A lot of time and thought can go into selecting the right Medicare coverage for you and your family. Budget and circumstance both need to be taken into consideration. What then happens if your budget or circumstances change? What if you decided that you made the wrong decision? Sometime after you sign up for Medicare, you may determine that you have the need or desire to change your Medicare coverage. However, you are limited to only certain times when you can change them.
Open Enrollment
Most often, the time when you are going to make the majority of your plan changes is going to be during open enrollment. Open enrollment is the designated period every year where you select your health insurance benefits for the next year to come. You can elect to change coverages, cancel, or enroll in a plan for the first time. Be careful, though, because once the open enrollment period closes you cannot make any changes until the next open enrollment period, which will be nearly a year away. There are special circumstances that will give you another opportunity to make changes.
Special Circumstances
If you experience one of these particular circumstances, often called a qualifying life event or QLE, Medicare grants you a special enrollment period which allows you 60 days from the date of the QLE to make any necessary changes to your policy or to enroll for the first time. A QLE is a change in your life circumstances that prompts a need for a change in health insurance coverage. There are three categories of special circumstances that apply to Medicare.
- You lose health coverage, or there are contract changes to your plan. Losing health coverage may include losing Medicare eligibility or leaving a job that provided health insurance.
- You move to a new address. Examples where moving to a new address might trigger a special enrollment period is if you are moving out of your plan’s service area or moving back to the United States from another country.
- You can get coverage elsewhere. If you can get equal or better coverage through your employer or a PACE plan, you may choose to cancel your Medicare coverage, and you would be granted a special enrollment period to do so.
In addition to the categories listed above, there are other, miscellaneous reasons for which you may qualify to change your coverage options outside of the annual enrollment period such as an error or misinformation. If you go through an experience that you think may make you eligible for a special enrollment period, but are not sure, you can find an extensive list on the Medicare website.