Do I Qualify?
The list below outlines several ways you can qualify for enrollment in a Medicare Advantage (MA) plan.
Anyone with an existing Medicare plan can enroll in a new Medicare Advantage and/or
a new Medicare Prescription Drug plan during the Annual
Election Period, from October 15 through December 7, for coverage effective January 1 of the following year.
If you meet one of the following criteria, you can enroll in a Medicare Advantage plan outside of the Annual Election
Period and the Medicare Advantage Disenrollment Period:
- You are new to Original Medicare.
- You're turning 65:
- You can enroll anytime during the three months before the month you turn 65.
- You can enroll anytime during the month you turn 65.
- You can enroll anytime during the three months after the month you turn 65.
- You have recently moved outside of your current service area for Medicare Advantage plans or Medicare Prescription Drug plans.
- You have both Medicare and Medicaid*, or your state helps pay for your Medicare premiums.
- You were recently approved for Medicare's program, which helps pay for your prescription drug coverage premiums.
- You no longer qualify for Extra Help paying for your Medicare prescription drugs.
- You recently moved into a long-term care facility (such as a nursing home).
- You recently left a Program of All-inclusive Care for the Elderly (PACE) program.
- You belong to a State Pharmacy Assistance Program
- Your current Medicare Advantage plan is ending its contract with Medicare, or Medicare is ending its contract with your current Medicare Advantage plan.
- You qualify for Original Medicare and you involuntarily lost your prescription drug coverage, and your coverage was 'creditable' (meaning it was as good as Medicare coverage).
- You qualify for Original Medicare and you have recently lost your employer coverage, or are leaving employer coverage.
- You qualify for Original Medicare and you recently returned to the United States after living outside of the country.
*Note: If you are covered under Medicaid and Medicare, you are eligible to switch plans once per month.
If you have questions about enrollment, please call us toll free at
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How do I disenroll from a Medicare Advantage Plan?
During the Medicare Advantage Disenrollment Period, from January 1 through February 14,
you may disenroll from a Medicare Advantage plan and return to Original Medicare Part A and Part B. Requests to disenroll in January are
effective February 1st. Requests made in February are effective March 1st.
Annual Election Period (AEP):
Medicare sets aside this period for enrollment in Medicare Advantage (MA) and Medicare Prescription Drug Plans (PDP). From October 15th to December 7th you have the opportunity to enroll in an MA or PDP plan, switch from your current plan or return to Original Medicare for coverage effective on January 1 of the following year.
A joint Federal and State program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most healthcare costs are covered if you qualify for both Medicare and Medicaid.
Medicare Advantage plans are health plan options offered by private insurance companies that are approved by Medicare. If you join one of these plans, you generally get all of your Medicare-covered healthcare through that plan. Medicare Advantage plans (called MA plans) combine Part A (hospital insurance) and Part B (medical insurance) together in one plan, and they can also be combined with Part D prescription drug coverage (called MA-PD plans).
Medicare Part D (Prescription Drug Coverage)
Medicare Prescription Drug Coverage available through either a Medicare-approved stand-alone drug plan or as coverage added to a Medicare Advantage plan (often called MA-PD).
Medicare Advantage Disenrollment Period:
From January 1 through February 14, you may disenroll from a Medicare Advantage plan and return to Original Medicare. Requests to disenroll will be effective on the first day of the month following your disenrollment request.
The program run by the Social Security Administration that helps with the costs of Medicare Prescription Drug Coverage (Part D) . If you qualify, Social Security will enroll you in the program. The amount of assistance you receive will depend on your financial situation and income.
State Pharmacy Assistance Program (SPAP):
A state program that provides assistance in paying for drug coverage, based on financial need, age, or medical condition and not based on current or former employment status. These programs are run and funded by the states.