Each year, millions of Medicare beneficiaries face an important decision-making window: the Annual Enrollment Period. This is not just a routine plan renewal; it's an opportunity to re-evaluate your healthcare and prescription drug needs to ensure your coverage is optimized for the year ahead. With plan benefits, costs, and formularies subject to change every year, taking the time to review your coverage is vital. This guide will walk you through considerations for a successful open enrollment, empowering you to make informed choices for your health and financial well-being.
What is the Medicare Annual Enrollment Period?
The Medicare Annual Enrollment Period (AEP), also known as the Fall Open Enrollment Period, is a key time for Medicare beneficiaries to review and adjust their healthcare coverage for the upcoming year. Because Medicare plans can change annually, including premiums, costs, and coverage, it’s important to take this time to evaluate your coverage and ensure you still have the right plan for your needs.
AEP officially runs from October 15 to December 7 each year. During this time, beneficiaries can switch from Original Medicare to a Medicare Advantage plan, change between different Medicare Advantage or prescription drug (Part D) plans, or enroll in a Part D plan for the first time. Any changes made during AEP will not take effect immediately; instead, they become effective on January 1 of the following year.
What You Can Do During Fall Open Enrollment for Medicare
During AEP, Medicare beneficiaries can:
Switch from Original Medicare (Medicare Part A and Medicare Part B) to a Medicare Advantage plan
Change from one Medicare Advantage plan to another Medicare Advantage plan
Switch from one Prescription Drug plan (Medicare Part D) to another
Add a Prescription Drug plan if you didn’t enroll when first eligible for Medicare
By September 30, you should receive an Annual Notice of Change (ANOC) from your Medicare plan provider that will let you know of any changes to your plan, including costs and benefits. Even if you are satisfied with your current coverage, it’s a good idea to consider all of your options.
Why You Should Review Your Plan Annually
Medicare plans may change their benefits and costs on an annual basis. A significant mistake beneficiaries can make is assuming their coverage will remain the same and failing to review it during the Annual Enrollment Period. This oversight can lead to unexpected and costly surprises in the new year. A thorough review is essential to identify potential changes that could impact your healthcare and budget. For instance, you should look for changes in monthly premiums, annual deductibles, and co-pays. You should also check to see if your preferred doctors, hospitals, and specialists are still in your plan's provider network and if your prescriptions are still included on the plan's formulary, as this can directly affect your out-of-pocket expenses.
Finding the Right Coverage For You
When reviewing your Medicare coverage during AEP (October 15 to December 7), several factors should guide your decision-making. First, consider the total cost, which includes not just the monthly premiums, but also deductibles, co-pays, and co-insurance. You also need to verify that your preferred doctors, specialists, and hospitals are part of the plan's network. If you take prescription drugs, review the plan's formulary to ensure your medications are covered and at a cost you can afford. For free and unbiased guidance through this process, beneficiaries can utilize a variety of resources. The official Medicare Plan Finder tool on Medicare.gov allows you to input your specific needs and compare plans side-by-side, while the State Health Insurance Assistance Program (SHIP) offers one-on-one counseling from trained volunteers.
Understanding Key Enrollment Dates and Periods
Understanding the different Medicare enrollment periods is key to making the right healthcare decisions. The Annual Enrollment Period and the Medicare Advantage Open Enrollment Period may sound similar, but have distinctly different purposes:
AEP (Fall Open Enrollment): The Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7, is the primary time for all Medicare beneficiaries to make a wide range of changes to their coverage, including switching between Original Medicare and a Medicare Advantage plan or changing Part D prescription drug plans.
Medicare Advantage Open Enrollment Period (MA OEP): OEP runs from January 1 to March 31 and is specifically for those already in a Medicare Advantage plan. This period allows beneficiaries to make a single change: either switch to a different Medicare Advantage plan or drop their plan to return to Original Medicare, and if needed, add a Part D plan.
Furthermore, it's important to distinguish between fall open enrollment for Medicare and the enrollment periods for the Health Insurance Marketplace. The Marketplace, created under the Affordable Care Act (ACA), is for individuals who do not have Medicare, and its Open Enrollment Period typically runs from November 1 to January 15. The two systems are separate, and if you have Medicare, you do not need to use the Health Insurance Marketplace.
How to Get Help Finding the Right Plan
While you aren’t required to take action during this time, the Medicare Annual Enrollment Period is a great time to make sure you’re getting all of the Medicare benefits available to you. Whether you’re worried about an increase in prescription drug costs or are looking for additional benefits, comparing the plans available to you is a good way to confirm your health and prescription drug needs are covered for the upcoming year.
Consulting an insurance professional can help make it easier to sift through all the information available to you. A SelectQuote licensed insurance agent can help you review available Medicare Advantage plans in your area, helping answer your questions about enrollment along the way.
Let SelectQuote Help You Find the Right Medicare Advantage Coverage For You
The Medicare Annual Enrollment Period is one of the best times to review your Medicare Advantage coverage and see what plans are available to you. At SelectQuote, we can compare Medicare Advantage plans from some of the most trusted insurance companies in the nation in just minutes to help you find the right coverage with the right carrier at the right price. There’s no obligation to enroll.
