Every year, we get a lot of questions about Medicare open enrollment and who is eligible to make changes to their coverage.  Below is a guide to help you navigate some of the questions we are frequently asked.

When is Medicare open enrollment for 2021 coverage?

The open enrollment period, or Annual Enrollment Period (AEP), runs from October 15 through December 7 each year. During this annual window, Medicare plan enrollees can reevaluate their existing coverage and make changes or purchase new policies if they want to do so. This period applies specifically to Medicare Advantage Plans and Part D Drug Plans.

These plans have to renew their contracts annually. Each year, they may reshuffle the combination of premiums, copays, deductibles, networks and drug formularies. This means you need to confirm your health care needs (doctors, services, drugs, etc.) are still covered by your existing coverage. If they aren’t, the AEP is your opportunity to make changes.

Potential Changes to Make

• Switch between Original Medicare (Part A & B) and Medicare Advantage (Part C)
• Switch from one Medicare Advantage plan to another
• Switch from one Part D prescription drug plan to another
• Enroll in a Part D prescription drug plan

Actions To Take

1. Review your Annual Notice of Change letter – review changes to your network, drug plan or cost structure
2. Assess your health care needs – Ensure your doctors and drug needs are still met at the best cost structure for you
3. Apply by December 7^th – Review any changes with broker or online at medicare.gov

A Few Other Things to Consider

Medigap Plans Do Not Change

The AEP does not apply to Medigap policies (Medicare Supplemental). These policies are purchased in combination with Original Medicare (Part A and Part B) and help cover out-of-pocket costs. Technically, you can make a change to your Medigap plan at any time. Although the policies are offered by private health care companies, the benefits included for each plan (i.e. Plan F) are standardized by the government so the only difference between providers is price.

If you would like to shop for a cheaper provider, you can do so at any time – but be sure to understand your state’s rules when changing Medigap plans. If you switch plans after the initial enrollment in Medicare, there are nuanced rules that often require new medical underwriting. This may lead to higher premiums or rejection of services.

General Enrollment Period

It’s a bit confusing, but be sure to understand the difference between the Annual Enrollment Period (AEP) and the General Enrollment Period (GEP). The GEP is for those that didn’t enroll in Medicare when they were first eligible.  If you happen to fall into this category, your window to sign up is from January 1 to March 31 and coverage will start July 1.  Once you are in the system, the AEP will be your opportunity to make changes going forward.

Nothing is Locked in Forever

This point can be lost when navigating the Medicare landscape. As long as you’ve signed up on time and play by the rules, you’ll have an opportunity every year to make changes so don’t put too much pressure on yourself.

If you have questions about Medicare or any other planning needs, get in touch.