The Fall Medicare Open Enrollment season occurs each year. This open enrollment period is for Medicare beneficiaries to make changes to their current coverage.
Below, we’ll go over everything you need to know about the Fall Medicare Open Enrollment season so that you’re well prepared this time around.
The 2020 Fall Medicare Open Enrollment Season
Most of the time, when an individual is talking about the Medicare Open Enrollment Period, they’re referring to the fall open enrollment season.
The Fall Medicare Open Enrollment Period is also called the Medicare Annual Enrollment Period or the Medicare Annual Election Period.
You know when the Medicare OEP season is approaching because you’ll start seeing tons of commercials on TV about it. These commercials end up creating more havoc than anything else.
They make beneficiaries feel like they NEED to make changes to their current coverage when, in reality, that’s not the case.
Tip: studies have shown over the past years that most Medicare beneficiaries do not make changes to their coverage each year.
When is the Fall Medicare Open Enrollment Season
The Fall Medicare Open Enrollment season occurs annually between October 15th and December 7th. Any policies that you enroll in during this time will become effective January 1st of the following year.
History of the Fall Open Enrollment Period
The Fall OEP was introduced back in 2006 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.
In laments terms, 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.
During this annual enrollment window, nearly 50 million Medicare enrollees can make changes to their coverage for the coming calendar year.
Tip: Unlike Medicare Advantage, Medigap plans do NOT change benefits from year to year.
How will I know if my Medicare benefits changed
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.
Tip: We’ll be happy to schedule some time to review your Annual Notice of Change letter with you.
If you’re satisfied with the changes documented in your ANoC letter, then there’s nothing you need to do! Your current coverage will renew automatically in 2021.
Next, we’ll go over what you can and cannot do during this fall open enrollment window.
Changes you can make during the Fall OEP
The Fall OEP is for any beneficiary that’s currently enrolled in Part A and Part B that want to either:
- leave Original Medicare & switch to Medicare Advantage
- leave Medicare Advantage and switch back to Original Medicare
- join, leave, or change your stand-alone Part D drug plan
Reasons You Would Want to Make Changes to Your Medicare Advantage Plan During the Fall OEP
- Unhappy with plan changes documented in the ANoC
- 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 starting in 2020.
If your current Advantage plan doesn’t include home health benefits, and you feel you would benefit from them, the Fall OEP is the time to switch to a plan that provides these new benefits.
Tip: 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.
Reasons You Would Want to Switch Your Part D Plan During the Fall OEP
- 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 during the Fall OEP
If you’re joining or making changes to your current Part D policy, you won’t have to answer any health questions. As long as you have Part A & B, you can switch to any other Part D plan as long as you live within the plans’ service area.
With Medicare Advantage plans, the only health question you’ll have to answer is whether or not you have End-Stage Renal Disease.
What if I want to make another change to my coverage after I already made a change
During the Fall 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.
Tip: 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 Fall 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 the Fall OEP.
Other Part D Enrollment Windows
There are two other enrollment windows for Part D outside the Fall OEP.
If you have a change in circumstance, you may be eligible for a Special Enrollment Period.
If you’re newer to Medicare and within your Initial Enrollment Period, then you can still make changes to your Part D coverage. Otherwise, you’ll have to wait until the next Fall Open Enrollment Period to make any changes.
Do you have to enroll in Medicare Part D every year?
No, your Part D coverage will renew each year.
Other Medicare Advantage Enrollment Windows
With Medicare Advantage, three other enrollment windows allow you to make changes.
Just like Part D, if you have a change in circumstances, you may qualify for a Special Enrollment Period.
Also, just like Part D, if you’re new to Medicare, then you may still be in your initial enrollment window for a Medicare Advantage plan.
However, when it comes to Medicare Advantage, this enrollment window is called your Initial Coverage Election Period. If you’re still within your ICEP window, you can still make changes to your current Medicare Advantage coverage after the Fall OEP has passed.
The third enrollment window for Advantage plans outside the Fall OEP is the Medicare Advantage Open Enrollment Period. This OEP window will begin shortly after the Fall OEP.
Tip: This OEP is newer, is did not begin until 2019. Many beneficiaries are unaware of this enrollment period. It used to be known as the Medicare Advantage Disenrollment Period.
What is the Open Enrollment Period for Medicare Supplements?
When it comes to Medicare Supplements, there is no annual open enrollment window. You can enroll in a Medigap plan at any time during the year.
However, there is an open enrollment window for Medicare Supplements that allows you to enroll without having to answer health questions, but it’s not annual. It’s a once in a lifetime window that begins the month your Part B becomes effective.
Tip: To reiterate, you can apply for a Medigap plan at ANY TIME of the year. Many beneficiaries end up enrolling during the Fall OEP when they leave their Medicare Advantage plan.
Don’t Take on the Fall Open Enrollment Season Alone!
We’re here to help you! Whether you’re enrolling in Medicare Advantage, Part D, or Medigap, we can compare all your options side by side to see which coverage is best for you.
We’re here to be a free Medicare resource for you. We work around the clock to make sure we keep you up to date and well informed on everything Medicare. If you run into any obstacles with your coverage, we’re by your side to help overcome them.