The doctor I want to use isn’t covered in my Medicare Advantage Plan. When can I switch to a different plan?

There are times that the doctor you want to use may not be covered in your Medicare Advantage plan. There are few different options should you find yourself in this situation.

  1. If you are not committed to your doctor, you can find another one that is in network that provides the same services. You can always find the provider directory on the carrier website or, give your agent a call! They can assist you in selecting a different doctor.
  2. You can try working with your agent to see if the plan can reach out to the doctor in question and negotiate them joining their network. While this does not always work, it is a good option to request if you love your current plan but are determined to see a specific doctor.
  3. If you do not wish to change your doctor, you may have the opportunity to switch to a different Medicare Advantage . This can be done either during the Annual Enrollment Period (AEP) or during a Special Election Period (SEP) if you are eligible. When you enroll during the AEP, your new coverage will begin on the January 1st. If you enroll during an SEP, your effective date will typically be the 1st of the following month.

Once the coverage of your new plan begins, you will be automatically disenrolled from your old plan.

What is the right thing to do before joining another Medicare Advantage Plan?

Before switching from one Medicare Advantage Plan to another, make sure you understand the differences between your current plan and the one you are looking at as your new option. Understand that different plans may have different premiums, co-pays, provider directories, etc. and that there is not a one-size-fits-all plan for every individual.

Can I change from a Medicare Advantage plan to Original Medicare? If Yes, When?

Yes. It is possible for you to leave your Medicare Advantage plan and go back to Original Medicare. Unless you have a Special Election Period (SEP), you can disenroll from your Medicare Advantage plan during one of the following times:

  • During the Annual Enrollment Period (Oct. 15 – Dec. 7)
  • During the Medicare Advantage Disenrollment Period (Jan. 1 – Feb. 14)

Any change you make during this period will become effective on the first day of the following month.