Every year, the Medicare Open Enrollment Period gives beneficiaries an opportunity to make changes to their current Medicare coverage. The OEP for Medicare begins on October 15th and ends December 7th. Below, we’ll explain what you can and cannot do during the Medicare Open Enrollment Period as well as answer some common questions we get from beneficiaries.
When is Open Enrollment for Medicare?
Why would I make changes to my coverage during the Medicare Open Enrollment Period?
The Open Enrollment Period for Medicare was introduced back when Part D first began.
Since Part D, as well as Medicare Advantage plans, re-file its benefits with Medicare every year, they created this election period for beneficiaries to make coverage modifications if they were unhappy with the benefit changes.
For recipients currently enrolled in an Advantage plan or Part D policy, your benefits, as well as your monthly premiums, can change from year to year.
This election period is when you can change your existing coverage if you’re not pleased with those changes.
How will I know if my Medicare benefits are changing next year?
Every year during September, you’ll receive a letter in the mail that contains a document called the Annual Notice of Change.
The Annual Notice of Change will inform you if your premium, copays, pharmacy networks, or drug formulary is changing in the upcoming year.
You’ll want to set some time aside to review this document once you receive it.
The document will compare any changes year over year in an easy to understand format.
If you’re satisfied with the changes documented in your Annual Notice of Change letter, then there’s nothing you need to do! Your current coverage will renew automatically.
Who’s eligible to make changes during this open enrollment window?
What Changes Can You Make During the Medicare Open Enrollment Period?
If you’re enrolled in Medicare, you can leave Medicare & switch to Medicare Advantage. If you’re enrolled in an Advantage plan, you can leave the plan and switch back to Medicare. You can also join, leave, or change your stand-alone Part D drug plan. When you switch back to Medicare, you can then choose to enroll in a Medigap plan.
Why would I want to leave or change my Medicare Advantage plan?
- Unhappy with plan changes documented in the Annual Notice of Change letter
- Your monthly premium is going to increase
- Your doctor is no longer within the plan’s network
- You’re tired of paying copays every time you visit the doctor
- You need more comprehensive coverage that is attainable through a Medigap plan
Due to the Bipartisan Budget Act, there are new home health benefits that will be added to SOME Medicare Advantage plans.
If your current Advantage plan doesn’t include home health benefits, and you feel you would benefit from them, this Open Enrollment Period is the time to switch to a plan that provides these new benefits. You can also wait for the Medicare Advantage Open Enrollment Period to make a change as well.
Since home health benefits we’re just recently introduced, there may not be an Advantage plan that includes these benefits available in your area yet.
Why would I want to leave or switch my Part D plan?
- the new plan formulary moved your medications to a different tier
- the plan is dropping one of your drugs completely
- your monthly premium increased
- the policies yearly deductible increased
- there’s a new plan option with more value
Do I have to answer any health questions if I make changes?
If you’re joining or making changes to your current Part D policy, you won’t have to answer any health questions. With Medicare Advantage plans, the only health question you’ll have to answer is whether or not you have End-Stage Renal Disease.
If you’re choosing to enroll in a Medicare Supplement plan at this time, and are outside your Medigap Open Enrollment Period, you will have to go through medical underwriting and answer some health questions. However, don’t let that concern you, we can help you every step of the way.
Can I make more than one change during this enrollment window?
During the Medicare Open Enrollment Period, you can make multiple changes to your coverage. The last change you made is what will take effect on January 1st.
This is not the case for all open enrollment windows. For example, the Medicare Advantage Open Enrollment Period only allows you to make a one-time change.
What happens if I miss the Medicare Open Enrollment Period?
There are multiple enrollment periods when it comes to Medicare. Depending on your current coverage, you may qualify for another enrollment window outside of this one.
Is there an Open Enrollment Period for Medicare Supplement Plans?
When it comes to Medicare Supplements, there is no annual enrollment window. You can enroll in a Medigap plan at any time during the year.
Although, Medigap is different in each state. Some states do have an Open Enrollment or birthday rule that allows beneficiaries to change plans during the year without underwriting.
You can apply for a Medigap plan at ANY TIME of the year. But, the Medicare Supplement Open Enrollment Period is the best time to enroll in Medigap. Although, this is a one-time enrollment period, not annual. So, if you miss yours, going through underwriting would likely be necessary.
Difference between Open Enrollment Period and Medicare Advantage Open Enrollment Period
The Medicare Open Enrollment Period is for current beneficiaries to make changes to their Medicare Advantage and Part D coverage. The Medicare Advantage Open Enrollment Period is ONLY for those who are currently enrolled in Medicare Advantage to make changes.
Difference between the Annual Election Period and the Open Enrollment Period
The Medicare Annual Enrollment Period is the same thing as the Open Enrollment Period. The Medicare Open Enrollment Period, depending on the context could also be referring to other enrollment windows.
How to Get Help During the Fall Medicare Open Enrollment Period
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