Medicare Advantage Enrollment Loophole

Rx and MA plan members may switch under one condition

by Amy De Vore+ on Dec 12, 2013 | 3 Comments

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What do you do if your health plan or Rx plan aren’t up to par? Medicare Advantage and Prescription Drug Plans are available year round as long as they meet one criterion.

How Can I Switch My Medicare Health Plan Outside of Open Enrollment?

If your plan does not work for you, Medicare is allowing for you to switch your MA plan or Rx plan anytime during the year if the plan you are choosing has a 5-star rating. It appears that you can only “switch” your plan, not enroll for the first time in one of these plans year round.

“Plan ratings are based on member surveys, information from doctors and health care providers, and other sources. The plan ratings are scores that show the quality and performance of the plan, on a scale of 1 to 5 stars, with 5 being the highest rated plans.” -from the CMS Blog.

To switch your Rx or Medicare Advantage plan call the number above or contact Senior65.

Learn More about Medicare Advantage Get a Medicare Advantage Quote

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Reader Comments and Questions

By Marian on May 16, 2017

As a retiree from a county job since 2009, I have been able to keep the same insurance plans offered to regular employees. However, this year, retirees over age 65 are not offered a supplement plan like the others employees but are being left only to an Advantage Plan with the same premium as last year. If I opt out, I will no longer be eligible for county retiree coverage. I do not know that this plan is of any advantage since prior to this year the coverage has been great. Would I be better off to shop for a supplement plan within my budget or stay with the county plan and hope for the best?

We do suggest that you enroll in a Medicare Supplement plan instead of enrolling in the Advantage plan through your county, unless your plan is considered "creditable coverage" and when you leave that plan, you would have guaranteed issuance into a Med Supp. For further help, speak to one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Michelle from

By Ray on May 30, 2016

Please compare Kaiser Permanante senior advantage with Humana MA and advice

We would need more information before comparing and giving advice on a plan (ie. your zip code, which specific plan, your health, specific doctors and hospitals you would like access to, etc). Please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
-Chris from

By Jacob House on April 26, 2016

I have had a liver transplant and now in ckd I had Obama care then just found out its illegal to have Obama care because I had medicare part a they can give me d June 1st but want let me get d I need all my drugs I tale 18 a day

To get prescription drug help you may want to contact Medicare and see if there is anything you can do since there was a misunderstanding. Also, did you sign up for Part B? If you did not, you will not have any type of doctor coverage, either at an office or at the hospital. If you need help finding a Medicare Supplement plan or Medicare Advantage plan to help lower your health costs, please call one of our licensed independent agents at 800-930-7956.
-Chris from

PLEASE NOTE: We cannot comment on specific Medicare claims. Contact Medicare directly if you are trying to see if your issue is covered.

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