Medicare Open Enrollment Period
Because there is some confusion as to what the Medicare Open Enrollment Period actually is, we will take a few minutes to explain it.
Many people confuse the term Medicare open enrollment period or OEP and the term Medicare Annual Enrollment or AEP. It important to understand the differences between these two enrollment periods.
The Medicare OEP, Open Enrollment Period:
This enrollment period takes place each year from January 1 to March 31. Anyone who is enrolled in a Medicare Advantage plan (Part C) can use this enrollment period to go over their current MA plan and make changes if they are necessary.
What can enrollees do during this time:
- Change from one MA or MAPD (Part C) plan to a different MA or MAPD plan.
- Drop your MA/MAPD plan and go back to Original Medicare (Parts A & B).
- If you go back to original Medicare, you can Enroll in a Medicare PDP prescription drug plan (Part D).
The new plan starts on the first day of the month following the submission of the member’s application.
Please note; the Medicare Advantage Open Enrollment Period is for Medicare Advantage plan members only.
Beneficiaries on Original Medicare cannot switch to a Medicare Advantage plan at this time. If that is what they want to do, they must wait for the Medicare Annual Enrollment Period.
The Medicare AEP, Annual Enrollment Period:
During this enrollment period, it is wise to review your client’s Medicare coverage and make any changes they decide on. The AEP runs from October 15th through December 7th each year.
What can beneficiaries do during AEP:
Switch from Original Medicare to Medicare Advantage (or vice versa).
If you’re enrolled in Original Medicare (Part A and Part B) and want to add benefits such as; prescription drug coverage, dental, vision, OTC and more, you may wan to try a Medicare Advantage plan. On the other hand, if you’re on a Medicare Advantage plan and want the flexibility of Original Medicare, you can return to it.
- Change Medicare Advantage Plans: If you’re already enrolled in a Medicare Advantage plan that doesn’t fully meet your needs, you can explore different plan options in your area.
- Enroll in a prescription drug plan (Part D): If you don’t have credible prescription drug coverage through your current plan or are in Original Medicare, you can join a standalone Medicare Prescription Drug Plan to help manage medication costs.
- Enrollees can either switch or drop prescription drug plans: Beneficiaries already enrolled in a Part D plan should compare prescription drug plans each year to ensure they have the most suitable coverage for their needs.
- Review Medicare Supplement Insurance (Medigap) Policies: Although Medicare Supplement plans are not part of the Annual Enrollment Period, it is a good idea to review these plans annually to assess whether they offer the best coverage for your needs.
Why are the Medicare Open Enrollment Period & Annual Enrollment periods important:
The significance of these enrollment periods is that they allow beneficiaries an opportunity to reassess their healthcare needs as their circumstances change. This gives them a chance to potentially save money on premiums, deductibles, and copayments or purchase additional coverage.
Anyone who fails to take advantage of this window may be stuck in an ineffective or expensive plan for another year. This can result in less coverage than they need and higher medical costs.
Tips to Help Clients Make Informed Choices:
- Assess Current Coverage: Review your client’s current plan to identify any gaps in coverage or services they require. Consider their healthcare expenses over the past year and anticipate any potential changes in healthcare needs for the upcoming year.
- Compare Plans: Use your resources through connecture or sunfire to compare the various plans available in the area. Look for plans that cover your specific medical needs, including prescription drugs, doctors, and hospitals.
- Check for Plan Changes: Insurance providers can make changes to their plans each year. This includes adjustments to premiums, drug formularies, and networks. Be sure you understand how these changes impact coverage and costs.
- Consider Future Needs: While it’s essential to address current healthcare needs, try to anticipate possible medical events or changes that may require different coverage choices in the future.