Annual Enrollment Period for Medicare
Medicare’s Annual Enrollment Period (AEP)—commonly referred to as "Medicare open enrollment" takes place between October 15 and December 7. During this time, people enrolled in Medicare can change their health plans and prescription drug coverage. Your current Medicare health and drug plans can change and you may notice differences in things like cost and coverage, and network changes such as participating providers and pharmacies. In addition, your financial or health needs may have changed over the course of the year. Here’s what you need to know:
During AEP, you have the ability to make some changes to your Medicare coverage, such as:
- Switching from Original Medicare to Medicare Advantage, or vice versa
- Switching from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another
- You also have the ability to enroll in a Medicare Part D plan if you didn’t when you were first eligible, although a late enrollment penalty may apply
If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.
- You must be enrolled in the Medicare Part A and Part B benefits included in your Medicare Advantage Plan
- You must live in the plan’s service area
- You cannot have End-Stage Renal Disease (some exceptions apply)
If you’re already enrolled in a Medicare Part D prescription plan or a Medicare Advantage Plan and you don’t want to make changes to your coverage for the coming year, you don’t have to do a thing, providing your current coverage will still be available in the coming year. If your current plan is being discontinued and isn’t eligible for renewal, you will receive a non-renewal notice from your carrier prior to open enrollment, giving you time to enroll in a new plan.
Reviewing Your Current Medicare Coverage
Prior to AEP, take some time to review your current coverage. Your current plan provider will send you an Annual Notice of Change and Evidence of Coverage (ANOC/EOC) packet. If you don’t receive it before AEP opens, call the number on your Medicare card and ask for another, or go online and download a copy. The ANOC/EOC will reflect any changes in your plan’s fixed drug costs, such as your monthly premium and deductible.
If you want to do a little research to ensure you have the best coverage for you, there are many resources available to you. The Medicare website has a Medicare Plan Finder that provides information on cost estimates and coverage information. Here, you can do a general search based on your location or a personalized search, which requires your ZIP code and complete Medicare information. A personalized search can help you find all of your out-of-pocket costs including premium, deductible and prescription costs. You can also get detailed information on your medication, including any restrictions which could include quantity limits on the number of pills per month, prior authorization from your provider, or step therapy (which requires you to take a lower cost drug before taking a higher priced one).
Other Resources for Medicare Open Enrollment Preparation
The National Council on Aging has a Medicare Questionnaire that you can use to compare plans and receive access to advice from a licensed benefits adviser at no cost to you.
Another expert resource is your local State Health Insurance Assistance Program (SHIP). SHIP is a federally-funded service that provides free, unbiased Medicare counseling. SHIP doesn’t sell insurance but can help you understand the differences among your choices. You can speak to a SHIP Counselor by phone or make an appointment to meet with them in-person. You can locate your local SHIP office online at www.shiptacenter.org.
Your local Area Agency on Aging can also help answer any questions you have regarding your Medicare coverage options. Similar to SHIP, they can provide you with expert, no-cost advice on a wide range of important issues for seniors. You can find your local agency via the Eldercare Locator site.
Considering Medicare Supplement Insurance
If you are already enrolled in a Medicare Part D prescription plan and are happy with your current coverage, you don’t have to do anything. However, it’s important to keep in mind that Medicare doesn’t cover everything. Co-pays and deductibles from hospital stays, confinement in a skilled nursing facility, home health care from a licensed agency, ambulances and physician fees may have to be paid out-of-pocket. If you feel you may need more extensive coverage, you may want to consider Medicare Supplement insurance.
Medicare Supplement insurance can protect you from unexpected costs by paying many or all co-insurance and co-pays not covered by Original Medicare. Many plans enable you to see any physician or provider anywhere in the country who accepts Medicare and they don’t require a referral to see a specialist. Medicare Supplement insurance is guaranteed renewable for life, as long as premiums are paid on time. We invite you to visit our Knowledge Center, where you can find additional information about Medicare Supplement insurance, as well as other ways to enrich your current coverage. Of course, if you still have questions, reach out to your agent and request a complimentary policy review.
Follow this advice and you’ll find that navigating the AEP is as easy as ABC.
Notice: Neither Bankers Fidelity Life Insurance Company®, its subsidiaries, nor its Medicare Supplement policies are affiliated with or endorsed by the U.S. Government, the federal Medicare program, or the Centers for Medicare and Medicaid Services.