Having the right healthcare coverage has never been more important. While your current Medicare plan may have worked well in the past, how do you know it’s still the best option going forward?
Not only will your health and prescription needs change, but so do the costs and coverages offered by each provider. That’s why it’s essential to speak with your agent before the upcoming Medicare Annual Enrollment Period (AEP) so you’ll be prepared.
Let’s take a closer look at the key dates and details you need to know.
When Is It?
The Medicare Annual Enrollment Period takes place from October 15th thru December 7th. Changes made during this period go into effect on January 1st.
What You Can Do
During the AEP, also known as Medicare Fall Open Enrollment, you can make the following changes to your coverage:
- Exit Original Medicare (Part A and Part B) and sign up for a Medicare Advantage plan (Part C).
- Exit your Medicare Advantage plan (Part C) and sign up for Original Medicare (Part A and Part B).
- Change from one Medicare Advantage plan to another.
- Change your Medicare Advantage plan from one that doesn’t offer prescription drug coverage to one that does.
- Change your Medicare Advantage plan from one that provides prescription drug coverage to one that doesn’t.
- Sign up for, change, or remove a Medicare Part D prescription drug plan.
Why It Matters
Each year, the insurance companies offering Medicare Advantage plans (Part C) and prescription drug plans (Part D) make updates to the prices and coverages available. These range from which providers and pharmacies are considered in network, to the types of medications covered and the associated costs involved.
Because these changes can have a significant impact on the type and cost of care you receive, it’s important to review them.
Know What’s Changing
Regardless of the type of Medicare coverage you have, you will receive a detailed explanation of the modifications being made to your existing plan prior to open enrollment 2021.
If you’re already enrolled in a Medicare Advantage plan, your current provider will send out an Annual Notice of Change (ANOC), an Evidence of Coverage (EOC), or both. These will contain the important details you need to know about what’s changing in the upcoming year. They usually arrive in September.
If you’re enrolled in Original Medicare (Part A and Part B), then you will receive the Medicare & You booklet. It comes out each September and contains the pricing and coverages going into effect next year. Then you can examine and compare them to the Medicare Advantage (Part C) options available in your area.
What to Look at Specifically
Here are some of the key factors to evaluate:
- Are your current healthcare providers considered in network?
- What types of visits are covered and at what cost?
- Is your preferred pharmacy in network?
- Are the medications you’re taking covered?
- Have the overall plan costs and coverages changed so you will be paying more (or less) out of pocket?
Why Make a Change
Once you examine the upcoming changes to your current plan, it’s a perfect time to see what other plans have to offer.
You may discover Medicare Advantage options that are better suited to your current health needs while also saving on premiums or medical visits in the process.
In addition, if you have a prescription drug plan (Medicare Part D), you will want to find out whether other plans in your region offer better pricing for the medications you require.
Once you have selected the best Medicare plan for you, you’ll be all set to sign up during the Medicare Fall Open Enrollment beginning October 15th.
(Prescription Drug Plan Note: If you choose to remove your Medicare Part D prescription drug coverage and later opt to re-enroll, you could be charged a late-enrollment penalty. This goes into effect if you lack coverage for 63 consecutive days or longer.)
Other Medicare Enrollment Periods
While it’s best to take advantage of the Medicare Annual Enrollment Period so your coverage will be in place at the start of the new year, that’s not always possible. If you need to make changes outside of the Oct 15th thru December 7th timeframe, here are some opportunities to do just that.
- Special Enrollment Period (SEP) – Life happens, and Medicare understands this. For example, if you’re newly married, divorced, or have moved outside of your current plan’s jurisdiction. Perhaps you’ve begun (or completed) a stay in an extended-care facility. Sometimes Medicare may terminate its contract with your provider. These are just a few of the situations that would qualify. This enrollment period will allow you to update your coverage.
- Initial Enrollment Period (IEP) – When you first become eligible for Medicare, this is the period when you can sign up. It starts three months before your 65th birthday month and continues through three months after it. This provides you with seven months to complete your enrollment.
- General Enrollment Period (GEP) – This enrollment period spans from January 1st through March 31st. It is for individuals who did not sign up during their Initial Enrollment Period and do not qualify for a Special Enrollment Period.
- Medicare Advantage Open Enrollment Period (OEP) – This enrollment is available from January 1st thru March 31st. You may use it to move from one Medicare Advantage plan to another Medicare Advantage plan or to make changes to your prescription drug coverage.
In addition, you may change from a Medicare Advantage plan to Original Medicare (Parts A and B). However, you cannot switch from Original Medicare to a Medicare Advantage plan during this period. So if you want to sign up for a Medicare Advantage plan, update your coverage during the Medicare Annual Enrollment Period, from October 15th through December 7th.
If you make changes during the Open Enrollment period, they will go into effect on the first day of the month following the receipt of your request by your new provider.
While there are many factors to keep in mind, the bottom line is you have the power to choose the best Medicare option available to you. Think about your health care and prescription needs over the past year and the procedures you may have planned for the future. Find out more about the plans available and identify which one will best meet your needs going forward. Then sign up during the Medicare Annual Enrollment Period, and enjoy peace of mind for the year ahead!