What is the Medicare Annual Enrollment Period?

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Fall is finally here. The time of year that brings to mind thoughts of pumpkins, apple cider, Halloween, and making changes to your Medicare plan. Maybe that’s a stretch, but if you’re 65 or older and on Medicare, you’ll want to be aware of the upcoming Medicare Annual Enrollment Period (AEP). 

The Medicare Annual Enrollment Period is the period during which Medicare enrollees can change various aspects of their coverage and plans. In 2019, the AEP begins on October 15th and ends on December 7th. Now is your chance to prepare for this year’s AEP. Any changes you make during this time will go into effect on January 1st. Have a look at the following guide we have prepared to ensure you are ready for October 15th!

Who is eligible to make changes?

Anyone with Medicare Parts A and B eligibility can change their plan during the Medicare Annual Enrollment Period. If you have End-Stage Renal Disease (ESRD), you will not be able to enroll in a Medicare Advantage Plan at this time. However, beginning in 2021, you will be able to.

What can I do during AEP?

There are several things you can do during this period:

  • You can change your plan from Original Medicare Part A and Part B to a Medicare Advantage Plan (Part C).
  • You can switch from a Medicare Advantage Plan to Original Medicare Part A and Part B.
  • You can switch your Medicare Advantage Plan to another plan through a different company.
  • You can opt to enroll in a Part D prescription drug plan.
  • You can change your Part D plan to another plan by a different provider.
  • You can cancel your Part D plan, opting out of your prescription drug coverage. 

You only need to act if you want to change something about your Medicare plan. If you would prefer that everything stayed the same, you don’t need to do anything. However, if you have anything except Medicare Part A, the premiums change from year to year. By letting your insurance renew automatically, you may be signing up to pay more without knowing it! If you want the most significant savings on your rates, give us a call at (877)-877-5505.

Why make changes?

Several factors may make you want to change your Medicare plan during the Annual Enrollment Period. If you pay a premium on your Part C or Part D, and it’s already hitting you hard in the wallet, you may want to cancel when you find out it will be even more costly in 2020. Or, what if the doctor you’ve seen for 20 years is suddenly not in your Medicare Advantage Plan network? You may want to change to a different plan so you can continue to see your same doctor. Another reason you may want to make changes is that sometimes, your medication is no longer covered by your plan. So you may decide to switch to a different prescription plan that includes it. Another possibility is that you’ll stop needing certain drugs and therefore will want to change to a less-expensive Part D plan.

In 2017, we received an inquiry from Terry, a 74-year-old Medicare beneficiary. Right before the 2018 AEP, Terry’s osteoarthritis quieted down, and he didn’t see a reason to enroll in a Medicare Advantage Plan. Six months after the AEP, he accidentally fell while taking a walk and ended up in the hospital. Unfortunately, his insurance didn’t fully cover the ambulance, extended hospital stay, or the variety of specific drugs he received as a patient. On top of just having spent an extended time recovering, he was forced to pay for most of the treatment out of pocket, as he didn’t have a Medicare Advantage Plan, a Medigap plan, or Part D to cover the expenses. So, when the next Annual Enrollment Period came, he gave us a call, determined to find out more about Medicare Advantage plans, Medigap plans, and Part D plans.

There are plenty of reasons to make changes, and some may be individual to you. If you’re ready to see what other options are out there, contact us via our online form.

How will Medicare change in 2020?

Aside from changes that occur in your individual Medicare Advantage plans and Part D plans, such as premiums and deductibles, there are some other changes you need to know about.

  • New beneficiaries who turn 65 on or after January 1st, 2020 will no longer be allowed to enroll in Medigap plans C and F. However, if you are eligible for Medicare now or will be before January 1st, 2020, you will still be able to apply for these plans. This is true for both now and in the future
  • As of 2020, there will no longer be a ‘donut hole,’ or coverage gap, for Part D plans. In 2019, when the value of prescriptions purchased by a beneficiary reached $3,820, they would be left paying more out-of-pocket costs. But in 2020, medicare beneficiaries will only be responsible for 25% of drug costs in the donut hole. These costs should be similar to what you paid for prescription drugs before reaching the donut hole.

All fall enrollment periods are not created equal

One thing to make yourself aware of is that the Fall Open Enrollment for Medicare is not the same thing as Open Enrollment for federal or state Marketplaces. The Medicare Open Enrollment starts October 15th and ends December 7th, while the ACA Marketplace starts November 15th and runs through December 15th. The second OEP is for people who are not on Medicare and was established by the federal government under the Affordable Care Act for people who are not old enough to be on Medicare. The Open Enrollment period refers to the time when uninsured and underinsured Americans can enroll in insurance plans using the federal Marketplace. The Open Enrollment often overlaps the Fall Open Enrollment, and therefore some people get confused. However, the federal Marketplace is not generally available to people who already have or are eligible for Medicare.

What if I am not satisfied with the changes I made during the AEP?

If after selecting a new Medicare Advantage Plan during the Annual Enrollment Period, you are unhappy with it, all is not lost. You will have another opportunity to switch your plan during the Medicare Advantage Open Enrollment Period (MA OEP). MA OEP runs from January 1st through March 31st. Under the new rule established in 2018, the MA OEP was extended to March 31st.. The new rule also gives you the opportunity to switch to another MA plan, whereas before you could only switch to Original Medicare. Any changes will go into effect on the first day of the next month after you enroll. The MA OEP is the time when you can change to another Medicare Advantage Plan or to Original Medicare with or without a Part D Prescription plan.

What if I miss the AEP deadline?

If you’d like to enroll in Medicare Part C or Part D, but you missed the AEP and MA OEP, you may be eligible to do so during the Special Enrollment Period (SEP). To qualify for the SEP, you must meet specific requirements. If you are ineligible for the SEP and missed the AEP and MA OEP, you will have to wait until next year’s AEP. If you only have Original Medicare, you will not be able to make changes to a Part D plan, during this time, however.

Next steps

Arm yourself with information and facts so that you are prepared for the AEP. Go over the benefits of the Medicare coverage you currently have. If you have Original Medicare, review the 2020 Medicare & You handbook. The handbook will provide information about the costs and benefits of Original Medicare for the next year.

If you already have a Medicare Advantage Plan or a Part D plan, your provider should mail you an Annual Notice of Change (ANOC) or Evidence of Coverage (EOC), by September 30th. Look over these documents to be informed about any increased costs or changes in benefits for 2020. What’s helpful about the Annual Notice of Change is that the report will give you a side-by-side comparison of 2019 versus the 2020 plan. Don’t delay reading through your ANOC or EOC. There could be changes in there you’ll want to know about, and if you procrastinate it may be too late to do anything about them!

Even if you are satisfied with your current plan, you should shop for different plans in your area, to help you save money. Reach out to the agents at Bobby Brock Insurance today to help you sort through your options!

Help is available

If you think you need to change your Medicare coverage or you want to learn more about your Medicare options, contact an agent/broker at Bobby Brock Insurance. We work with top-rated insurance companies to find you the best rate. We will help you go over your options and answer all of your questions about Medicare’s Annual Enrollment Period.​

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Justin Brock

President & CEO of Bobby Brock Insurance