No Need to Wait for Open Enrollment



🔍 TL;DR: Seniors Can Switch from Managed Medicare to Traditional Medicare during Nursing Home Stay – No Need to Wait for Open Enrollment!

Dear Seniors and Families,

At HHS Solutions, we understand that navigating the world of Medicare can be complex, especially when faced with the need for nursing home care. One common question we receive is whether seniors must wait for open enrollment to transition from managed Medicare to traditional Medicare during a nursing home stay. We are pleased to share the answer with you – no, you don’t have to wait!

Medicare recognizes that certain situations, like a nursing home stay, may require a change in your healthcare coverage. According to Part D guidelines, there are Extreme Circumstances provisions that allow seniors to switch from managed Medicare to traditional Medicare outside of the usual open enrollment periods.

👵🏽 Why Consider Switching during Nursing Home Stay?

Nursing home stays often bring unique healthcare needs, and traditional Medicare may better align with the services required during this time. It’s crucial to explore your options to ensure you have the most suitable coverage for your specific situation.

💡 Understanding Extreme Circumstances:

Extreme Circumstances, as outlined in Medicare Part D, take into account scenarios like nursing home stays. This provision recognizes the urgency of certain health-related transitions and allows seniors to make changes to their Medicare coverage outside of the typical enrollment windows.

🏥 How to Make the Switch:

If you find yourself in a nursing home and believe that transitioning from managed Medicare to traditional Medicare is the right choice for you, here’s what you can do:

Consult Your Healthcare Provider: Speak with your healthcare provider to discuss your current health needs and whether traditional Medicare might better meet those needs during your nursing home stay.

Contact Your Medicare Plan: Reach out to your current Medicare plan to inquire about the process of switching to traditional Medicare under Extreme Circumstances. They can provide guidance on the necessary steps and documentation.

Stay Informed: Keep yourself informed about your Medicare options and rights. Understanding the rules surrounding Extreme Circumstances ensures you make informed decisions about your healthcare coverage.

Wishing you and your loved ones good health and peace of mind.


-HHS Solutions Team