Jack's Blog on Medicare Plan Choices

What happens to your medical and drug deductibles if you switch plans mid-year?

Medicare Advantage (MA) plans operate on a calendar year basis (January-December) for deductibles. When you switch plans mid-year:

1. Medical Deductibles:

Any amount you’ve paid toward your deductible on your old plan does NOT transfer to your new plan

You’ll start over with the new plan’s deductible, even if you already met your previous plan’s deductible

You’ll need to meet the full deductible amount on your new plan regardless of what you paid before

2. Prescription Drug Deductibles:

Similar to medical deductibles, drug deductibles also start over with your new plan

Money spent on prescriptions under your old plan won’t count toward your new plan’s deductible

You’ll need to meet the new plan’s full drug deductible before drug coverage begins

Special note: Mid-year plan changes are typically only allowed during Special Enrollment Periods (SEPs) triggered by specific qualifying events. It’s important to consider these deductible implications when deciding to switch plans mid-year.

Here is my disclaimer.  I gather most of my information from Medicare.gov and CMS.gov and to the best of my knowledge, it is accurate.  Please use this information as a guideline.

Before choosing an Advantage or Supplement plan, ensure you have a thorough understanding of Medicare itself. When it’s time to explore your options, don’t fall for a sales pitch from a single company or an agent representing only one provider.

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