Whether you’re new to Medicare or have been enrolled for years, it’s always good to make sure you’re getting the most out of your benefits. Not only will your health care needs change over time, but some of your coverages and costs may as well.
Medicare understands this and has rules in place regarding when updates to your coverage can be made. Discover what they are, the deadlines you should be aware of, and which changes are allowed to help you maximize your health benefits.
Medicare AEP at a Glance
There are different enrollment periods for the various Medicare plans offered. If you’re interested in signing up for or making changes to a Medicare Advantage plan or a Medicare Prescription plan, then the Medicare Annual Election Period (AEP) is the perfect time to do so.
- Key Dates: The Medicare AEP takes place October 15th thru December 7th.
- Who It’s for:
- Those who want to make changes to their existing Medicare Advantage Plan or Medicare Prescription Drug Plan.
- Those who signed up for Original Medicare (Parts A and B) during their initial enrollment period and wish to change to a Medicare Advantage plan (Part C).
- Those who want to enter or exit a Medicare Prescription Drug Plan
- Those who want to exit their Medicare Advantage plan and enroll in Original Medicare.
- Why You Should Take Advantage:
- Review your current and projected health care needs. Are they being met by your current Medicare plan? Could additional or different benefits be helpful, such as prescription coverage?
- Has your Medicare Advantage plan changed its costs or coverages? Is it still the best one for you, or is there a more suitable one?
Let’s take a closer look at the specifics of Medicare coverage and how you can make the most of the upcoming Medicare Annual Election Period.
Medicare’s Main Parts
Here’s a brief overview of the types of coverages Medicare offers:
- Medicare Part A – This is hospital insurance. It provides coverage for inpatient care at hospitals, skilled nursing facilities, and hospice care.
- Medicare Part B – This is medical insurance. It provides coverage for selected doctors’ treatments, outpatient services, medical supplies, and preventative care.
- Medicare Part C – Also known as Medicare Advantage, this type of plan bundles together Medicare Part A and Part B, and often Part D. In addition, most plans offer bonus benefits that Original Medicare (comprised of Parts A and B) will not. These may include dental, hearing, vision, and more. These plans are provided by private organizations with Medicare’s approval, ensuring that they meet Medicare’s coverage requirements.
- Medicare Part D – This is prescription drug coverage. Not only does it assist with costly medications, but it can also help with vaccines and shots. You can choose to obtain it with Original Medicare or Medicare Advantage plans.
Changing Your Medicare Coverage
Now that you know the main types of coverage available, let’s examine when you’re eligible to make changes to the Medicare plan you have.
Typically, you’ll want to take advantage of the Annual Election Period (AEP). This happens during the same time each year. Sometimes, however, special circumstances arise and a Special Enrollment Period (SEP) is needed. We’ll look at each of these options in turn.
What is AEP
October 15th through December 7th is the Medicare Annual Election Period (AEP). During this time, you may make the following changes to your plan:
- Exit Original Medicare (Part A and Part B) and join a Medicare Advantage Plan (Part C).
- Exit your Medicare Advantage Plan and sign up for Original Medicare.
- Change from one Medicare Advantage plan to another Medicare Advantage Plan
(Potentially adding or removing a prescription drug benefit in the process)
- Add a Medicare Part D plan to your Original Medicare coverage.
- Remove your Medicare Part D coverage.
Any updates you make to your coverage during this period will become official on January 1st.
Why Make Changes during the Medicare AEP?
Your health evolves from year to year, and your coverage should, too. Invest a little time now to see what Medicare plans are best suited to your needs.
Are you requiring more prescriptions or health visits than before? Or perhaps the reverse is true and you don’t need all of the benefits you currently have.
Is there a more cost-effective plan available in your area that offers the coverage you need? Are there new benefits being offered in a different plan that would be helpful to you?
The time you invest in examining your coverage now could yield major benefits in the year ahead.
Additional Enrollment Periods
While the Annual Election Period happens during the same timeframe each year, Medicare recognizes that additional enrollment periods are required. Here’s a brief look at the different types available:
- Special Enrollment Period – This is for people whose individual circumstances have changed. Specifically, you may have moved to a location outside of your current plan’s jurisdiction, or into or out of an extended-care facility. Perhaps Medicare terminated its contract with your provider. These are just a few examples.
- Initial Enrollment Period (IEP) – As the name suggests, this is for newly eligible Medicare enrollees. It begins three months before your 65th birthday month and concludes three months after it, spanning a total of seven months.
- General Enrollment Period (GEP) – This begins January 1st and ends March 31st. It may be used by those who did not sign up during their IEP and do not meet the criteria for a SEP.
- Medicare Advantage Open Enrollment Period – This begins January 1st and ends March 31st. During this period, you may change from one Medicare Advantage plan to another, and prescription drug coverage changes are allowed. You may also switch from Medicare Advantage to Original Medicare (Parts A and B). Note that your new coverage will become effective on the first day of the month following the receipt of your request by your new provider. NOTE: This enrollment period does not allow you to switch from Original Medicare to a Medicare Advantage plan. So if you’re looking to do so, be sure you change your coverage during the Medicare Annual Election Period (AEP), from October 15th through December 7th.