Everyone with a Medicare Advantage plan has two opportunities to change plans each year: during Medicare’s Open Enrollment Period and Medicare’s Annual Enrollment Period. What’s the difference? Although they do have some things in common, the enrollment timeframes and changes you can make are different.
Whether you recently enrolled in a Medicare Advantage plan or have had the same plan for years, you might find your benefits are no longer a good fit and you need to make a change. It’s important to understand Medicare’s different enrollment periods and your options for finding healthcare coverage that better suits your needs.
Medicare Open Enrollment Period (OEP)
The Medicare Open Enrollment Period is taking place now. It runs from January 1 to March 31 each year and is only for those who are already enrolled in a Medicare Advantage plan.
Many people think that after they enroll in a Medicare Advantage plan, they are locked into that plan until fall the Annual Enrollment Period, when they can select a different plan for the following year. However, this is not the case.
During the Open Enrollment Period you can:
- Switch from your current Medicare Advantage plan to another Medicare Advantage plan (with or without drug coverage).
- Switch from your Medicare Advantage plan back to Original Medicare and join a separate Medicare Prescription Drug Plan.
During this enrollment period, you cannot switch from Original Medicare to a Medicare Advantage plan.
Your new benefits will be effective on the first day of the month after you make the change.
There are many reasons seniors with Medicare Advantage plans decide to change plans. They might realize they did not fully understand their benefits and picked the wrong coverage. There may have been changes to their plan that make it no longer the best option for them, such as changes to the doctor and hospital network. Alternatively, higher out-of-pocket costs for premiums, deductibles, coinsurance, copays, or prescription drugs may make them rethink their plan choice.
In other cases, the holders’ circumstances may have changed. They may have enrolled in an HMO plan but now want the option for out-of-network coverage with a PPO plan. Perhaps they have received a new medical diagnosis and wish to seek medical treatment out of their area. Lastly, they may have decided to travel for part of the year and want the flexibility to see doctors outside of their HMO network.
Be sure to reach out to an agent to discuss any planned changes. As you can only make one change during this enrollment timeframe, you should be certain you are making the right decision. You cannot make another change until Medicare’s Annual Enrollment Period in the fall, unless you qualify for a Special Enrollment Period.
Medicare Annual Enrollment Period (AEP)
Most people are familiar with the fall enrollment period that runs from October 15 to December 7 every year. It differs from the Open Enrollment Period in what you are allowed to do.
During the AEP enrollment period (October 15 to Dec 7) you can:
- Switch from one Medicare Advantage plan to another
- Switch from a Medicare Advantage plan back to Original Medicare
- Switch from Original Medicare to a Medicare Advantage plan
- Switch from a Medicare Advantage plan with drug coverage to one without drug coverage
- Switch from a Medicare Advantage plan without to drug coverage to one with drug coverage
- Join a Medicare Prescription Drug plan, drop a Medicare Prescription Drug plan, or switch from one Medicare Prescription Drug plan to another
Your new benefits will go into effect on January 1 of the following year.
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