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 Open Enrollment Period” or “Annual Election Period”… we’re here to eliminate the confusion and clarify what these enrollment periods are.
What You Need to Know About the Medicare AEP vs OEP
What Can I Do During the Fall Medicare AEP?
- Drop an Advantage Plan and return to Original Medicare
- Elect to change from one Advantage plan to a different one
- Change from Original Medicare to an 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.
What Can I Do During the Medicare OEP?
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 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.
What can I do during the OEP if I’m currently enrolled in a Medicare Advantage plan?
- Cancel your stand-alone Part D prescription drug plan
- Drop your Advantage Plan and return to Original Medicare
- Enroll in a stand-alone Part D prescription drug plan
- Elect to change from one Advantage Plan to another
Regarding enrolling in a stand-alone Part D plan… most Advantage Plans include prescription coverage. Once you sign up with a Part D plan, the dis-enrollment from Medicare Advantage Plan happens automatically and returns you to Part A and Part B.
You can enroll in a Medicare Supplement Plan once you are disenrolled from your Medicare Advantage Plan if you can medically qualify.
How Many Changes Can I Make during the OEP?
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 in using this election period.
Below are some of the reasons someone may choose to change:
- Provider network changes
- Dental coverage provided isn’t as comprehensive
- Certain benefits covered at 80% such as chemotherapy, durable medical equipment, and Part B drugs
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.
If you have questions on Medicare OEP vs AEP talking with an agent can help. Our agents are qualified to understand the difference between AEP and OEP.
There are many SEPs that you may qualify for, such as moving out of the coverage area of your plan, qualifying for a low-income subsidy, or receiving both Medicare and Medicaid.