How to Switch Medicare Plans in Texas

Switching between Medicare Advantage plans

This is the easy case. During the Annual Enrollment Period, October 15 through December 7, you can move to any Medicare Advantage plan available in your Texas county, with the new plan starting January 1.

You also get one additional switch during Medicare Advantage Open Enrollment, January 1 through March 31, if you are already in an Advantage plan.

Changing Part D plans

Also straightforward during the Annual Enrollment Period. Because formularies change every year, this is the change most people should at least consider annually, particularly if their prescriptions changed.

Switching Part D plans does not affect your Medigap policy or your Original Medicare coverage.

Going from Advantage back to Original Medicare

You can drop a Medicare Advantage plan and return to Original Medicare during either the annual window or the January-to-March window. The complication is not the Medicare side; it is the Medigap side.

To have predictable costs on Original Medicare you generally want a Medigap policy. Outside your initial six-month guaranteed-issue window, Texas insurers can medically underwrite that application and can decline it. Someone who developed a health condition while on an Advantage plan may find they cannot get the Medigap policy they assumed would be waiting.

Changing Medigap policies

You can apply to change Medigap carriers at any time of year, but outside a guaranteed-issue situation the new carrier can underwrite you. If you are healthy, shopping your Medigap policy periodically can save real money, since carriers raise rates differently over time.

If your health has changed since you first enrolled, be cautious about dropping a policy before a replacement is actually approved in writing.

Why switching is harder in parts of Texas

In Harris, Dallas, Bexar and Tarrant counties, dropping an Advantage plan usually means choosing among several alternatives. In the rural counties of West Texas and the Panhandle, there may be only one or two plans available at all, so switching can mean effectively choosing between the plan you have and Original Medicare.

That makes the Medigap underwriting question sharper for rural Texas residents. If the only realistic path off an Advantage plan is Original Medicare plus a supplement, and a supplement requires passing underwriting, the practical number of options can be one.

Switching questions

Will I be asked health questions? Not for Medicare Advantage or Part D. Almost always for Medigap outside a guaranteed-issue window.

Can I be turned down for an Advantage plan? No, with the narrow exception of certain plans for people with End-Stage Renal Disease. Advantage plans cannot medically underwrite.

Do I need to cancel my old plan? No. Enrolling in a new Medicare Advantage or Part D plan automatically disenrolls you from the previous one. Cancelling separately can create a gap, so let the new enrollment do it.

Guaranteed-issue rights that override underwriting

There are specific situations where a Texas insurer must sell you a Medigap policy regardless of your health, outside the usual six-month window. The most common is trial right: if you joined a Medicare Advantage plan when you first became eligible for Medicare and you leave it within the first twelve months, you can generally buy a supplement with guaranteed issue.

A second applies if your Medicare Advantage plan leaves your county or ends its contract, and a third if you moved out of the plan's service area. In each case the window is time-limited, usually about 63 days, and it is your responsibility to act within it rather than the carrier's to remind you.

These rights are the reason the first twelve months on an Advantage plan are worth treating as a genuine trial period. If the network turns out not to fit, that is the cheapest moment to change course, and the window does not reopen later.