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Can I change Medicare Part D prescription drug plans at any time?

En español | No, you can’t switch Medicare Part D plans any time you might need to, but you do you have options if you want to choose a different plan.

You can get prescription drug coverage either by enrolling in a stand-alone Medicare Part D plan or from a Medicare Advantage plan that combines medical and drug coverage. Private insurance companies that Medicare regulates offer both types of plans.

Every year, you have the chance to change Part D plans — or your Medicare Advantage plan if you’re among the more than 2 in 5 Medicare beneficiaries in those plans — during Medicare’s annual open enrollment period, and soon after you have an additional opportunity to quit a Medicare Advantage plan to return to original Medicare and a Part D plan. Plus, you may qualify for more chances to change plans outside those windows.

Changing Part D plans during open enrollment

Oct. 15 to Dec. 7, open enrollment. You can sign up for a Medicare Part D plan or switch from one Part D plan to another during each year’s open enrollment period.

You also can sign up for a Medicare Advantage plan or switch to a different Medicare Advantage plan — with or without drug coverage — during that time. Coverage in your new plan begins Jan. 1.

Even if you’ve been happy with your Part D plan, comparing your options during open enrollment every year is a good idea. Medicare prescription drug plans can change coverage and costs from year to year. Type your zip code, drugs and dosages into the Medicare Plan Finder to find the total cost for every plan available in your area, including premiums and copayments for your specific medications.

Jan. 1 to March 31, Medicare Advantage open enrollment. If you have prescription drug coverage through a Medicare Advantage plan, you have an extra opportunity to switch to another Medicare Advantage plan or change from Medicare Advantage to original Medicare and join a Part D plan during Medicare Advantage open enrollment each year. You can make one change during that period.

Be aware: If you decide to leave a Medicare Advantage plan for original Medicare, you may not have a guaranteed right to buy a Medigap policy to help cover original Medicare’s out-of-pocket costs if more than six months have passed since you signed up for Medicare Part B. Check with your State Health Insurance Assistance Program (SHIP) to find out whether an insurer could reject you or charge you more for preexisting conditions.

When you switch plans during Medicare Advantage open enrollment, coverage begins the first day of the month after the plan receives your request. This period applies only to people who already have an Advantage plan, not to people in original Medicare with stand-alone Part D coverage. 

Changing Part D plans outside of open enrollment

You may qualify for a special enrollment period to change your Part D plan in certain situations at other times during the year:

If you receive financial assistance from the Part D Extra Help program, you can change Part D plans as often as once each calendar quarter during the first three quarters of the year. Extra Help helps people with low incomes and assets pay Part D premiums and copayments.

If you move into, live in or leave a nursing home or long-term care facility, you generally can join or switch Part D plans. And after you move out, you can take two additional months to decide if you want a different plan.

If you move outside your current drug plan’s service area, you usually have up to two months to switch to a new Part D or Medicare Advantage plan.

If your current Part D plan terminates its contract with Medicare, you have up to two months before and one month after the plan’s Medicare contract ends to go to another plan.

If a five-star Part D or Medicare Advantage plan covers your area, you can switch into that plan once any time of the year, except for the first week in December. You can use this special enrollment period for plans that have earned an overall five-star rating from the Centers for Medicare & Medicaid Services once a year. Coverage begins the first day of the month after the plan receives your enrollment request.

To find out whether a five-star plan is available in your area, visit the Medicare Plan Finder and filter the results for your zip code based on star ratings. Plans with a five-star rating have a special icon below the plan name in the Plan Finder. You can also call 800-MEDICARE (800-633-4227) or your SHIP center to find out if a five-star plan is available.

If a federal employee made a mistake when processing your enrollment or termination of enrollment in a plan, you get a two-month special enrollment period to switch to another plan. But Medicare must approve this claim.

Keep in mind

Unless you have similar prescription coverage from an employer, retiree plan, Tricare or other source, signing up for Medicare prescription drug coverage is important even if you don’t take many medications. Otherwise, you could end up with a lifetime late enrollment penalty when you do sign up.

Start by choosing a low-premium plan if you don’t take any medications. You can switch plans later during open enrollment or a special enrollment period as your needs change.

Updated May 18, 2022

     

        


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