# October, 10, 2019

Medicare Annual Enrollment Prep 101

The Medicare Annual Enrollment Period (AEP) allows people already enrolled in Medicare to make changes to their plan(s). It begins on October 15 and lasts through December 7. This post walks you through the entire process to help you make the most of these eight weeks. It’s our Medicare Annual Enrollment Prep 101.

Do You Have to be Enrolled in Medicare?

Yes, you must already be enrolled in Medicare to take part in Annual Enrollment. Of course, if your Initial Enrollment Period (IEP) falls during AEP, you may sign up for Medicare that way.

If you failed to enroll during your 7-month IEP, you must wait to sign up during Medicare Advantage Open Enrollment, which begins January 1 and ends March 31. Your coverage will begin on July 1. If a full 12 months pass from when you became eligible to when you actually enrolled in Part B, that coverage gap may cost you late penalties. It all depends on whether you qualify for a Special Enrollment Period (SEP). Medicare provides an extensive list of special circumstances that qualify you for an SEP.

What Can You Do During Annual Enrollment?

Annual Enrollment allows you to make changes to your existing Medicare coverage. This includes:

  • Joining a Medicare Advantage (MA) plan (either for the first time or changing to a new plan)
  • Leaving an MA plan to return to Original Medicare (Parts A and B)
  • Enrolling in a Part D prescription drug plan (either for the first time or changing to a new plan)

If you’ve been without creditable drug coverage for 63 consecutive days AND don’t qualify for a Special Enrollment Period, you likely face late penalties.

Do You Have to Make Changes During AEP?

No, you don’t have to make changes to your Medicare plan during Annual Enrollment. If you do nothing, your current coverage simply carries over to next year.

However, that doesn’t mean you shouldn’t at least review how your coverage will change next year. And your current plan will almost definitely change next year. That’s why Medicare requires all plans to send their beneficiaries the Annual Notice of Change (ANOC) document.

Review ANOC for Medicare Annual Enrollment prep

Your plan mails the ANOC in September, along with the Evidence of Coverage (EOC). These two documents include everything you need to know about your plan and it’s vital you review them. We’ve discussed these documents before, but as a reminder, a few changes you might see include:

  • Providers leaving and entering the plan’s network
  • Adding and removing prescription medications from the drug formulary
  • Plan service area changes (including knocking you completely out of said service area)
  • Changes to out-of-pocket costs, including premiums and co-pays

Remember, all plans change from year to year. An hour spent reviewing your coverage options could lead to substantial savings.

What Should You Do Next?

We recommend answering a few questions, taking into account how your current plan will change next year.

  • Have your healthcare needs changed since last year? For example, did you receive any new diagnoses, or has your doctor recommended any procedures?
  • Has your income changed?
  • Did your doctor prescribe any new medications?
  • Are your providers still in your plan’s network?
  • Does your Part D plan still cover all of your prescriptions? Or your favorite pharmacy?

Compare your answers to these questions to the ANOC and EOC to help determine whether your current coverage will work for you next year.

Are You Happy with Your Plan?

Just because a plan looks great on paper doesn’t mean it’s the right plan for you. Or, maybe it was the right plan a few years ago, but it hasn’t kept up with changing healthcare needs.

Are you satisfied with your Medicare plan?

The ideal Medicare plan makes it easy to:

  • Reach your providers
  • Refill prescriptions
  • Access online resources and help
  • Find answers to your common questions

Of course, you really only need to ask yourself one question: Would you recommend your plan to a friend? If the answer is no, it’s probably time to look for a new plan.

Consider the Full Cost of Your Medicare Plan

When reviewing plan options, one mistake countless beneficiaries make is not considering the true cost of their Medicare plan. They see a low monthly premium and grab it. Unfortunately, your monthly premium only accounts for one of your out-of-pocket costs. You also need to consider:

  • Deductibles
  • Co-pays
  • Co-insurance

For a true idea of how much your Medicare plan costs, review your total healthcare spend for the past 12 months (or more, if you have the records). If you’re relatively healthy, a low premium, high deductible plan may be perfect for you. But, if you’ve acquired any chronic conditions over the past year, that same plan may no longer be your best option.

Get Help from a Licensed Medicare Agent

With so many pieces to manage, Medicare Annual Enrollment can be tricky. A licensed Medicare agent can help you understand your options and compare plans to find the best one to fit your unique needs. That’s the good news. The great news is that it won’t cost you a dime. Just call us toll-free at 800-637-7602 to start comparing your plan options. Or, use our online plan finder tool to see which Medicare plans are available in your area.


Donna Frederick

After retiring from a career as an executive travel counselor in 2006, Donna Frederick embarked on a second career as a licensed insurance agent. During that first year, many clients told Donna how overwhelmed they felt by Medicare, but that her assistance helped them finally understand the Medicare program. That experience inspired Donna to focus her efforts on educating her clients to ensure they fully understand their Medicare options. Today, Donna takes pride in providing outstanding customer service and going the extra mile to make sure each client knows all of their options and has a sound understanding of their Medicare plan, from costs to coverage and all points in between.

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Last Updated 12/21/2018