How to Change Your Medicare Coverage
- Kathleen Bennett
- Sep 6
- 4 min read
There are specific times throughout the year when you can make changes to your Medicare coverages. Shopping your Medicare plan can help save money or get coverages that better suit your current needs.
This guide will help you plan ahead so you can take advantage of opportunities to shop your Medicare coverage.
When can I make changes to my Medicare coverage?
There are two primary times to review and change your Medicare plan: Medicare Annual Enrollment (AEP) which is often called “Medicare Open Enrollment” and Medicare Advantage Open Enrollment.
In Oregon, we also have the Oregon Birthday Rule which allows you to make certain changes during a 30-day window around your birthday each year.
Medicare Annual Enrollment Period (AEP) or “Medicare Open Enrollment”
From October 15 to December 7 each year, you can sign up for, change plans, or drop coverage for Medicare advantage or Part D Prescription Drug Plans. You cannot make changes to your supplement plans during the AEP.
Here’s a summary of the options you have during Medicare Open Enrollment:
Switch to a Medicare Advantage plan if you are currently on Original Medicare.
Switch from a Medicare Advantage plan back to Original Medicare.
Switch from one Medicare Advantage plan to another.
Join, switch, or drop a Part D prescription drug plan if you are on Original Medicare.
Keep your current plan.
Changes will go into effect on January 1 of the following year.
How do I prepare for Medicare Open Enrollment?
Use this time to review your health needs and budget for the upcoming year. Here are a few questions to guide you:
Do you anticipate needing any surgeries or new treatments and prescriptions?
Are your current premiums and out-of-pocket costs working for you?
Are your preferred doctors, hospitals, and pharmacies still in your network?
It is recommended to work with a licensed agent who can help you choose the best coverages for your needs. Find a local Medicare agent in your area and schedule an appointment with them between October 15-December 7.
Be on the lookout for scams. Medicare-related scams increase around the AEP since scammers know people are expecting mail about their Medicare coverage.If you get a call or text asking for your Medicare number, do not give it. Check Medicare Summary Notices and claims statements for any unexpected charges. Guard your Medicare card like a credit card. Report suspected fraud to 1-800-633-4227.
Medicare Advantage Open Enrollment (MA OEP)
Medicare Advantage enrollees can switch to a different plan or switch back to Original Medicare from January 1-March 31 each year. This period is only open to those already enrolled in a Medicare Advantage plan.
Changes made during the MA OEP take effect on the first day of the month following the month you make the change.
Can I make changes to my Medicare plan outside of Open Enrollment?
Yes, there are two additional times you can make changes to your Medicare coverage in Oregon with the Oregon Birthday Rule or Special Enrollment Periods (SEP).
The Oregon Birthday Rule
The Oregon Birthday Rule allows you to make changes and shop for more affordable Medigap (Medicare Supplement) plans. Medigap plans are the private health insurance policies that help pay for the out-of-pocket costs that Original Medicare (Parts A and B) do not cover. The advantage of the Birthday Rule is that you can switch to a Supplemental Plan of equal or lesser benefits under “guaranteed issue.” This means insurers cannot deny coverage or charge a higher premium due to your health status.
The Oregon Birthday Rule does not include making changes to Medicare Advantage plans or Prescription Drug Plans (Part D).
You can switch Medicare supplement plans in Oregon beginning 30 days before your birthday and ending 30 days after your birthday.
Example: Mary’s birthday is June 1. As an Oregon resident on Medicare, can make changes to her supplement plans May 2-July 1 each year.
Changes made during the Oregon Birthday Rule take effect the month after you apply.
How do I use the Oregon Birthday Rule to change my Medicare supplements?
To take advantage of this special time to shop your Medicare supplement policy, we recommend taking these steps:
Review your current coverage and premium. You should receive your new premium about a month before your birthday.
Research new options. You can work with a licensed Medicare agent or explore on your own with Oregon’s Senior Health Insurance Benefits Assistance (SHIBA) program. It is free to work with a licensed agent.
Apply to a new policy, if you find a more affordable or better suited option.
Cancel your old policy, if you applied to a new policy. Double check that you will not have a gap or overlap of coverage.
Special Enrollment Periods (SEPs)
Finally, you may also be eligible to make changes to your Medicare coverage if you qualify for a Special Enrollment Period (SEP). Qualifying events include moving out of your plan’s network, losing or gaining other coverage, and several other events as listed on Medicare.gov’s site.
Changes will typically go into effect the month after you apply, but may vary.
When do changes I make to my Medicare plan take effect?
Medicare Annual Enrollment Period: January 1 of the following year.
Medicare Advantage Open Enrollment: The first day of the month following the month you made the change.
Oregon Birthday Rule: The month after you apply.
Special Enrollment Period: Typically the month after you apply, but may vary.
Who can help me review and change my Medicare plan?
You can get free Medicare enrollment assistance through your State Health Insurance Assistance Program (SHIP) or an independent, licensed broker who works with multiple insurance companies. Hillock Insurance is a licensed broker serving Medicare patients. Our agents have more than 30 years of experience helping over 1,500 customers throughout Oregon, especially those in Enterprise, Joseph, Wallowa, and Lostine.