Most people are aware that you can enroll in or make a Medicare Advantage or Part D plan change during the Medicare Annual Enrollment Period (AEP), which runs from October 15th thru December 7th every year. It’s hard not to know about this window, with all the advertising and mail solicitations that you are likely bombarded with during this time!
Did you know that Medicare has another enrollment period where you may be able to make plan changes too, called the Medicare Advantage Open Enrollment Period (MA OEP)? From January 1st thru March 31st every year, this MA OEP allows some Medicare plan changes as well.
Medicare Annual Enrollment Period (AEP) vs. Medicare Advantage Open Enrollment Period (MA OEP)
You may wonder what the differences are between these two separate enrollment periods. The Annual Enrollment Period is for anyone who is enrolled in Medicare to make coverage elections or changes to their Medicare Advantage or Part D plans for the upcoming year, while the Medicare Advantage Open Enrollment Period is only for those who are currently enrolled in a Medicare Advantage plan.
Below illustrates what you can and cannot do during the Medicare Advantage Open Enrollment Period:
Here’s what you can do during the Medicare Advantage Open Enrollment Period:
- If you’re enrolled in a Medicare Advantage Plan, with or without Part D drug coverage, you can switch to another Medicare Advantage Plan, with or without Part D drug coverage.
- You can disenroll from a Medicare Advantage plan and return to Original Medicare. If you do this, you can also join a stand-alone Part D drug plan to cover prescriptions. (note that in most states, moving from a Medicare Advantage plan to Original Medicare does not guarantee that you can enroll in a Medigap plan without a medical underwriting review)
During the Medicare Advantage Open Enrollment Period, you can only make one plan change. Any change made will take effect on the first of the following month.
Here’s what you can’t do during this period unless you have a qualifying special enrollment situation.
- Switch from Original Medicare to a Medicare Advantage plan.
- Enroll in a stand-alone Part D prescription plan if you are in Original Medicare.
- Switch from one Part D prescription plan to another Part D prescription plan, if you are in Original Medicare.
Without a special qualifying enrollment situation, you would likely need to wait until the next Medicare Annual Enrollment Period to make these changes. The Medicare Annual Enrollment Period runs October 15th thru December 7th every year.
Should You Re-Evaluate Your Coverage?
If you are currently enrolled in a Medicare Advantage plan, and unhappy with or unsure about your choice, you can re-evaluate your options and if desired, make a plan change during the MA OEP that runs January 1st thru March 31st. Plan changes are effective the first of the month after you request the change. Benefits, provider networks, and drug costs can vary widely amongst plans so this can be a good opportunity to re-evaluate your options if you aren’t happy about your current selection.
Here are some key considerations when re-evaluating Medicare Advantage plan coverage:
- Is your plan’s monthly premium affordable for you?
- Are your preferred providers in your plan’s network? Make sure to check that your providers are in your plan’s network every year, as plan provider networks can and do change.
- Are your medications included in your plan’s formulary and are the costs reasonable?
- Is your preferred pharmacy in your plan’s network?
- Are your medical costs such as deductibles, copays, and coinsurance affordable for you?
- Do you have the extra benefits that you want for things like dental, vision, hearing exams and hearing aids, over-the-counter item allowance, and a fitness or gym membership?
- Does your plan offer a Part B premium-reduction benefit or Part B premium Give Back? In some regions, plans can include a monthly credit towards your Part B monthly premium. This can show as an increase in your Social Security check or a credit on your Part B premium bill.
If you would like to speak with an independent licensed Medicare agent to better understand the options available to you, contact us today.