If you aren’t happy with your Medicare coverage, you have a once-a-year opportunity to make changes. During the Medicare Annual Enrollment Period, also know as the Medicare Annual Election Period, you can change to a different type of Medicare plan, switch Medicare Advantage plans, or change your prescription drug coverage.
The Medicare Annual Enrollment Period, or AEP, runs from October 15 to December 7.
Changes Allowed During the Medicare Annual Enrollment Period
- Switch from Medicare Advantage (Part C) to Original Medicare Parts A and B
- Switch from Original Medicare to Medicare Advantage
- Change from one Medicare Advantage plan to another
- Sign up for a Medicare Part D prescription drug plan
- Change from one Part D prescription plan to another
- Cancel your prescription drug coverage
Any changes you make during the AEP in 2018 will take effect on January 1, 2019.
Medicare Advantage and Medicare Part D plan benefits change each year. This means your premiums can increase and your benefits may change.
You’ll receive an Annual Notice of Change in September, this will explain any changes that are going to impact your Medicare Advantage or Part D plans.
If you’re unhappy with the changes, you can change your plan during the Medicare Annual Enrollment Period.
Some Reasons Why You Would Want to Change Your Plan During the 2019 Medicare AEP
- Your premiums are increasing a good amount
- Your Medicare Advantage plan no longer has your doctor in your current plan network
- Drug formulary changes drop your medication off the covered drugs list
Do My Medigap Plan Benefits Change During the Annual Election Period?
No, your Medigap benefits do not change like Part D and Medicare Advantage plans do. Since they’re standardized by the government, your plan will cover the same benefits from year to year.
What may change is your premiums. Rate increases do happen annually, on the anniversary date of your policy. Your carrier sends out a letter the month before your anniversary date that informs you of any premium increases.
Medigap Plan Comparison Shopping During AEP
Yes, a lot of beneficiaries like to shop and compare their current Medigap plans during AEP since they’re already shopping for Part D plans. Since benefits are standardized, your benefits will NOT change. You don’t have to be worried about switching plans to find a more affordable premium.
However, you’re not given guaranteed issue during AEP when switching Medigap plans. This only applies for Medicare Advantage and Part D plans. This means, you’ll have to answer health questions and go through medical underwriting, unless you qualify for a Special Enrollment Period.
Switch from Medicare Advantage to Original Medicare
If you are enrolled in Medicare Advantage, you do have additional opportunities to switch your coverage back to Original Medicare.
- The “Medicare Open Enrollment Period” runs from January 1st to March 31st starting in 2019. During this time, you can switch to another Medicare Advantage plan or back to Original Medicare and pick up Part D and a Medicare Supplement plan instead. Your coverage starts on the first day of the month after you enroll.
- You have a right to change from Medicare Advantage back to Original Medicare at any time. As long as it’s within the first 12 months of joining a Medicare Advantage plan.
Difference between Original Medicare and Medicare Advantage
Original Medicare includes Part A, for hospitalization costs, and Part B, for other medical expenses. Expenses such as doctor visits, tests, emergency room visits and outpatient procedures. Medicare does not cover prescriptions. With Original Medicare, you can see any health care provider you want, as long as they accept Medicare.
Many people supplement their Original Medicare coverage with a Medicare Part D prescription drug plan and a Medicare Supplement. Depending on the plan, Medigap may pay almost all your remaining medical and hospital costs.
Medicare Advantage, also known as Medicare Part C, is alternative Medicare coverage. These plans are sold by private insurance companies instead of the government.
All Medicare Advantage plans must offer at least as much coverage as Original Medicare Parts A and B. Many plans offer additional benefits, such as prescription drug coverage.
But unlike Original Medicare and Medigap, Medicare Advantage operates with provider networks. You may be restricted to a certain network of providers.
Or, you may pay more if you see an “out of network” provider than if you see one who is “in network.” If you choose Medicare Advantage, you cannot supplement your coverage with a Medigap plan.
Will I pay a penalty if I sign up for prescription drug coverage during the AEP?
If you have gone without prescription coverage and want to sign up for it during the AEP, you will pay a late enrollment penalty when you do sign up if:
- You didn’t join a Part D prescription drug plan or a Medicare Advantage plan with prescription coverage when you first became eligible; AND
- You have gone without creditable prescription drug coverage for 63 consecutive days.
The penalty will be added to your monthly premium for as long as you have prescription drug coverage.
Can I get a Medigap plan if I switch from Medicare Advantage to Original Medicare?
Yes, you have a “guaranteed issue right” to buy a Medigap policy if you cancel your Medicare Advantage plan and switch back to Original Medicare within 12 months of joining Medicare Advantage. The insurance company cannot charge you more money because of pre-existing conditions, and it cannot turn you down.
If you had a Medigap policy before you signed up for Medicare Advantage, you can get your old policy back, if it is still offered. If you have not had Medigap coverage before, you can choose any Medigap plan.
You also have guaranteed issue rights if you are switching to Medigap because you are losing your Medicare Advantage coverage. You can learn more here.
If you don’t qualify for guaranteed issue rights, you can still apply for a Medigap plan, but the insurance company will take your health into account in deciding whether to issue you a policy, and what the monthly premium will be.
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