Florida Medicare beneficiaries who are eligible for a Medicare Advantage plan (MA or Part C plan) can join, switch, or make changes to their coverage only during certain times of the year. Any beneficiary who is interested in switching Medicare Advantage plans must reside in the plan’s service area and meet the plan’s eligibility requirements, such as having certain chronic conditions in the case of Special Needs Plans (SNPs).
There are three situations and time periods in which beneficiaries can switch Medicare Advantage plans in Florida:
Any beneficiary enrolled in Original Medicare, Part A and Part B, can switch Medicare Advantage plans during the Medicare Annual Coordinated Election Period (AEP), which runs from October 15th to December 7th each year. During this time, Florida residents have the option to switch from one Medicare Advantage plan to another Medicare Advantage plan, both with and without drug coverage. They also have the option to switch back to an Original Medicare plan or make changes to their Medicare Part D Prescription Drug Plan coverage.
The Medicare Advantage Disenrollment Period (MADP), which lasts from January 1st to February 14th, is another time in which beneficiaries have the opportunity to change their Medicare Advantage coverage. This disenrollment period does not apply to anyone with any other type of Medicare plan. During this time, any beneficiary can disenroll from their MA plan and return to Original Medicare. Those who leave their MA coverage have the option to pick up a stand-alone Part D Prescription Drug Plan (PDP) at this time. However, Florida beneficiaries are not allowed to switch from Original Medicare to a Medicare Advantage plan, switch from one MA plan to another, switch from one PDP to another, or make changes to a Medicare Medical Savings Account (MSA) Plan.
There are also other Special Enrollment Periods (SEPs) for which a beneficiary in Florida may be eligible. During this time, an individual can change, join, or switch his Medicare Advantage or PDP coverage. Qualifying events include, but are not limited to, moving to a new address, changing Medicaid eligibility, losing employer or union insurance coverage, or involuntarily losing credible drug coverage. Additionally, Any Florida resident who is eligible for both Medicare and Medicaid can make changes to their MA coverage at any time.
Florida Medicare beneficiaries are also eligible for a 5-star Special Enrollment Period in which they can switch to a 5-star Medicare Advantage plan at any time during the year. A 5-star rating is given to a Medicare plan that is considered excellent in both quality and performance. Beneficiaries can join a 5-star MA plan if there is one available in their area and if the plan is not a Medicare Cost Plan. This special enrollment period can only be used once a year. It is important to note that if you move from a Medicare Advantage Prescription Drug plan to an MA plan without drug coverage, you would have to wait until the next open enrollment period to sign up for drug coverage and may be subjected to a late enrollment penalty.
Any beneficiary who wishes to switch to a new Medicare Advantage plan in the state of Florida is not required to notify their old insurance policy of their switch. They will be automatically disenrolled from their original MA plan once their new insurance coverage begins.