Plan Finder to choose their 2023 Medicare coverage or if they were given misleading information by someone like an agent or broker and ended up enrolled in a plan that does not meet their needs.  To use this SEP, the Medicare beneficiary should call 1-800-MEDICARE to explain their circumstances and request to change plans using this Special Enrollment Period.  For more information about Medicare enrollment periods and other SEPs that may be available, see Medicare’s publication on this topic here

We encourage readers who have questions about using these enrollment periods to make changes to their coverage or who have questions about getting a transition refill to call PA MEDI at 1-800-783-7067.