With nonstop TV ads and a steady stream of mailers, you probably don’t need us to tell you that Medicare Annual Enrollment is here. But Medicare has a few enrollment periods, and that can lead to confusion. This post describes what you can do during Medicare Annual Enrollment and why you should take advantage of it.
The Medicare Annual Enrollment Period (AEP) occurs every year from October 15 through December 7. Also known as Open Enrollment, this 8-week period allows beneficiaries to compare their Medicare plan options and make changes for the coming year.
No, AEP is not open to people who have never enrolled in Medicare Part A or B. If you are newly eligible for Medicare, you must sign up via your Initial Enrollment Period (IEP). This 7-month period begins 3 months before you turn 65 and ends 3 months after your birth month.
If you missed your IEP and do not qualify for a Special Enrollment Period, you must wait until the General Enrollment Period in January. Your coverage will begin July 1.
For those who are new to Medicare, our Medicare 101 post is the perfect place to get started.
The Annual Enrollment Period allows current Medicare beneficiaries to make changes to their existing Medicare coverage. During Annual Enrollment, you can:
Any changes you make during AEP go into effect on January 1.
One thing all beneficiaries should understand is that Medicare offers Annual Enrollment for a reason. Like every other type of health insurance, Medicare plans change every year. AEP is your chance to maximize your coverage while minimizing your costs.
Following are four advantages to participating in AEP.
Medicare uses a 5-star rating system to indicate plan quality. Five stars indicate the best plans while anything below three is considered poor quality.
Medicare rates Advantage plans based on their performance in five categories. These are:
Medicare also provides ratings on Part D plans, with the overall score based on the plan’s performance in four categories. These are:
If you have a Medicare Advantage plan that includes prescription drug coverage, its rating covers all of the above categories.
Nearly every plan implements cost changes from year to year. To determine the full cost of a plan, you must look at all out-of-pocket spending, not just the monthly premium. Often, low premiums hide high deductibles or co-pays. Your plan may also impose requirements that, if you fail to meet them, raise your out-of-pocket costs. This is particularly true of Part D plans with step therapy requirements.
There are nearly always changes to the provider network of an MA plan. If your network will no longer include one or more of your providers, you’re likely facing much higher out-of-pocket costs next year. This is true for all providers, not just your primary physician. Make sure anyone you rely on for healthcare is part of your network, including your pharmacy for your Part D plan.
Just as provider networks change every year, so too do drug formularies. Plans add and remove drugs from their formularies or make changes to their tier structure. They may also change step requirements. All of these may result in you losing coverage for one or more of your prescriptions. Or, the plan may keep covering your prescriptions but implement other changes, such as to mail order or the ability to get 90-day supplies.
Medicare makes it really easy to review planned changes to your current coverage. In September, you should have received two documents from your plan(s): The Annual Notice of Change (ANOC) and Evidence of Coverage (EOC).
These documents detail any changes expected in your MA or Part D plan next year, including costs and coverage. Our ANOC post has all the details about how to use these documents to compare your plan options.
If you did not receive the ANOC or EOC, call your plan right away.
Our plan finder tool lets you review plan options in your area. You can also call to speak with one of our licensed agents about your Medicare plan options.
Chris Gasparini has been a licensed insurance agent since 2005. He enjoys helping Medicare beneficiaries navigate their options to find the best solution for their unique needs. Chris feels as though his work truly helps people. Because he represents multiple insurance companies and plan types, Chris is able to help Medicare beneficiaries find the best, most cost-effective plan. Every day, he leaves work knowing he did what was right for each and every client he serves.
The MedicareUSA website is operated by HealthPlanOne, LLC a licensed health insurance agency based in Connecticut; in California d/b/a HPOne Insurance Agency, license #OF30784. HealthPlanOne, is a licensed and certified representative of Medicare Advantage HMO, PPO and PPFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal.
For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Medicare supplement plans are not connected with or endorsed by the U.S. Government or the federal Medicare program.
The Centers for Medicare and Medicaid Services (CMS) does not review or approve Medicare Supplement plan information.
Other Pharmacies are available in the plans' networks.
Last Updated 12/21/2018