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Knowledge and Insights

Medicare Open Enrollment

Medicare Open Enrollment, also known as the Annual Enrollment Period (AEP), runs from October 15 through December 7 each year. During this time of year you can change your Part D plan or change your Medicare Advantage plan. If you have original Medicare combined with a Medicare Supplement and Part D plan (prescription drug coverage) this is the only time of year you can change your Part D plan.  Do you need to change plans? Not necessarily. Part D plans will stay in force unless you decide to change plans or carriers. If you submit an application for a new plan, the old plan will automatically be terminated. A common question we hear this time of year is, “Do I need to re-enroll or “re-up” my plan?” No, you do not need to pro-actively re-apply for a Part D each year unless you have let your plan lapse. The only way a carrier can terminate your plan is if you fail to pay the premium, or submit an application for a new plan during the Annual Enrollment Period.

Another function of the Medicare Open Enrollment period is to allow individuals on Medicare Advantage Plans, also known as Medicare Part C, to change plans or move back to original Medicare and a Medicare Supplement. Medicare Advantage plans are network based plans, with co-pays assessed to you when you access medical care.

Should you review or change plans? That is the key question for sure.

Items to consider regarding Part D plans:

  • Have your prescriptions changed during the year?
  • Is your favorite pharmacy a preferred pharmacy with your plan for the coming plan year?
  • Did you receive a notice from your carrier that they will no longer be covering a prescription you are taking?
  • Did the premium increase by a significant amount?
  • Have you been with the same Part D plan for more than 5 years?

Items to consider regarding Medicare Advantage plans:

  • Is the current plan meeting your needs, both realized and potential?
  • Do you have access to the doctors or hospitals you are using now? Would use in the future?
  • Are you being overwhelmed by co-pays?

Your answers to these questions should help you determine if you are content to stay put on your existing plan, or whether you should explore your options for the coming year.

If you want to explore your options, you can call the agent who placed you with your existing plan. Furthermore, you can log in to www.MEDICARE.gov, and utilize the Plan Finder tool which will allow you to enter your current physicians, prescriptions, and favorite pharmacy, and will return results on the various plans.

Please read the ANOC  letter you receive from your carrier 
In accordance with the requirements of CMS (Center for Medicare Services) each carrier must send out an annual ANOC information packet. ANOC stands for Annual Notice of Change. This document will contain any information about the changes in your plan for the coming year. It is prudent to take the time to read this document. If you do not find it stimulating to read from cover to cover, please at least scan it for the key points as mentioned above in the questions to ask yourself.

AEP and Medicare Supplements
Medicare Supplement plans can be changed at any time during the year, and are not tied to the Medicare Open Enrollment period.

A word on Medicare Advantage plans
Keep in mind that most carriers impose medical underwriting if you wish to move from a Medicare Advantage plan back to original Medicare with a Medicare Supplement and Part D. What that means is that you will need to answer medical questions to be picked up by a Medicare Supplement plan.

Please seek guidance from a licensed insurance professional before making changes to your coverage.

 

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