Getting Ready for Medicare Open Enrollment
Medicare has several periods each year when beneficiaries
can make important plan changes and coverage elections. However, we often find
that many beneficiaries are not certain what each of these election periods is
for and what they should be doing each year to review their coverage.
In this post, we’ll explain the upcoming windows and how you
can prepare for them.
Medicare Open Enrollment Period vs Annual Election Period
Medicare uses the term “open enrollment” for multiple
different election periods, so it’s easy to get them confused. We find it
easiest if beneficiaries refer to the fall enrollment period as the Annual
Election Period (AEP). This helps to keep the election periods straight in your
mind.
The Annual Election Period begins October 15th
and goes until December 7th. There is also a new Medicare Open
Enrollment Period for 2019 which will go from January 1st to March
31st. Let’s go over what
changes you can make in each period because they are different.
Medicare’s Annual Election Period: October 15 – December 7
When you enroll in a Medicare Advantage plan
or a Part D drug plan, you are locked in for the rest of the calendar year. You
must wait until the Annual Election Period to make changes to your plan(s).
During the AEP you can switch from one Medicare Advantage
plan to another and you can switch from one Part D drug plan to another drug
plan. You can also switch from a Medicare Advantage plan back to Original
Medicare and vice versa.
When you make any of these changes during the AEP, your new
plan goes into effect January 1st of the following year. (If you don’t
make any changes to your current plan, your current plan will auto-renew for
the next year.)
Medicare’s New Open Enrollment Period: Jan 1 – March 31
Sometimes people who enroll in a Medicare Advantage plan
during the AEP find that they do not like their new plan. It could be that they
did not understand their coverage, or it might also be that they learned too
late that one of their doctors is not in the network.
In recent years, these beneficiaries would be locked into
that plan for the entire year. However, beginning in 2019, Medicare has a new Open Enrollment period from January 1st
to March 31st that will allow beneficiaries who are enrolled in a
Medicare Advantage plan to make a one-time change.
During this OEP, they can change to a different Medicare Advantage
plan or they can disenroll from their Advantage plan to return to Original
Medicare and elect a new standalone Part D drug plan to go alongside that
coverage.
It’s important to note that if you drop your Advantage plan
and decide not to enroll in a Part D plan, you can be penalized for the time
you go without creditable drug coverage.
Here’s a recap:
The Medicare Annual Election period in the fall is
for all Medicare beneficiaries. It is for enrolling in, disenrolling from or
changing either your Medicare Advantage plan or your Part D drug plan. The last
plan selection that you make prior to December 7th will become
effective January 1st.
The Medicare Open Enrollment Period which begins in
January only applies to beneficiaries who are enrolled in a Medicare Advantage
plan. These beneficiaries can either switch from one Medicare Advantage plan to
another or they can switch from a Medicare Advantage plan back to Original
Medicare.
You cannot switch from one Part D drug plan to another
during the OEP. That’s the main difference between the AEP and the OEP.
Your Annual Notice of Change Letter
The first step to getting ready for the AEP is to review your Annual Notice of Change (ANOC). Your ANOC is a letter sent to you by your
current Medicare Advantage plan or Part D drug plan.
This letter states all changes that your current insurance carrier
is making for the following year. It lists changes in monthly premiums, copays,
coverage, deductibles, and drug formularies. You will want to review this
thoroughly to ensure you make the right decision during the AEP.
Medigap Open Enrollment
To add to the confusion around the term “open enrollment,”
there is also a one-time Open Enrollment period for Medigap plans.
The Medigap Open Enrollment is a one-time window that begins
with your Part B effective date. During the six months directly after your Part
B effective date, all Medicare beneficiaries have a one-time chance to enroll in a Medigap plan without having to answer health questions. This is a “use it
or lose it” enrollment period. Once it has passed, it does not recur again.
This does not mean that later you cannot attempt to change
your Medigap plan. In fact, Medicare beneficiaries can apply for new Medigap
plans anytime throughout the year. However, unless you live in a specific state
with different rules or have a guaranteed issue window because you are leaving
employer group health coverage, you will have to answer health questions
whenever you apply for a Medigap plan outside of your one-time Medigap open
enrollment period. Depending on your answers and your medical record, you could
be denied coverage for a new Medigap plan.
Get Ready with A Medicare Broker
Working with a Medicare broker can take the stress out of
the decision making. A broker can evaluate each of your plan options in your
area and explain any applicable rules. This will help you have more confidence
in your choice.
About Guest Post Author, Danielle Roberts: This guest post was written by our Medicare expert, Danielle Roberts, one of the co-founders of Boomer Benefits
and a frequent contributor to this blog. As always, we greatly
appreciate her willingness to share her expertise and her ability to
calmly explain these difficult-to-understand issues in clear terms.
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