What’s the best time of year to change my Medicare plan if I develop a new diagnosis?
Answered by 18 licensed agents
Those changes depend. The only time to make changes for the upcoming year is during AEP, from October 15 through December 7. There may be other opportunities to change. I recommend meeting with a licensed Medicare agent to review your options.
If you have an MAPD plan generally you can change your plan during AEP. If your new condition is a chronic condition, heart/ diabetes, you may be able to change your MAPD plan to a C-SNP Plan related your new chronic condition. You are allowed to make the change to a C-SNP outside of AEP. / If you have a Medicare Supplement, it may effect your ability to change plans since it must go through underwriting. It doesn’t hurt to check with underwriting to see if you can lower your premiums.
That's a great question. In reality, waiting until after a diagnosis can often be too late.
Most people who are thinking of switching, almost always want to switch to a Medicare Supplement plan once they have been diagnosed with something. Unfortunately, in most states, you have a limited "guaranteed issue" window and once that passes, you'll have to answer health underwriting questions.
Depending on your diagnosis, you might be uninsurable at that point, making it difficult or even impossible to switch.
That's why it's so important to consider all of your options, and to think beyond just asking "what's the premium" to considering "how do I want my healthcare to work down the road if I get sick?" A good Medicare Advisor will help you answer those questions so that you have coverage that will meet the test of time.
If you are diagnosed by a doctor with a chronic illness such as diabetes, heart failure, cardiovascular disease, COPD, end stage renal disease and among others listed by insurance carriers, you can change immediately.
If you live in a "Birthday Rule" state, you can change on your birthday without having to answer any medical questions. You have open enrollment. If you don't live in a "Birthday Rule" state, you would have to answer the medical questions for a new Medicare Supplement or enroll in a Medicare Advantage plan during AEP (Annual Enrollment Period) or have an SEP (Special Enrollment Period).
Medicare recipients have certain times of the year they can change their Medicare Advantage plan. Annual Enrollment is from October 15th through December 7th with an effective date of January 1st. Then Open Enrollment is only for Medicare Advantage plan holders. They can change their plan one time January 1st through March 31st with the first of the following month the effective date after the application date. Their can be Special Enrollment times throughout the year such as weather related or you move out of the service area of your plan when you can change.
Medicare Supplement holders have a 6 month window starting the first month you enroll in Medicare part B that you can changes plans with no health questions asked. After this time you can change all year long. However, the new plan will normally have a medical application you must pass to change to the new plan.
What's the best time of year to change my Medicare plan if I develop a new diagnosis? You can only change your Medicare plan like a Medicare Advantage MA or Prescription Drug Plan PDP unless you have a enrollment period like AEP or Special Enrollment Period. If have Medigap plan
you can change anytime but if you have underwriting you wait six months before they pay out of cost that you are responsible for.
The only time you can change your Medicare Advantage plan is during The Annual Election Period unless you develop a condition that qualifies you for a Chronic Care Plan if available in your area, are Institutionalized and an Institution Plan is available in your are &/or you become qualified for a level of Medicaid.
The easy answer is AEP Annual Enrollment Period, but depending on whether you are already enrolled in, let's say, a Medicare Advantage plan and you develop a Chronic qualifying condition, you would be eligible for Enrollment immediately into a CSNP Chronic Special Needs Plan. if deemed necessary. SNP special needs plans are often eligible as needed, and you can be enrolled in them if deemed necessary at any time of the year. This is true of the ISNP Institutional Special Needs Plan as well. Let's say a stroke has forced you into a nursing home or other type of healthcare facility, like a physical rehab... etc.
The time which you can make changes to your Medicare Advantage and Part D plans are October 15th to December 7th each year, for a January 1st effective date.
If you are diagnosed anytime during the year, you would have to wait until the Annual Enrollment Period to make those changes.
With a new diagnosis, the best time of year to change a medicare plan is either right away (if it's a Qualifying Life Event, such as cancer) or during Open Enrollment Period (between January 1 - March 31) if you are already in a Medicare Advantage plan and would like to change Medicare Advantage plans. If you are in a Medigap plan and are within the first 6 months of having it when you get a diagnosis, you can change Medigap plans during that time without having to go through underwriting. Beyond that time, however, you will likely have to go through underwriting and your preexisting condition won't allow you to qualify.
Medicare Advantage plans can be changed during Annual Enrollment period (AEP) from October 15th - December 7th and also during Open Enrollment Period (OEP) from January 1st - March 31st.
Medicare Supplemental plans can be changed at any time of the year, but you will undergo the underwriting process.
Prescription Drug Plans (PDP) can only be changed during (AEP), unless you qualify for a special election period.
If you are diagnosed with a chronic condition you have a one time Special Enrollment Period, SEP throughout the year to join a Chronic plan if one is available in your area. In my experience Chronic plans can be more costly to use than a lot of core plans that are already available.
That’s a great question. You can actually change your plan depending on your current plan and current diagnosis . If it’s a difference in your plan it would give you a sep for the following month. Remember it depends on your individual plan and individual situation.
Well if it’s after an enrollment period you won’t be able to switch. So the best time is either this Annual Enrollment Period or during Open Enrollment from Jan 1 - March 31st.
