My Coverage Is Changing — What Should I Do?
Changes to health coverage can happen for many reasons — your plan may change, employer coverage may end, you may move, or your personal circumstances may change. Before making a decision, first understand what is changing, when it takes effect, and what choices may be available to you.
Understand Your Timing
Start with the effective date of the change. When does your current coverage end or change? Some coverage changes may create an opportunity to make Medicare coverage changes outside the normal annual enrollment periods. The timing and reason for the change can determine which options may be available.
Know What Changes
Identify exactly what is changing. Consider premiums, deductibles, copays, prescription drug coverage, provider access, pharmacy access and other benefits that are important to you. A change in one part of your coverage does not necessarily mean everything has changed.
Choose Your Next Direction
Once you understand what is changing and when, review the choices available for your particular situation. The goal is not to begin with a particular plan or company. Start by understanding your needs, your Medicare rights and the questions you should ask before choosing your next direction.
Things Worth Knowing
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Certain changes in coverage or circumstances may qualify someone for a Special Enrollment Period (SEP), but eligibility and timing depend on the specific situation.
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Moving to a new service area can affect the Medicare plans available where you live.
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Changes involving employer or union coverage may have different Medicare rules from changes involving an individual Medicare plan.
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Provider and hospital participation can change, so provider access should be reviewed when evaluating coverage changes.
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Prescription drug formularies, pharmacy networks and drug costs can change and should be reviewed separately.
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Do not cancel existing coverage until you understand when replacement coverage begins and whether a gap could occur.
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Medicare rules vary by circumstance. Important enrollment rights and deadlines should be verified using official Medicare information.