How to Switch Medicare Plans in Lawrence

Name: Lawrence Senior Insurance
Address: 911 Massachusetts St b8, Lawrence, KS, 66044
Telephone: 785-247-1314

Your healthcare needs change over time. The Medicare plan that worked well when you first enrolled might not meet your needs today. Maybe your doctor left your plan’s network, your medications changed, or your health status shifted. Whatever the reason, you may need to switch Medicare plans.

Switching plans isn’t as simple as calling your insurance company whenever you want. Medicare has specific enrollment periods that control when you can make changes. Understanding these windows helps you switch to better coverage without losing access to care.

This guide explains when Lawrence seniors can switch Medicare plans, what options you have during different enrollment periods, and how to compare plans before making a change.

When Can You Switch Medicare Plans?

You cannot switch Medicare plans anytime you want. Medicare restricts plan changes to specific enrollment periods throughout the year.

The rules differ depending on what type of coverage you have. Medicare Advantage enrollees have more flexibility to switch plans than people with Medigap. Original Medicare beneficiaries can add Medicare Advantage during certain periods but face restrictions when trying to add Medigap outside their initial enrollment window.

Here are the main enrollment periods when you can make changes:

Each period has different rules about what changes you can make. Let’s break down each one.

Medicare Annual Election Period (October 15 - December 7)

The Annual Election Period, often called AEP or Fall Open Enrollment, is the most important time to review and change your Medicare coverage. This period runs from October 15 through December 7 every year.

During AEP, you can:

Switch from one Medicare Advantage plan to another Medicare Advantage plan
Switch from Medicare Advantage back to Original Medicare
Switch from Original Medicare to a Medicare Advantage plan
Join a Part D prescription drug plan
Switch from one Part D plan to another
Drop your Part D coverage

Any changes you make during AEP take effect on January 1 of the following year.

This enrollment period gives you the broadest range of options. You don’t need a special reason to make changes. You simply review your current coverage, compare it to other available plans, and switch if you find better coverage.

Lawrence seniors should use this time to check whether their current plan still meets their needs. Review your plan’s formulary to confirm it covers your medications. Check that your doctors still participate in the network. Compare your plan’s costs to other options available in Douglas County.

If you want to switch from Medicare Advantage to Original Medicare during AEP, you can also add Medigap coverage. But you won’t have guaranteed issue rights unless you qualify for a special situation. Insurance companies can ask health questions and potentially deny your Medigap application based on pre-existing conditions.

Medicare Advantage Open Enrollment Period (January 1 - March 31)

The Medicare Advantage Open Enrollment Period gives people already enrolled in Medicare Advantage a second chance to make changes. This period runs from January 1 through March 31 each year.

This enrollment period has limited eligibility. You can only use it if you’re currently enrolled in a Medicare Advantage plan. People with Original Medicare cannot make changes during this period.

During the Medicare Advantage Open Enrollment Period, you can:

You can only make one change during this period. Once you switch plans, you cannot make another change until the next enrollment period.

Changes made during this period take effect the first day of the month after your plan receives your enrollment request.

This enrollment period helps Lawrence seniors who chose a Medicare Advantage plan during AEP but discovered problems after their coverage started. Maybe the network was smaller than expected, or prior authorizations created delays in care. The Medicare Advantage Open Enrollment Period gives you a chance to fix these issues.

Special Enrollment Periods

Special Enrollment Periods let you change your Medicare coverage outside the regular enrollment windows if you experience certain qualifying life events.

Common triggers for Special Enrollment Periods include:

Moving to a new address

If you move outside your current plan’s service area or move to an area where new plans are available, you can switch plans. This includes moving within Lawrence if new options become available at your new address.

Losing current coverage

If you lose employer coverage, Medicaid, or other health insurance, you qualify for a Special Enrollment Period to enroll in Medicare coverage.

Plan leaving your area

If your Medicare Advantage plan stops serving Douglas County or your plan’s contract with Medicare ends, you can choose a new plan.

Qualifying for Medicaid or Extra Help

If you become eligible for Medicaid or the Medicare Part D Extra Help program, you can change your drug coverage or Medicare Advantage plan.

Other qualifying events

Moving into or out of a nursing home, gaining or losing employer coverage, and certain plan compliance issues can trigger Special Enrollment Periods.

The length of your Special Enrollment Period depends on which qualifying event you experience. Most last for several months, giving you time to research options and choose new coverage.

LMH Health Network Changes - Why Some Lawrence Seniors Need to Switch

Lawrence Medicare beneficiaries faced a major network change in January 2025. LMH Health dropped Aetna and Humana Medicare Advantage plans from its network.

If you have an Aetna or Humana Medicare Advantage plan and want to continue receiving care at LMH Health, you need to switch to a different plan.

Your options include:

Blue Cross Blue Shield Medicare Advantage plans (which include LMH Health in their networks)
UnitedHealthcare Medicare Advantage plans (which include LMH Health)
Wellcare Medicare Advantage plans (which include LMH Health)
Original Medicare plus a Medicare supplement plan (LMH accepts all Medigap plans)

If you have Aetna or Humana Medicare Advantage and didn’t switch during the recent Annual Election Period, you can still make changes during the Medicare Advantage Open Enrollment Period (January 1 through March 31). This network change qualifies as a reason to switch plans.

Staying in your current Aetna or Humana plan means you’ll pay out-of-network costs if you receive care at LMH Health. These costs are significantly higher than in-network rates, and some services may not be covered at all.

How to Compare Plans Before Switching

Switching Medicare plans is a big decision. You need to compare plans carefully to make sure your new coverage meets your needs without costing more than necessary.

Follow this checklist before switching plans:

Check if your doctors are in the new plan's network

Check if your prescriptions are on the plan's formulary

Compare monthly premiums

Compare out-of-pocket maximums

Compare copays for services you use often

Check star ratings for quality

This comparison process takes time, but it protects you from switching to a plan that costs more or provides worse access to care.

Switching Medigap Plans

Switching Medigap plans follows different rules than switching Medicare Advantage plans. You usually cannot switch Medigap plans without answering health questions.

After your initial six-month Medigap Open Enrollment Period ends, insurance companies can use medical underwriting when you apply for a new Medigap plan. They can review your health history and potentially:

Kansas does provide some guaranteed issue rights in specific situations. You may be able to switch Medigap plans without medical underwriting if:

The rules for switching Medigap coverage are complex and depend on your individual circumstances. Contact a licensed insurance agent to understand your options before trying to switch plans.

Get Help Switching Medicare Plans

Comparing Medicare plans and understanding enrollment periods requires detailed knowledge of coverage rules and local plan options. You don’t need to navigate this process alone.

Licensed Medicare insurance agents can help you compare plans available in Lawrence, check provider networks, review drug formularies, and enroll in new coverage during the appropriate enrollment period. This service is free and comes with no obligation to purchase.

Ready to explore your Medicare plan options? Call 785-247-1314 to speak with a local agent who can help you compare plans and switch to coverage that better meets your needs.