Making changes to your Medicare coverage

Even after you’ve signed up for Medicare, it’s crucial to regularly evaluate your coverage to ensure it continues to address your health care needs. Each year, you’ll have the opportunity to make certain changes to your Medicare plan during a seven-week open enrollment window known as the Annual Enrollment Period.

Your local State Health Insurance Assistance Program or a Medicare broker can help you understand the ins and outs of your current coverage and potential adjustments you want to make. And we can be a helpful resource as you evaluate your options and financial considerations.

In this article:

• When can I make changes to my Medicare coverage?
• How often should I review my Medicare benefits?
• What changes can I make during open enrollment?
• How may travel impact my coverage?
• Will moving affect my Medicare coverage?
• Questions to discuss with us

When can I make changes to my Medicare coverage?

Medicare’s Annual Enrollment Period (AEP) is the window when you can make changes to your Medicare coverage. It runs each year from Oct. 15 to Dec. 7, with any changes you make taking effect on Jan. 1 of the next year.

If you experience a qualifying life event — such as moving — then you may be eligible to make changes to your Medicare plan during the Special Enrollment Period, which is a two-month window.

How often should I review my Medicare benefits?

Given health and financial implications, all retirees should actively evaluate their Medicare selections on an annual basis. A lot can change in a year — a new health condition or diagnosis may warrant a change in coverage. Further, Medicare benefits are continuously changing due to the industry landscape, regulatory environment and other external pressures.

What changes can I make during open enrollment?

Open enrollment is the annual timeframe when you can make changes to your Medicare coverage. You can make several changes to your plan during the open enrollment window:

• If you have a prescription drug plan (Part D), you can choose a different Part D plan.
• If you don’t have a prescription drug plan, you can sign up for one.
• If you have Original Medicare, you can move to a Medicare Advantage plan.
• If you have a Medicare Advantage plan, you can switch to a different Medicare Advantage plan.
• If you have a Medicare Advantage plan, you can switch back to Original Medicare.

However, there are some important caveats to consider if you are thinking about changing your Medicare coverage:

• If you’re signing up for a prescription drug plan for the first time during an Annual Enrollment Period, you may be subject to a late-enrollment penalty, which will be added to your Part D premium as long as you have Part D coverage. You can avoid the penalty if you had “creditable” prescription drug coverage (such as from an employer or union) before you enrolled in Part D or if you get support from the Medicare Extra Help program.
• If you’ve had a Medicare Advantage plan for longer than 12 months and want to switch back to Original Medicare, getting a Medigap policy may be difficult. Once you’re past your Initial Enrollment Period (or Special Enrollment Period, if you qualify), Medigap insurers are not required to sell you a policy if you don’t meet their underwriting requirements. Before making the switch, contact Medigap insurers directly to see if you will be able to purchase a policy.

Learn more: Medicare basics: What is Medicare and how does it work?

How may travel impact my coverage?

If you have Original Medicare, you have coverage anywhere in the U.S. or its territories. And though Original Medicare doesn’t pay for medical services outside the country (except in some very specific circumstances), some Medigap policies do provide travel coverage.

Medicare Advantage plans also cover emergency and urgent care throughout the U.S., and some plans offer emergency care during foreign travel. However, regular medical coverage is typically limited to local providers and hospitals, which may create limitations and challenges for those that have vacation homes in different states or those that travel a lot.

If you plan to make foreign travel a big part of your retirement, however, you may want to talk to your local State Health Insurance Assistant Program or a Medicare broker about your coverage options.

Learn more: How to plan travel in retirement: How much to budget?

Will moving affect my Medicare coverage?

The good news: Moving your residence is considered a “qualifying life event” for Medicare, which means you will be eligible for a Special Enrollment Period, a two-month window during which time you can immediately change your Medicare coverage. Whether you need to make any changes will depend on where you move and the type of Medicare coverage you’ve chosen:

We’re here to help you navigate health care in retirement

Throughout retirement, we can help you understand how changing your Medicare coverage may impact your broader financial situation.