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Medicare Open Enrollment

 

November 1, 2018



The Medicare Open Enrollment period is from October 15th until December 7th each year.

During the annual enrollment period (AEP) you can make changes to various aspects of your coverage. You can switch from Original Medicare to Medicare Advantage, or vice versa. You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another. And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria: You must be enrolled in Medicare Part A and B. You must live in the plan’s service area. You cannot have End-Stage Renal Disease (some exceptions apply).

Medicare Advantage plans continue to see changes

While healthcare reform is slowly reducing rebates paid to Medicare Advantage plans, these plans continue to be popular. Thirty-three percent of Medicare recipients were enrolled in a Medicare Advantage plan in 2017—a significant increase from the enrollment total in 2009 when the ACA was signed into law. Most people continue to have numerous Medicare Advantage plans as well as Part D plans available to them. However, these providers can change the coverage options they offer from year to year so it’s important to stay up-to-date.

Is auto-renewal available?

If you’re already enrolled in a Medicare Part D prescription plan or a Medicare Advantage Plan and you don’t want to make changes to your coverage for the coming year, you don’t need to do anything during open enrollment, assuming your current plan will continue to be available. If your plan is being discontinued and isn’t eligible for renewal, you will receive a non-renewal notice from your carrier prior to open enrollment. If you don’t, it means you can keep your plan without doing anything during open enrollment.

But be aware that your benefits and premium could change from one year to the next. So even if you’re confident that you want to keep your current coverage for the following year, it’s important to make sure you understand any changes that may apply, and that you’ve double checked to make sure that your current plan is still the best available option. The available plans and what they cover changes from one year to the next, so even if the plan you have now was the best option when you shopped last year, it’s important to verify that again before you lock yourself in for another year.

Changing Medicare Advantage coverage after the annual enrollment period

Between January 1 and February 14 each year, if you are enrolled in a Medicare Advantage plan, you can leave your plan and return to original Medicare. You cannot switch to another Advantage plan unless you have a circumstance that affords you a Special Enrollment Period.

After you leave your plan, you will have until February 14th to enroll in a Part D plan that will begin the first day of the following month after you enroll.

Enrolling in Original Medicare

If you didn’t sign up for Medicare A and B when you were first eligible, you have a chance to do so each year from January 1st to March 31st, with coverage effective July 1st. You may be subject to a late enrollment penalty, however. For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12 month period that you were eligible but not enrolled.

Each year, most Medicare beneficiaries should receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing Medicare Advantage and Medicare Part D plan providers by September 30th. CMS makes information available to the public on http://www.Medicare.gov in October. The Medicare website is also a tremendous asset for individuals with questions about Medicare rules, timelines, Medicare Part D, etc.

It’s important to carefully review the information sent to you by your plan provider, since this will cover any possible changes. For example, increasing co-pays, changes to drug formularies or changes to treatment coverage. Once open enrollment gets underway, you can make changes that reflect your current health coverage needs.

 
 

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