Medicare AEP vs OEP… what do these letters stand for? AEP stands for Medicare Annual Enrollment Period and OEP stands for Medicare Open Enrollment Period.
Every time you flip the channel or change the radio station, you see and/or hear ANOTHER segment about Medicare enrollment. The worst part is, each segment refers to a different terminology discussing enrollment periods for Medicare.
Whether you head the term “Fall Enrollment Period”, “Medicare Advantage Enrollment Period” or “Annual Election Period”… we’re here to eliminate the confusion and clarify what these enrollment periods are.
Medicare AEP vs OEP
The Annual Enrollment Period, otherwise referred to as AEP, is the time of year when a Medicare Beneficiary can make plan changes. The AEP runs from October 15th to December 7th.
During AEP the plan benefit changes for the next year are released, allowing Medicare Beneficiaries to look around to ensure they are electing the plan that best fits their needs.
What Can I Do During AEP
During the Annual Enrollment Period, Medicare Beneficiaries can elect to any of the following:
- Drop a Medicare Advantage Plan (Part C) and return to Original Medicare
- Elect to change from one Medicare Advantage plan to a different one
- Change from Original Medicare to a Medicare Advantage plan
- Elect to change from one Part D prescription drug plan to another
- Cancel your current Part D plan
- Pick up a Part D plan if you currently do not have one
Any changes you make during the AEP will go into effect on January 1st of the following year.
With Medicare Advantage and Part D plan benefits changing every year, premiums could increase, benefits can be changed, and prescription drug formularies can be changed. A formulary is a list of approved medications the plan will cover.
Every year in September you will receive an Annual Notice of Change (ANOC) letter. This letter explains all the changes that will be affecting your plan in the upcoming year.
The AEP gives you a chance to change if you are not happy with the future adjustments to your plan.
The Open Enrollment Period (OEP) will return in January of 2019. It is replacing the election period known as the Medicare Advantage Disenrollment Period (MADP).
The MADP that is being replaced ran from January 1st to February 14th and allowed Medicare Beneficiaries that elected to be on an MAPD to drop the MAPD and go back to Original Medicare.
There are several reasons that someone may want to go back to Original Medicare, generally it is due to restrictive networks, or doctors leaving the network. Medicare Advantage contracts run for a calendar year starting January 1st.
Doctors in network for a Medicare Advantage plan can leave the network before that period is over. If you are on a Medicare Advantage plan and this happens you will have to choose a new doctor.
In most states and situations, a doctor leaving your plan does not give you a Special Enrollment Period (SEP) to drop or change the Medicare Advantage Plan.
If this happens during the OEP you would be able to make the change. The OEP starts on January 1st and runs through March 31st annually beginning in 2019.
What Can I Do During OEP
In the Open Enrollment Period Medicare Beneficiaries currently enrolled into a Medicare Advantage plan can:
- Cancel your stand-alone Part D prescription drug plan
- Drop your Medicare Advantage Plan and return to Original Medicare
- Enroll into a stand-alone Medicare Part D prescription drug plan
- Elect to change from one Medicare Advantage Plan to another
Regarding enrolling in a stand alone Part D plan… most Medicare Advantage Plans include prescription coverage. Once you sign up with a Part D plan, the disenrollment from Medicare Advantage Plan happens automatically and return you to Medicare Part A and Part B.
You can enroll in a Medicare Supplement Plan (Medigap) once you are disenrolled from your Medicare Advantage Plan, if you can medically qualify.
One Chance to Make Changes
You only get once chance to make an election during the OEP. Once the election has been made you cannot change it again until the next AEP.
If you decide to make a change, it will go into effect the following month. For example, a plan change on January 5th would start on February 1st.
There are many reasons that a beneficiary may want to change from the plan they are enrolled into using this election period.
Below are some of the reasons someone may choose to change:
- Provider network changes
- Finding out dental coverage provided from the plan is not as comprehensive as originally understood
- Discovering certain benefits are only covered at 80% such as chemotherapy, durable medical equipment, and Part B drugs that are administered in the doctor’s office
If you have problems with your plan after the AEP and OEP, you may still be able to change plans. These other chances to make a change are referred to as Special Election Periods (SEP).
There are many SEPs that you may qualify for, such as moving out of the coverage area of your plan, qualifying for low-income subsidy, or receiving both Medicare and Medicaid.
Due to the confusing periods and choices you have with Medicare, it is recommended that you speak to a licensed insurance agent that specializes in Medicare.
Allow us to lend you our expertise to understand your choices and help you with the enrollment process. Give us a call to speak to a licensed agent, or complete our rate form to compare Medicare plan rates now.