new to medicare?
Understanding Medicare as You Approach Eligibility
If you are approaching age 65 or may qualify due to a disability or certain medical conditions, it can be helpful to learn about Medicare and the enrollment timelines that apply to your situation. Reviewing your options early can help you understand when you may be eligible to enroll and what choices may be available in your area.
Download the free Medicare & You guide to learn what’s covered, what it costs, and how to avoid gaps in your coverage from day one.
Select a Topic to Learn More About the Different Parts of Medicare and Enrollment Periods
Original medicare vs medicare advantage
“2 Ways” To Get Medicare
There are two ways you can receive your Medicare coverage. You can get your benefits through Original Medicare, or you can choose a Medicare Advantage plan.
Know the basics
Medicare 101
Part A
Cost For Hospital Plan – Part A
You usually don’t pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes while working. This is sometimes called “premium-free Part A.”
If you buy Part A, you’ll pay either $311 or $565 each month in 2026, depending on how long you or your spouse worked and paid your Medicare taxes.
But most people get premium-free Part A. You can get premium-free Part A at 65 if:
- You already get retirement benefits from Social Security or the Railroad Retirement Board.
- You’re eligible to get Social Security or Railroad benefits but haven’t filed for them yet.
- You or your spouse had Medicare-covered government employment.
- If you’re under 65, you can get premium-free Part A if:
- You got Social Security or Railroad Retirement Board disability benefits for 24 months.
- You have End-Stage Renal Disease (ESRD) and meet certain requirements.
In most cases, if you choose to buy Part A, you must also have Medicare Part B (Medical Insurance) and pay monthly premiums for both.
What Does Part A Cover?
- Inpatient Hospital Care
- Inpatient Rehabilitation Centers
- Long-Term Care – in the Hospital
- Skilled Nursing Facility (SNF)
- Hospice
- Home Healthcare
- Blood
Part B
Cost For Medical Plan – Part B
You pay a premium each month for Part B. If you get Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill.
Most people will pay the standard premium amount. However, if your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you may pay an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
The standard Part B premium amount is $202.90 (or higher, depending on your income). However, most people who get Social Security benefits will continue to pay the same Part B premium amount as they paid in 2026. You’ll pay a different premium amount if:
- You enroll in Part B for the first time in 2026.
- You don’t get Social Security benefits.
- You’re directly billed for your Part B premiums.
- You have Medicare and Medicaid, and Medicaid pays your premiums. (Your state will pay the standard premium amount of $202.90.)
- Your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount.
- If you’re in 1 of these 5 groups, here’s what you’ll pay:
| If your yearly income in 2024 (for what you pay in 2026) was | You pay each month (in 2026) | ||
| File individual tax return | File joint tax return | File married & separate tax return | |
| $109,000 or less | $218,000 or less | $106,000 or less | $202.90 |
| above $109,000 up to $137,000 | above $218,000 up to $274,000 | Not applicable | $284.10 |
| above $137,000 up to $171,000 | above $274,000 up to $342,000 | Not applicable | $405.80 |
| above $171,000 up to $205,000 | above $342,000 up to $410,000 | Not applicable | $527.50 |
| above $205,000 and less than $500,000 | above $410,000 and less than $750,000 | above $109,000 and less than $391,000 | $649.20 |
| $500,000 or above | $750,000 or above | $391,000 or above | $689.90 |
Part B Deductible & Coinsurance
You pay $283 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment.
What Does Part B Cover?
- Doctor’s Services
- Outpatient Care
- Home Health Services
- Preventive Care
- DME
- Drugs
- Outpatient Mental Health Care
- Outpatient Hospital Services
- Physical Therapy
- Transplant & Immunosuppressive Drugs
Part C
Costs For Medicare Advantage Plan – Part C?
Your out-of-pocket costs in a Medicare Advantage Plan (Part C) depend on:
- Whether the plan charges a monthly premium.
- Whether the plan pays any of your monthly Medicare Part B (Medical Insurance) premiums.
- Whether the plan has a yearly deductible or any additional deductibles.
- How much you pay for each visit or service (copayment or coinsurance). For example, the plan may charge a copayment, like $10 or $20, every time you see a doctor. These amounts can be different than those under Original Medicare.
- The type of health care services you need and how often you get them.
- Whether you go to a doctor or supplier who accepts assignment (if you’re in a PPO, PFFS, or MSA plan and you go out-of-network).
- Whether you follow the plan’s rules, like using network providers.
- Whether you need extra benefits and if the plan charges for it.
- The plan’s yearly limit on your out-of-pocket costs for all medical services.
- Whether you have Medicaid or get help from your state.
Note: Each year, plans establish the amounts they charge for premiums, deductibles, and services. The plan (rather than Medicare) decides how much you pay for covered services you get. What you pay for the plan may change only once a year, on January 1.
Get More Cost Details From Your Plan
If you’re in a Medicare plan, review the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC) your plan sends you each fall. The EOC gives you details about what the plan covers, how much you pay, and more. The ANOC includes any changes in coverage, costs, or service area that will be effective in January.
Part D
Costs For Medicare Drug Coverage – Part D
You’ll make these payments throughout the year in a Medicare drug plan:
Premium
Most Medicare Prescription Drug Plans charge a monthly fee that varies by plan. You pay this in addition to the Medicare Part B premium. If you belong to a Medicare Advantage Plan (Part C) or a Medicare Cost Plan that includes Medicare prescription drug coverage, the monthly premium you pay to your plan may include an amount for drug coverage.
Get your premium automatically deducted
Contact your drug plan (not Social Security) if you want your premium deducted from your monthly Social Security payment. Your first deduction will usually take 3 months to start, and 3 months of premiums will likely be deducted at once.
After that, only one premium will be deducted each month. You may also see a delay in premiums being withheld if you switch plans. If you want to stop premium deductions and get billed directly, contact your drug plan.
How much does Part D cost?
Most drug plans charge a monthly fee that varies by plan. Most people only pay their Part D premium. If you don’t sign up for Part D when you’re first eligible, you may have to pay a Part D late enrollment penalty.
If your modified adjusted gross income as reported on your IRS tax return from 2 years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain limit, you may pay a Part D income-related monthly adjustment amount (Part D-IRMAA) in addition to your monthly plan premium. This extra amount is paid directly to Medicare, not to your plan.
Yearly deductible
This is the amount you must pay each year for your prescriptions before your Medicare Prescription Drug Plan begins to pay its share of your covered drugs.
Deductibles vary between Medicare drug plans. No Medicare drug plan may have a deductible of more than $615 in 2026. Some Medicare prescription drug plans do not have a deductible.
Copayments or coinsurance
The amount you pay for each of your prescriptions after you have paid the deductible (if your plan has one) is either a copayment or coinsurance. Some Medicare Prescription Drug Plans have different levels or ” tiers ” of copayments or coinsurance, with different costs for different types of drugs.
- With a copayment, you pay a set amount (like, $10) for all drugs on a tier. For example, you may pay a lower copayment for generic drugs than brand-name drugs.
- Coinsurance means you pay a percentage of the cost (like 25%) of the drug. Usually, the amount you pay for a covered prescription is for a one-month supply of a drug. However, you can request less than a one-month supply for most types of drugs. You might do this if you’re trying a new medication that’s known to have significant side effects or you want to synchronize the refills for all your medications. If you do this, the amount you pay is reduced based on the quantity you actually get. Talk with your doctor to get a prescription for less than a one-month supply.
| If your filing status and yearly income in 2024 was | |||
| File individual tax return | File joint tax return | File married & separate tax return | You pay each month (in 2026) |
| $109,000 or less | $218,000 or less | $109,000 or less | your plan premium |
| above $109,000 up to $137,000 | above $218,000 up to $274,000 | not applicable | $14.50 + your plan premium |
| above $137,000 up to $171,000 | above $274,000 up to $342,000 | not applicable | $37.50 + your plan premium |
| above $171,000 up to $205,000 | above $342,000 up to $410,000 | not applicable | $60.40 + your plan premium |
| above $205,000 and less than $500,000 | above $410,000 and less than $750,000 | above $109,000 and less than $391,000 | $83.30 + your plan premium |
| $500,000 or above | $750,000 or above | $391,000 or above | $91.00 + your plan premium |
Changes To The Coverage Gap
Brand-name prescription drugs
The coverage gap will be eliminated, meaning once you’ve spent $2,100 in out-of-pocket costs, you will no longer pay anything for covered prescriptions. This simplifies the process and reduces financial burdens for beneficiaries.
Generic drugs
Generic drug costs will fall under the $2,100 annual cap. After reaching the cap, you won’t have to pay for generic drugs for the rest of the year.
Items that count towards the coverage gap
- Your yearly deductible, coinsurance, and copayments
- The discount you get on brand-name drugs in the coverage gap
- What you pay in the coverage gap
Items that don’t count towards the coverage gap
- The drug plan premium
- Pharmacy dispensing fee
- What you pay for drugs that aren’t covered
Medicare Prescription Payment Plan
Starting in 2025, beneficiaries will have the option to spread their out-of-pocket costs into monthly payments over the calendar year, making medication expenses more predictable and manageable.
The Medicare Prescription Payment Plan will provide a new way to manage out-of-pocket costs for prescription drugs covered by your Medicare plan. This option allows you to spread your drug costs evenly across the calendar year (January–December), making payments more predictable. It’s available to anyone with a Medicare drug plan or a Medicare health plan that includes drug coverage, such as a Medicare Advantage Plan. All plans will offer this option, but participation is entirely voluntary.
If you choose to enroll, you’ll still pay your plan premium each month (if applicable), but instead of paying for prescriptions directly at the pharmacy, you’ll receive a bill from your health or drug plan to cover those costs. There’s no additional fee to use the Medicare Prescription Payment Plan. If you need more information about this benefit, please feel free to call us at 1-88-446-9157.
If you think you should get a discount
If you think you’ve reached the coverage gap and you don’t get a discount when you pay for your brand-name prescription, review your next “Explanation of Benefits” (EOB). If the discount doesn’t appear on the EOB, contact your drug plan to make sure that your prescription records are correct and up-to-date. Get your plan’s contact information from a Personalized Search (under General Search), or search by plan name. If your drug plan doesn’t agree that you’re owed a discount, you can file an appeal.
Costs If You Get Extra Help
To check the level of Extra Help you’re entitled to, you’ll need to provide some information.
Documentation
Examples of documents you can send with your plan include:
- A purple notice from Medicare that says you automatically qualify for Extra Help.
- A yellow or green automatic enrollment notice from Medicare.
- An Extra Help “Notice of Award” from Social Security.
- An orange notice from Medicare that says your copayment amount will change next year.
- If you have Supplemental Security Income (SSI), you can use your award letter from Social Security as proof that you have SSI.
You can also give your plan any of the following documents (called “Best Available Evidence”), which they must accept as proof that you qualify for Extra Help. If you don’t have or can’t find any of these documents, ask your plan for help.
Proof you have Medicaid and live in an institution or get home- and community-based services
- A bill from the institution (like a nursing home) or a copy of a state document showing Medicaid paid for your stay for at least a month.
- A print-out from your state’s Medicaid system showing that you lived in an institution for at least a month and that Medicaid paid for your stay.
- A document from your state that shows you have Medicaid and are getting home- and community-based services.
Other proof you have Medicaid
- A copy of your Medicaid card (if you have one).
- A copy of a state document that shows you have Medicaid.
- A print-out from a state electronic enrollment file or from your state’s Medicaid systems that shows you have Medicaid.
- Any other document from your state that shows you have Medicaid.
Once you give your plan this information, your plan must:
- Make sure you pay no more than the LIS drug coverage cost limit.
In 2026, costs are no more than $5.10 for each generic/$12.65 for each brand-name-covered drug. - Contact Medicare so we can get proof that you qualify, if it’s available. You can expect your request to take anywhere from several days to up to 2 weeks to process, depending on the circumstances. Call 1-800-MEDICARE (1-800-633-4227).
Costs If You Pay A Late Enrollment Penalty
The late enrollment penalty is an amount added to your Medicare Part D monthly premium. You may owe a late enrollment penalty if you go without a Medicare Prescription Drug Plan (Part D), or without a Medicare Advantage Plan (Part C) (like an HMO or PPO) or other Medicare health plan that offers Medicare prescription drug coverage, or without creditable prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period is over.
Learn how to avoid the late enrollment penalty.
*Note: If you get Extra Help, you don’t pay the late enrollment penalty.
How much is the Part D penalty?
The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.
Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” ($38.99 in 2026) times the number of full, uncovered months you didn’t have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium.
The national base beneficiary premium may increase each year, so your penalty amount may also increase each year.
How do I know if I owe a penalty?
After you join a Medicare drug plan, the plan will tell you if you owe a penalty and what your premium will be. In general, you’ll have to pay this penalty for as long as you have a Medicare drug plan.
What if I don’t agree with the late enrollment penalty?
You may be able to ask for a “reconsideration.” Your drug plan will send information about how to request a reconsideration.
Complete the form, and return it to the address or fax number listed on the form within 60 days from the date on the letter stating you had to pay a late enrollment penalty. You should also send any proof that supports your case, like a copy of your notice of creditable prescription drug coverage from an employer or union plan.
Do I have to pay the penalty even if I don’t agree with it?
By law, the late enrollment penalty is part of the premium, so you must pay the penalty with the premium. You must also pay the penalty even if you’ve asked for a reconsideration. Medicare drug plans can disenroll members who don’t pay their premiums, including the late enrollment penalty portion of the premium.
How soon will I get a reconsideration decision?
In general, Medicare’s contractor makes reconsideration decisions within 90 days. The contractor will try to make a decision as quickly as possible. However, you may request an extension. Or, for good cause, Medicare’s contractor may take an additional 14 days to resolve your case.
What happens if Medicare’s contractor decides the penalty is wrong?
If Medicare’s contractor decides that all or part of your late enrollment penalty is wrong, the Medicare contractor will send you and your drug plan a letter explaining its decision. Your Medicare drug plan will remove or reduce your late enrollment penalty and will send you a letter that shows the correct premium amount and explains whether you’ll get a refund.
What happens if Medicare’s contractor decides the penalty is correct?
If Medicare’s contractor decides that your late enrollment penalty is correct, the Medicare contractor will send you a letter explaining the decision, and you must pay the penalty.
*Your actual drug plan costs will vary depending on:
- The drugs you use
- The plan you choose
- Whether you go to a pharmacy in your plan’s network
- Whether the drugs you use are on your plan’s formulary
- Whether you get Extra Help paying your Medicare Part D costs
Look for specific Medicare drug plan costs, and then call the plans you’re interested in to get more details.
If you have limited income and resources, your state may help you pay for Part A and/or Part B. You may also qualify for Extra Help to pay for your Medicare prescription drug coverage.
Enrollment Periods
Initial Enrollment Period (IEP)
Available Programs: Part A • Part B • Part C • Part D
The first time you can sign up for Medicare. This 7-month window includes the three months before your 65th birthday month, your 65th birthday month, and the three months following it.
Special Enrollment Period (SEP)
Available Programs: Part A • Part B • Part C • Part D
For individuals keeping employer coverage after age 65. You may enroll anytime while covered, enroll in Parts A and B within 8 months after employment or coverage ends, or enroll in Parts C and D within 63 days.
General Enrollment Period (GEP)
Available Programs: Part A • Part B
If you missed your Initial Enrollment Period, you can enroll in Medicare Parts A and B between January 1 and March 31 each year.
Open Enrollment Period (OEP)
Available Programs: Part C • Part D
Review and change Medicare Advantage or Prescription Drug plans. Coverage changes take effect January 1.
Medicare Supplements (Medigap)
Available Programs: Medicare Supplement Plans
You may sign up for a Medicare Supplement a few months before your 65th birthday, with coverage effective the month you turn 65. To be guaranteed coverage without medical underwriting, you must enroll before the 6th month after you turn 65 and are enrolled in Part B.
- Initial window: From a few months before your 65th birthday through the 6th month after turning 65 (and enrolling in Part B) — carriers must accept you regardless of health history.
- Lost or moved: If you lose coverage or move, you have 63 days after that qualifying event to enroll with guaranteed acceptance.
- Outside these windows: Carriers may require medical underwriting before accepting you. Our agents can help you navigate what’s best for your situation.
Initial Enrollment Period (IEP) For Medicare At Age 65
This is the time frame for most people to sign up for Medicare. It runs for seven months, starting three months before the month in which you turn 65 and ending three months after that month. (For example, if your birthday is in May, your IEP begins Feb. 1 and ends Aug. 31.)
Use this period to enroll in Part A (Hospital Insurance) even if you do not intend to enroll in Part B. (An exception may be if you are still working and have employer health coverage that takes the form of a high-deductible plan and a health savings account. )
Use this period to enroll in Part B (which covers doctor’s services, outpatient care, and medical equipment) if:
- You have no other health insurance.
- You still have health benefits from a former employer but you have retired or stopped working or plan to stop shortly.
- You still have health benefits from the former employer of your spouse who has retired or stopped working or plans to do so shortly.
- You are covered by COBRA insurance that extended employer health benefits after you (or your spouse) stopped working.
- You have group health insurance from an employer with fewer than 20 workers, or your health plan (such as the TriCare program for active or retired military personnel) requires you to enroll in Part B on turning 65.
- You have individual health insurance you have purchased yourself.
- You do not qualify for Part A and have no other health insurance.
- You are living (but not working) outside the United States.
Be aware that if you are in any of the above situations and delay signing up for Part B beyond your IEP you may face a late enrollment penalty when you eventually sign up and — perhaps more detrimentally — you will be able to sign up only during the general open enrollment period (see below) at the beginning of each year and coverage will not begin until the following July.
But in other situations, if you continue to work beyond age 65 and have group health insurance from an employer for whom you or your spouse is still working, you may be able to delay signing up for Part B without penalty. See “Special enrollment period for Part B” below.
If you are already receiving Social Security retirement benefits when you turn 65, Social Security will automatically enroll you in Medicare Parts A and B. You have the right to decline Part B within a certain length of time if you or your spouse is still working for an employer that provides your health insurance.
You can also enroll in Part D prescription drug coverage during this initial enrollment period. But if you already have drug coverage from elsewhere — such as a former or current employer, COBRA, or the Veterans Affairs health program — you may not need to sign up at this time. See “Special enrollment period for Part D” below.
Initial Enrollment Period (IEP) For Medicare Through Disability
If you become eligible for Medicare under age 65 because of disability, you will receive a letter from Social Security saying when your Medicare coverage will begin. It typically starts 24 months after your disability benefits were approved. Social Security will automatically enroll you in Part A and Part B. If you wish to opt-out of Part B, you can if you or your spouse is still working for an employer that provides health coverage and has more than 100 workers.
When you turn 65, you’ll be entitled to a second seven-month IEP — this time based on age instead of disability. You get to start over, so if you previously paid a Part B late penalty, you won’t have to pay it any longer.
Special Enrollment Period (SEP) For Part B
This SEP allows you to enroll in Part B without penalty beyond age 65 provided that you can show you have had group health insurance from an employer (or employers) for whom you or your spouse were still working since you turned 65. The SEP runs for eight months from the date you (or your spouse) stopped working. But you can enroll before this date to ensure unbroken health coverage. Your Part B coverage begins on the first of the month after you enroll.
If you work outside the United States when you turn 65 or later, you’re entitled to the same SEP when you return to this country if you (or your spouse):
- had American-style group health insurance from an employer for whom you were working when abroad;
- were covered under the national health insurance program of the country you were living in while working abroad (as an employee or as a self-employed person);
- received health coverage from an approved organization (such as the Peace Corps) while working abroad as a volunteer.
You are not entitled to this SEP (and must therefore enroll in Part B during your initial enrollment period to avoid a late penalty) in certain situations — for example, if you work beyond age 65 for an employer that has fewer than 20 employees; or if you are covered beyond 65 by the employer insurance of a domestic partner to whom you are not married.
Special Enrollment Period (SEP) For Part D
Part D drug coverage has different rules than Part B. You can delay enrolling in Part D beyond age 65 provided that you continue to have “creditable” drug coverage — meaning that Medicare considers it of at least equal value to Part D. When this coverage ends, you will be entitled to this SEP and can sign up immediately and without penalty in the following circumstances:
In all these cases, the special enrollment period lasts for 63 days beyond the crucial date — such as the end of drug coverage, your return to the United States, or your release from prison. But your actual coverage in a Part D drug plan must have begun on or before the 63rd day to avoid a late penalty. Since coverage cannot begin until the first of the month after enrollment, it’s best to sign up no later than the end of the second calendar month after the critical date.
- When drug benefits from your current employer (or from your spouse’s employer) terminate on retirement or through no fault of your own.
- When COBRA coverage terminates.
- When you lose drug benefits from a retiree health plan through no fault of your own.
- When you return from abroad to live permanently in the United States.
- When you are released from prison.
If you let this SEP expire before enrolling in a Part D drug plan, you must wait until the next annual enrollment period (see below), and you will receive a late penalty — added permanently to your plan’s premiums — for every month of delay.
Annual Open Enrollment Period (AEP): Oct. 15 Through Dec. 7
Every year, open enrollment allows you to review your existing Medicare coverage and, if you want to, change to a different plan for the following year. Use this period to:
- Switch from one “stand-alone” Part D drug plan to another.
- Switch from one Medicare Advantage plan to another.
- Change from traditional Medicare to a Medicare Advantage plan.
- Change from a Medicare Advantage plan to traditional Medicare.
- Enroll in a stand-alone Part D drug plan if you change from a Medicare Advantage plan to traditional Medicare.
- Enroll in a stand-alone Part D drug plan for the first time if you voluntarily opted out of other drug coverage, such as coverage provided by a current or former employer.
In all cases, your new coverage begins on Jan. 1. If you’re switching drug plans or Medicare Advantage plans, you do not need to actively “disenroll” from the one you are leaving — the act of enrolling in a new plan automatically cancels coverage under the old one. Similarly, if you’re in a Medicare Advantage plan but enroll in a stand-alone drug plan during the open enrollment, this automatically cancels the old plan and also switches you to the traditional Medicare program for your medical benefits.
Note: However, this open enrollment period does not apply to Medigap supplemental insurance.
Medicare Advantage Open Enrollment Period (OEP): Jan. 1 Through March 31
If you’re in a Medicare Advantage Plan, you can change to a different Medicare Advantage Plan or switch to Original Medicare (and join a separate Medicare drug plan) once during this
time. Any changes you make will be effective the first of the month after the plan gets your request.
This period is specifically for people enrolled in a Medicare Advantage health plan who want to change to traditional Medicare. It doesn’t matter how long you’ve been in the Medicare Advantage plan. Even if you’ve just signed up with a plan (during a recent annual open enrollment) and your coverage began only on Jan. 1, you can still use this period to change your mind and switch to the traditional Medicare program. You also can enroll in a stand-alone Part D prescription drug plan at this time. In both cases, your new coverage begins the first day of the month after you make the change.
Part B General Enrollment Period (January 1–March 31)
This period is specifically for people who missed signing up for Medicare Part B at the required time — either during their initial enrollment period or during a special enrollment period for Part B. If you need to sign up for Part B during this period, be aware that your coverage will not begin until July 1, and you may be required to pay a late penalty based on how many years you have delayed.
Other Special Enrollment Periods (SEPs) For Medicare Advantage And Stand-alone Drug Plans
There are several other SEPs available in specific circumstances:
- If you joined a Medicare Advantage plan during your initial enrollment period when you turned 65, your first year in the plan counts as a trial period. You can change to traditional Medicare at any time within these 12 months. And you have a guaranteed right to buy Medigap supplemental insurance within 63 days of your plan coverage ending.
- If you gave up a Medigap policy to join a Medicare Advantage plan, and this is your first year ever in such a plan, the first 12 months also count as a trial period. Within that timeframe, you can switch back to traditional Medicare and get your Medigap policy back.
- If you are receiving Extra Help to pay for your prescription drugs, you can change your drug plan at any time. Coverage in the new plan begins the month after you enroll in it.
- If you live in a nursing home, you can change your drug plan the month you move into the home and any month while you’re living there. You also get a two-month SEP to switch to another plan after you move out.
- If you have access to a Medicare Advantage or Part D drug plan that has earned Medicare’s top quality rating of five stars, you can switch to that plan at any time of the year.
- If you move out of your plan’s service area, you have the right to change to a new plan in your new area. (But if you’re in a drug plan that serves an entire state, and you move within that state, your coverage will continue and you won’t be entitled to a SEP.)
- If your plan withdraws from your service area, leaves Medicare, or is closed down, you will receive a letter explaining how long your coverage will last and when you can switch to a different plan of your choice.
- If you were tricked or misled into joining a Medicare Advantage plan, you can ask Medicare to investigate and grant you a SEP to change to another plan.
- If your plan breaks its contract with you — for example, by denying promised benefits — you can ask Medicare to investigate and grant you a SEP to change to another plan.
