The Medicare Open Enrollment Period – which is also now known as the Medicare Annual Election Period – happens every year in the fall.

It starts on October 15th and goes until December 7th, giving beneficiaries a chance to change their Medicare coverage and benefits. Those new benefits and coverage will go into effect on January 1st 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 do not have to take advantage of the open enrollment period every single year. Every year in September you will receive an Annual Notice of Change from your coverage provider(s). If you’re happy with the upcoming changes and don’t want to alter your benefits in any way, you can avoid the hassle.

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.

Medicare Open Enrollment Periods

Switching Between Original Medicare and Medicare Advantage

During the Medicare open enrollment period, beneficiaries can choose to either switch from Original Medicare to a Medicare Advantage plan or to switch 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 just sit back and enjoy your retirement years.

Managing Your Part D Prescription Drug Plan

During the Open Enrollment Period, you also have the option to either enroll in, change or discontinue your Medicare Part D prescription drug plan.

Here are some of the 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 back 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 cannot have Medicare Part D and Medicare Advantage at the same time. This is because Medicare Advantage plans come with their own prescription drug coverage. It’s illegal for providers to sell you duplicate coverage.

If you’re switching from Original Medicare to Medicare Advantage or vice versa, you’ll also need to make changes to your prescription drug plan so that you can keep getting the medication you need to preserve your health.

FAQs

Changing your Medicare benefits and creating a plan that’s right for you is a very personal event. It’s 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 just 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 ger rates using our rate form now.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.