Switching a Medicare Advantage Plan, Outside of Open Enrollment

I would like to leave or switch my Medicare Advantage Plan (Part C).  I receive this question all the time from Medicare beneficiaries outside of Medicare’s Open Enrollment (Oct 15th to Dec 7th).  These plans have yearly contracts with Medicare so in most cases you will need to keep the plan for the remainder of the year.  Here is a list of a few reasons you may be able to receive a special circumstances to switch or leave a plan.

  • You have the Extra Help program from Social Security
  • You receive Medicaid benefits from the state you reside in
  • You have recently lost state Medicaid benefits or federal Extra Help
  • You are on a State Pharmaceutical Assistance Program
  • You have moved to a new area were my current plan doesn’t service
  • You have moved to a new area that my current plan does service but there are new plans available
  • You moved back into the U.S. after living outside the country
  • You are moving into, current residing, or moved out of a long-term institution(like a skilled nursing facility or long-term care hospital)
  • You were released from jail
  • Medicare has terminated or “sanctioned” your current plan’s contract
  • I dropped a Medigap policy and signed up for a Medicare Advantage plan for the first time
  • I’m currently in my first year of Medicare and selected a Medicare Advantage plan
  • You have been diagnosed with a chronic condition and there is a Special Needs Plan that you qualify for in your area

Understand that most of these circumstances have an opening and a closing window of when you are eligible to initiate a switch. Please feel free to contact our licensed agents if you would like additional information regarding these special enrollment options.

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