As the new year begins, Medicare plans that were purchased by December 7th have already begun. However, did you know that there is another opportunity in the spring to enroll in Medicare?
This enrollment period is called Open Enrollment Period (OEP) and it runs from January 1st to March 31st. It allows Medicare Advantage plan enrollees another opportunity to make changes to their plan. However, there are rules and regulations.
This article will outline the important rules and regulations that you must know about before deciding if you want to take advantage of changing plans during this enrollment period.
The difference between AEP and OEP
Annual Enrollment Period (AEP)
Medicare has an official Annual Enrollment Period (AEP) which runs from October 15th to December 7th annually. During this period, current or new Medicare enrollees can enroll in a new Medicare Advantage plan (Part C), Medicare Supplement plan, and/ or a Prescription Drug Plan or Part D.
It is important to note that this is the only time of year in which you can change from a Medicare Advantage plan or a Medicare Supplement plan, but you will be underwritten based on your health history.
While there are Special Enrollment Periods throughout the year in which you can make changes to your plan, they are limited and you often have to meet the requirements to enroll.
Open Enrollment Period (OEP)
In contrast to AEP, the Open Enrollment Period (OEP) is not as flexible. During this time, only Medicare enrollees who have a Medicare Advantage plan can change plans, or they can go back to Original Medicare (Part A and B) and get a Part D plan to maintain drug coverage.
If you do choose to change plans, you must keep that coverage for the remainder of the year unless you qualify for a Special Enrollment Period (SEP) throughout the year.
While OEP is a second chance to enroll in a Medicare plan if you may find you are dissatisfied with the new plan you just enrolled in, it is important to note that making changes to your plan during this time is restricted to Medicare Advantage plans, and you must currently be enrolled in one to make any changes to your plan. Additionally, if you have a Medicare Supplement plan, you can’t make a change during this time. Changes are reserved for AEP, so if you missed that period, you must have a SEP or wait until the next AEP in October.
Do I need to switch plans?
With AEP being a main focus of Medicare enrollment, OEP is often forgotten as an option to make changes to your plan.
But making changes is not necessary and you should not make any changes unless you are certain you want to because these can be irreversible and long-lasting for the year, changing the cost and accessibility of your medical care.
If you are looking to switch plans, there are a few things to think about.
- Are you satisfied with your current coverage?
OEP was created to help Medicare Advantage enrollees change plans if they were dissatisfied with their current coverage. Figuring out if you are satisfied with your coverage depends on the features of the plan that are important to you.
For example, if you originally purchased a plan because of the fitness benefits but found your gym is not in the network, there are other options. Or, maybe your doctor left the network as of January 1st and you need to find a new plan. OEP allows you to make these changes to ensure you have the right coverage for the upcoming year.
- Did you miss AEP?
AEP is short and ends only after 11 weeks. During this time of year, a lot is going on so it can be easy to miss deadlines or get confused when you need to enroll. If you were planning to explore new Medicare Advantage plans, you now have an extended option. Take advantage of this period to make any final decisions before it is too late.
- Did your medical needs change? Original Medicare as an option
OEP is not just for changing Medicare Advantage plans, as you can also switch back to Original Medicare. As a reminder, you are not required to enroll in a Medicare Advantage plan, but you do need to enroll in Medicare Part A and Part D, as well as Part B to have complete medical coverage to qualify for a Medicare Advantage plan.
That said, only having Original Medicare may not be the best option since you must pay 20% of all costs, but in some cases like being in a nursing home, having only Original Medicare is the preferred option when it comes to billing.
Additionally, if you have an upcoming surgery or are concerned about a big bill, it may not make sense to only have Original Medicare because you could be subject to large out-of-pocket costs. Looking at your upcoming healthcare needs is key to making this decision.
Another consideration is drug coverage. If you do decide to drop your Medicare Advantage plan and go back to Original Medicare, you will need to enroll in Medicare Part D coverage to avoid any penalties. But, be prepared to pay a monthly premium.
In conclusion, Medicare OEP is a time of year that may be forgotten but can also be an important opportunity to change plans if you have a Medicare Advantage plan.
Still looking to review your coverage? There is still time! Schedule a free 15 minute consultation to learn more about how to make changes to your plan by March 31st and secure the right coverage for you.