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Changing Part D plans


The majority of the time, Fall Open Enrollment is the only time you can update your Medicare Part D prescription medication coverage (October 15 through December 7). On January 1st of the following year, your new coverage will start. During the Fall Open Enrollment period, you are free to make as many changes as you need, and your final decision becomes effective on January 1. It is typically a good idea to make as little modifications as possible to prevent enrollment issues.

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Changing Part D plans

The Medicare Advantage Open Enrollment Period (MA OEP), which runs from January 1 through March 31 each year, allows beneficiaries of Medicare Advantage Plans to make changes to their Part D coverage. You must leave your current Medicare Advantage Plan and enroll in a different Medicare Advantage Plan with prescription drug coverage or Original Medicare with a stand-alone Part D plan if you want to change your medication coverage during this time. The first of the month following the month you enroll will see the implementation of any changes made during the MA OEP. You shouldn’t alter your prescription coverage through the MA OEP if you want to preserve your Medicare Advantage Plan.

You can be qualified to modify your Part D coverage during a Special Enrollment Period (SEP) in specific situations. Depending on which of the following situations applies to you:

  • You are not at responsible for losing respectable coverage.
  • You alter your employer-provided drug coverage.
  • You leave the coverage region of your Part D plan.
  • If you joined the MA Plan when you initially became eligible for Medicare due to age and want to de-enroll during the first year, you do so and sign up for Original Medicare.
  • You want to sign up for a five-star plan that is offered in your service area.
  • Extra Help is yours or yours lost.
  • You’ve been accepted to or live at an acceptable institution.
  • You don’t get enough information to determine whether your current prescription drug coverage is legitimate.
  • Your Part D plan terminates coverage, fails to pay benefits on time, or misrepresented the benefits you would receive.
  • Because of a mistake made by a federal employee, you enroll in a Part D plan or fail to enroll in one.
  • You sign up for the PACE (Program of All-Inclusive Care for the Elderly) program.
  • You are given special needs plan eligibility (SNP).

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Note: A Part D plan may modify its formulary after the first 60 days of the year. Unless there are safety concerns or a generic version of your drug is available, your plan should continue to cover any of your medications that are dropped from the formulary midway through the year. If your plan quits covering a medication you require, you will not be eligible for a SEP.

Typically, you should use 1-800-MEDICARE to enroll in your new plan without terminating your current one. When your new coverage starts, you should be automatically enrolled in it and disenrolled from your old one. Try to sign up at the start of an enrollment term to prevent coverage gaps.

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