The Medicare Open Enrollment Period – also known as the Medicare Annual Election Period – happens every year in the fall.
It starts on October 15 and goes until December 7, giving beneficiaries a chance to change their Medicare coverage and benefits. Those new benefits and coverage will go into effect on January 1 of the following year.
Here is everything you need to know about getting the most out of your Medicare Open Enrollment Period.
Changes You Can Make During Your Open Enrollment Period
To be clear, you don’t have to take advantage of the Open Enrollment Period every year. Every year in September, you will receive an Annual Notice of Change from your coverage provider(s). You can avoid the hassle if you’re happy with the upcoming changes and don’t want to alter your benefits.
However, if the upcoming changes make your health plan too expensive, remove necessary prescription drugs from your formulary, force you to switch doctors – or any of the above – it’s a good idea to take advantage of the Open Enrollment Period.
Switching Between Original Medicare and Medicare Advantage
During the Medicare Open Enrollment Period, beneficiaries can choose to switch from Original Medicare to a Medicare Advantage plan or from a Medicare Advantage plan to Original Medicare.
There are several reasons why beneficiaries might want to switch from one to the other, such as:
- Your Medicare Advantage plan has become more expensive than the Original Medicare
- There are new Medicare Advantage plans in your area that are less expensive than the Original Medicare
- If your current doctor leaves or gets removed from your Medicare Advantage provider network
- If your prescription drug formulary (with either Medicare Advantage or Medicare Part D) removes or increases the cost of your lifesaving prescription drugs
- And more
The ultimate goal of making changes to your health plan during the Medicare Open Enrollment Period is to get the medical benefits you need from the doctors and providers you want at a price you can afford.
Again, if you’re happy with what you have and you’re not upset by your annual changes, then you don’t have to do a thing. You can sit back and enjoy your retirement years.
Managing Your Part D Prescription Drug Plan
During the Open Enrollment Period, you can enroll in, change or discontinue your Medicare Part D prescription drug plan.
Here are some reasons why beneficiaries might want to consider making these necessary changes during this enrollment window.
- Enroll in Medicare Part D because you’re switching from a Medicare Advantage plan to the Original Medicare.
- Your current provider is increasing their prices, removing the prescriptions you need from their formulary, or both.
- You need to discontinue your current Medicare Part D prescription drug plan because you’re switching from Original Medicare to Medicare Advantage.
Legally, you can’t have Medicare Part D and Medicare Advantage simultaneously. The reason is that Medicare Advantage plans come with their own prescription drug coverage. It’s illegal for providers to sell you duplicate coverage.
Suppose you’re switching from Original Medicare to Medicare Advantage or vice versa. In that case, you’ll also need to change your prescription drug plan to keep getting the medication you need to preserve your health.
Changing your Medicare benefits and creating a suitable plan for you is a personal event. Likely, you’ll still have more questions about what to expect. Here are some of the most frequently asked questions from beneficiaries like you.
Do I have to make changes to my Medicare benefits every single year?
Thankfully, no. As long as you’re happy with your current benefits and costs – and as long as your Annual Notice of Change doesn’t make any changes to your plan that you can’t handle – you can avoid the hassle.
What’s the Medicare Annual Election Period?
The Annual Election Period, or Annual Enrollment Period, is another name for the Medicare Open Enrollment Period.
How does the Medicare Advantage Open Enrollment Period differ from the Medicare Open Enrollment Period?
You can only take advantage of the Medicare Advantage Open Enrollment Period if you currently have a Medicare Advantage plan. And you can only switch to a different Medicare Advantage plan during this window. Regular Open Enrollment is for switching back and forth from Medicare Advantage to Original Medicare or the other way around.
Is there an Open Enrollment Window for Medigap?
Yes, but it’s not annual. You can enroll in a Medicare Supplement plan at any point in the year. There are no restrictions. But if you want to get a plan without going through medical underwriting, you need to enroll in a plan during your Medicare Supplement OEP. This is the case for most states, but some states’ laws differ, so you may want to check with your insurance agent for more details.
How to Get Help During the Medicare Open Enrollment Period
Changing your benefits during open enrollment can be a stressful and confusing process. But we’re here to help. Feel free to reach out and contact us at any time. We can assist you in getting the best plan for your needs. You can also get rates using our rate form now.