I am not happy with my Medicare Advantage plan. Can I switch
plans in the middle of the year, or do I have to wait until open
enrollment for next year's plans?
In most cases, you cannot switch plans midyear. To choose a
Medicare Advantage plan for next year, you must wait until
open-enrollment season, which runs from October 15 to December 7.
There's a special enrollment period -- January 1 to February 14 --
that lets you switch out of a Medicare Advantage plan into
traditional Medicare (and sign up for a stand-alone Part D
prescription-drug policy), but you can't use that window to move
from one Medicare Advantage plan to another.
A new option, however, allows the relatively few people who have
access to a five-star Medicare Advantage plan to switch plans once
during the year outside of open enrollment. (Medicare Advantage
plans are assessed on 50 measures, focusing primarily on each
plan's coverage, communications and customer service. The highest
rating is five stars.) The catch: There are only 12 five-star
Medicare Advantage plans in the U.S. (out of 569 plans available)
in 2012, up from just three in 2011. The largest five-star plan is
Kaiser Pemanente's Medicare Advantage plan, which is available in
31 counties in California. There are other five-star plans in
certain counties in Colorado, Hawaii, Illinois, Iowa, Maine,
Massachusetts, Oregon, Washington and Wisconsin. To see whether any
five-star plans are in your area, go to the
Medicare Plan Finder
and sort the Medicare Health Plans (another name for Medicare
Advantage plans) by overall plan ratings when the list of available
plans pops up, or call 1-800-Medicare (1-800-633-4227). The star
ratings are assessed once per calendar year.
If you do have the opportunity to switch to a five-star plan,
first decide whether it suits your needs. "Choice, convenience,
coverage and cost are still important," says Jan Berger, M.D.,
chief medical officer for Silverlink Communications, which helps
Medicare Advantage plans communicate with consumers. "If you are
lucky enough to be in an area with a five-star plan, you still have
to weigh whether your doctor is in the plan and whether your drugs
and hospitals are covered by the plan."
You can find more information about each rating in the plan's
page in the Medicare Plan Finder. Also see Medicare's
Choose Higher Quality for Better Health Care
fact sheet for more information.