For Connecticut Medicare recipients both under and over 65 blog home | site home
image

Call Us(203) 374-3645

PO Box 55135Bridgeport CT 06610

9.00 am to 9:00 pm7 days most weeks

Did you know there are (at least) two times of year when you can switch Medicare insurance plans?

You probably know about the Annual Election Period (Open Enrollment) that starts in October. You might not know about the other time (or times) when you can switch plans.

Why is This Important?

You can change plans if your health or other circumstances change. You should know when you can so you can take full advantage.

When you can change plans (not all will apply to you):

  • Annual Election Period
  • Medicare Advantage Disenrollment Period
  • When You’re New to Medicare (Turning 65)
  • When You’re New to Medicare (Due to Disability)
  • If You Get Coverage from Work After 65
  • If You Move to Another State (or county)
  • You have a Medicare Supplement
  • You Move to the United States
  • Your Insurance Company Does Something Wrong
  • You Lose Drug Coverage and It’s Not Your Fault
  • You Lose Eligibility for an Income-Based Program
  • A Five Star Plan is Available to You (There are 2 in Connecticut)
  • You Live In, Or Recently Moved Out of, an Institution (Such as a Nursing Home)
  • You Are Released from a Correctional Facility
  • You Dropped a Medicare Supplement Plan to Enroll in A Medicare Advantage Plan
  • You Were Misled by a Federal Employee
  • You have a Medicare Supplement

Annual Election Period

(October 15th through December 7th each year.)

During the AEP you can move in any direction.

You can move sideways. You can switch from one Medicare Advantage (or Medigap) Plan to another. You can switch from one Medicare Advantage Plan to another.

You can move up or down. You can “trade in” your Medicare Advantage plan for a Medicare Supplement Plan. Or vice versa.
 

Medicare Advantage Disenrollment Period

(January 1st through February 14th)

You can only move in one direction. You can drop your Medicare Advantage Plan. And, if you choose, apply for a Medicare Supplement Plan.
 

When You’re New to Medicare (Turning 65)

If your birthday is NOT the first of the month: You can apply for coverage during the three months before the month of your 65th birthday (recommended). You can apply during the month of your birthday or the three months after. (But you may have a lapse in coverage.)

If your birthday is the first of the month: Your seven-month window starts and ends one month earlier. (See above paragraph)

Important: You’ll need to get Medicare Part A and B first. You must have your Medicare card before you apply for your Medicare Advantage or Medicare Supplement Plan. It can take two weeks (sometimes a month) to get your card. So, start the process as early as you can.
 

When You’re New to Medicare (Due to Disability)

If you receive income from Social Security for full disability, you should qualify after receiving benefits for 24 months.

Important: You’ll need to get Medicare Part A and B first. You must have your Medicare card before you apply for your Medicare Advantage or Medicare Supplement Plan. If you receive Social Security benefits before you are eligible for Medicare, you’ll probably get your card in the mail without asking for it…

But… you may want to call Social Security after you’ve received benefits for 22 months if you don’t have your Medicare card yet.
 

If You Get Health Coverage from Work After 65

So long as your group coverage is “creditable” (meets the government’s minimums) you can change from your group coverage at any time. (Most people wait until just before they retire. But you may want to switch earlier if your group plan is too expensive.)

You can apply up to 8 months after you lose your employer-sponsored coverage.

(Not recommended. You could have a hospital stay during the time you don’t have full coverage. You may be limited to more expensive plans until the next Annual Election Period. If you miss your opportunity to enroll in Part B, you could pay a penalty and must wait even longer to get full coverage.)

Important: You’ll need to get Medicare Part A and B first. You must have your card before you apply for your Medicare Advantage or Medicare Supplement Plan. It can take two weeks (sometimes a month) to get your card. So, start the process as soon as you can.
 

If You Qualify for the Medicare Savings Program or “Extra Help”

You can switch plans at any time. You can switch from any type of Plan to any other type of plan.

Income limit for these program: {{ snippets.MSP_ALMB_limit_single }} if single {{ snippets.MSP_ALMB_limit_married }} if married.
 

If You Move

This always applies if you move to another state or back to the US from another country. It can apply if you move to another county in Connecticut. (Or another town in another state that town has different plans available.)

You can change plans if your current plan isn’t offered in your new location. You can change plans if new plans are available to you in your new location.

You can apply for coverage a month before your move (recommended). You have two months after your move to change plans without penalty.

If you move to another state, you may not be eligible to enroll in a Medicare Supplement Plan without answering health questions.
 

If You have a Medigap

You can switch to another Medigap (Medicare Supplement) at any time.  You can only switch to a Medicare Advantage Plan during the Annual Election Period or if you meet one of the other exceptions.

Warnings & Limitations

Pre-existing Conditions

So long as you are a Connecticut resident, you can switch to a Medicare Supplement Plan without any health questions asked. If you’ve maintained continuous coverage there will be no limits on your policy.

If you have had a recent lapse in coverage, your policy won’t cover any pre-existing conditions until you’ve had the policy for several months.

Medicare Advantage Plans can deny you if you have End Stage Renal Disease. This is kidney disease requiring a transplant or dialysis. (This is the only condition that they can ask about.)

IF You Leave Connecticut

You may want to switch to a Medicare Supplement Plan before you move. (You’ll have to do this during the Annual Election Period or Medicare Disenrollment Period unless you qualify for one of the other exceptions listed above.)

Most states will allow you to keep your Connecticut Medicare Supplement Plan.  (Although your price will be adjusted based on your zip code.) None will allow you to keep your Medicare Advantage plan.

You may not be able to “upgrade” your plan after you move. Most states have more restrictive rules.

You Have a Supplement

You can switch from one Medicare Supplement (Medigap) to another Medicare Supplement at any time. (This one isn’t an exception. The Annual Election Period rules never applied to Medigap Plans.)

You can only switch to or from a Medicare Advantage Plan during the Annual Election Period or if you meet one of the other exceptions. The same is true for Prescription Drug Plans.

You Move to the United States

If you are a lawful resident or become one, you may be eligible for Medicare and for a Medigap (Medicare Supplement) or Medicare Advantage Plan.
 

Your Insurance Company Does Something Wrong

If your insurance company does one of these things, you could be eligible to change plans during any month of the year.

  • Lie to you. (You enroll based on misleading information from the company or an agent representing the company.)
    Call 1-800-MEDICARE if you think you’ve been misled. (Your policy change can be made retroactive in many situations.)
  • Is sanctioned by Medicare for an issue that affects you
  • Go out of business
  • Stop offering your policy
  • Told you your drug coverage is “creditable” (meets Medicare’s minimum standards) but it isn’t
  • Failed to tell you would lose “creditable” drug coverage.

You have 2 months to apply for another policy. This 2-month clock starts ticking when you are notified of the change by the insurer or by Medicare.
 

You Lose Drug Coverage and It’s The Insurance Company’s Fault

If you involuntarily lose “creditable” drug coverage, you have two months to change plans. Your two-month window starts when you lose coverage. (Or when you find out you have lost coverage if you don’t know ahead of time.)
 

You Lose Eligibility for an Income-Based Program

This won’t apply to every program. However, if you go back to work, or start taking your social security benefits you may no longer be eligible for certain programs. If you lose Medicare Savings Program (MSP) or “Extra Help” status you’ll have 60 days to change plans.

(Some plans are only available to individuals who have MSP status. You may be forced to switch plans.)

A Five Star Plan is Available to You (There are 2 in Connecticut)

5 Stars means what it sounds like. It is the highest rating a plan can get. Few plans achieve this. They must get top marks in all applicable “domains” listed below.

The “Domains” for Prescription Drug Plans

  • Customer Service
  • Member Complaints and Changes
  • Member Experience
  • Drug Safety and Accuracy of Drug Pricing

The “Domains” for Medicare Advantage Plans

  • Screening Tests and Vaccines
  • Managing Chronic Conditions
  • Member Experience
  • Member Complaints and Changes
  • Customer Service

You can switch to a 5-star Medicare Advantage or Prescription Drug Plan program at any point in the year. You can only take advantage of this “exception” once per year.

There are no 5-star Medicare Advantage Programs in Connecticut in 2018. However, there are 5-star Prescription Drug Plans in Connecticut.

You Live In, Or Recently Moved Out of, an Institution (Such as a Nursing Home)

Are you expected to stay in a facility for 90 days or more? You may qualify to change plans. Plans designed for “institutionalized” persons may be available to you.

Facilities include:

  • Nursing homes (skilled, intermediate or custodial)
  • Rehabilitation hospital
  • Hospital

You can change plans while you are in the institution and up to two months after you leave.

Mildly fun fact: This reminds me of the Andy Griffith show. (One of my favorites when I was a kid.) This exception is called the Open Enrollment Period for Institutionalized Individuals (OEPI). You remember Opie, right?
 

You Are Released from a Correctional Facility

You have 2 months to apply for coverage.
 

You Dropped a Medigap Plan to Enroll in A Medicare Advantage Plan

You can only take advantage of this once in your lifetime. It applies the first time you move from a Medicare Supplement Plan to a Medicare Advantage Plan. You have 12 months to switch back.
 

You Were Misled by a Federal Employee

If you…

  • joined a plan
  • chose not to join a plan

…due to an error of a federal employee… you have 2 months to make changes. Your 2-month window opens when you get the notice of error from Medicare.
 

This One Doesn’t Apply in Connecticut Currently

If you have a severe or disabling condition, there may be special plans available to you.

About Post Author

image
Alston J. Balkcom

“ Connecticut-licensed insurance agent since 1985.”

Have a Medigap (Medicare Supplement) or Medicare Advantage Plan and want to switch plans? You may not have to wait until the Annual Election Period (Open Enrollment Period) to switch plans.