When Can I Join a Health or Drug Plan?

With new health care laws taking effect, many people have questions about their coverage. There are several concerns about Medicare and when people can join drug or health plans associated with it. When people decide how they are going to obtain their Medicare coverage, they may select a Medicare prescription drug coverage plan, which is also called Part D coverage. They may also select a Medicare Advantage plan, which is known as Part C.

There are certain times that people are able to enroll in each of these plans or make changes to existing plans. There is no need to sign up for Medicare year after year, but people who are enrolled in these plans will have options to change plans or review their plans annually.

When a person first enrolls in Medicare for Part C or Part D coverage, there are several important things he or she must remember. These include the following:

  • A person who has just turned 65 is eligible for Medicare.
  • People who are under the age of 65 but are disabled are eligible for Medicare.
  • A person who has already turned 65 and is disabled is eligible for Medicare.
  • People who do not have Part A coverage but are enrolled in Part B coverage during the open enrollment period can enroll in a prescription drug plan from Medicare.

A person who has Part A coverage but enrolls in Part B during the open enrollment for Part B can enroll in a Medicare Advantage plan. It is important to know when the open enrollment periods are for each of these plans. Remember that there are two separate enrollment periods each year. During the open enrollment period for Medicare Advantage plans and prescription coverage, people may take the following steps:

  • Change from Advantage to original Medicare.
  • Change from original Medicare to Advantage.
  • Switch from Advantage without prescription coverage to Advantage with prescriptions.
  • Switch from one Advantage plan to another.
  • Join Medicare prescription drug plans.
  • Switch from an Advantage plan offering prescriptions to one that does not offer them. – Drop Medicare prescription coverage completely.
  • Switch from one Medicare prescription plan to another.

There is also a disenrollment period. During this time, it is possible for people in Advantage plans to leave their plans to switch to original coverage. For those who switch to original Medicare, there will be a time to join a prescription drug plan also. Coverage begins the first day of the month following plan enrollment.

There are also several things a person cannot do during disenrollment. A person may not switch from original Medicare to an Advantage plan, and it is not possible to switch from one prescription plan to another. It is also not possible to switch from one Advantage plan to another or to switch, drop or join a Medicare Medical Savings Account plan.

To learn more about current enrollment periods, disenrollment or plan provisions, discuss concerns with an agent.