Medicare Advantage Plans

When to Enroll in a Medicare Advantage Plan

Important Dates and Information about When You Can Enroll

Picking the right Medicare Advantage plan can be tricky, especially when you have so many choices. Depending on what type of plan you want to enroll in, the time of year it is, and when you became eligible for Medicare Part A and Part B, your options may be limited. Keep reading to find out about the rules for Medicare enrollment periods.

Medicare Advantage Plans – Enrollment Periods

If you recently became eligible for Medicare, through age or disability, you generally have the option to apply for coverage in a Medicare Advantage plan close to the date when your Medicare Part A and Part B coverage starts.

Your coverage can't start before both your Part A and Part B coverage begins. However, you generally have a period of seven months to apply for coverage in a Medicare Advantage plan.

This means you can apply for coverage in a Medicare Advantage plan three months before, the month of, or three months after your Medicare Part A and Part B coverage starts. You must be enrolled in both Medicare Part A and Part B.

If you didn't recently become eligible for Medicare, your options are different depending on the time of year.

October 15 – December 7 – Annual Election Period:

The Medicare Advantage and Prescription Drug Annual Election Period (AEP) runs from October 15 through December 7 of each year. During this time, Medicare beneficiaries may change and/or enroll in a stand-alone Prescription Drug Plan (PDP), Medicare Advantage plan or return to Original Medicare. Changes you make during this period will take effect on January 1.

January 1 – February 14 – Medicare Advantage Disenrollment Period (MADP):

Medicare beneficiaries that have a Medicare Advantage plan can return to Original Medicare, but are no longer able to switch Medicare Advantage health plans during this time. Medicare beneficiaries may enroll in a stand-alone Prescription Drug Plan (PDP), which may cause termination of their Medicare Advantage plan and a return to Original Medicare.

"Lock-in" Period:

Between February 15 and October 14 and between December 8 and December 31 of each year, Medicare beneficiaries usually cannot switch coverage. This time is referred to as the "lock-in" period. During this period, you generally must stay with your current plan until January 1, when any new coverage you choose between October 15 and December 7 begins.

In certain situations, beneficiaries may be able to join, switch, or drop a Medicare Advantage plan or a Prescription Drug Plan (PDP) during a Special Election Period (SEP).

Examples of special circumstances include, but are not limited to, individuals who:

  • Recently moved
  • Enter, reside in or leave a Long Term Care Facility
  • Are eligible for both Medicare and Medicaid
  • Qualify for Extra Help
  • Are disenrolling from an Employer or Union coverage; or,
  • Involuntarily lost creditable prescription drug coverage

Beneficiaries’ and Plan’s Rights and Responsibilities Upon Disenrollment

CarePlus will send the member a written acknowledgement of disenrollment notice within ten (10) calendar days of receipt of the request to disenroll. The disenrollment notice will include the effective date of disenrollment with the plan. Beginning on the effective date of the member’s disenrollment, CarePlus will not cover any health care the individual receives. In addition, beginning on the effective date of the member’s disenrollment, the individual can see a doctor through the Original Medicare Plan, unless the individual has enrolled in another Medicare Advantage Plan. If the member’s doctor(s) needs to send claims to Medicare, the member may want to let the doctor(s) know that he/she just disenrolled from CarePlus and that it may take a few weeks for Medicare to update their records.

For additional information, please call Member Services at 1-800-794-5907; from 8 a.m. to 8 p.m., 7 days a week. From February 15th to September 30th, we are open Monday – Friday from 8 a.m. to 8 p.m. TTY users should call 711.

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