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Switching Plans During Medicare Advantage Open Enrollment Period (MA OEP)

Switching Plans During Medicare Advantage Open Enrollment Period (MA OEP)
Enrollment periods for any type of insurance coverage can be difficult to navigate. Medicare is no different. There are several enrollment periods that enable you to receive or change how you receive the Medicare coverage you’re entitled to as a Senior.
 
These include:
 
  • Initial Enrollment Period (IEP)
  • Special Enrollment Period (SEP)
  • Annual Election Period (AEP)
  • Medicare Advantage Open Enrollment Period (MA OEP)
 
Understanding the differences between each enrollment period is often a point of confusion for Seniors. This blog will focus on what changes Medicare Advantage Open Enrollment Period (MA OEP) allows you to make to the way you receive Medicare coverage.
 
First, to better understand MA OEP, we’ll briefly discuss what you can do during IEP, SEP, and AEP.
 

1.  Initial Enrollment Period (IEP)

You are first able to sign up for Medicare during your Initial Enrollment Period (IEP), which takes place when you turn 65 years old and lasts for seven months total:
 
  • The three months prior to the month you turn 65,
  • the month you turn 65, and
  • the three months after you turn 65.
 

2.  Special Enrollment Period (SEP)

Special Enrollment Periods (SEPs) allow those on Medicare Advantage or a Medicare drug plan to make changes to your Medicare Advantage plan and Medicare prescription drug coverage provided certain events occur in your life.1 Each SEP has its own rules about when and what type of changes you can make. An uncomprehensive list of life events that may prompt an SEP include:1
 
  • A change in where you live
  • A loss of your current coverage
  • A chance to get other coverage arises
  • The contract your plan has with Medicare changes
 

3. Annual Election Period (AEP)

The Annual Election Period (AEP) occurs every year from October 15 to December 7. It allows Medicare beneficiaries to make these changes to the way they receive Medicare benefits:
 
  1. Change from a Medicare Advantage plan back to Original Medicare.
  2. Change from Original Medicare to a Medicare Advantage plan.
  3. Switch from one Medicare Advantage plan to another Medicare Advantage plan*.
  4. Drop, switch, or join a Medicare Part D (prescription drug) plan.
 
*with or without prescription drug coverage
 
Read more about AEP.
 
Now that we’ve briefly discussed IEP, SEP, and AEP, let’s discuss Medicare Advantage Open Enrollment Period (MA OEP).
 

Medicare Advantage Open Enrollment Period (MA OEP)

MA OEP takes place every year from January 1 to March 31. MA OEP allows Seniors enrolled in a Medicare Advantage plan to make a one-time change to the way they receive their Medicare benefits by choosing one of the following:
 
  1. Switch to Original Medicare (Medicare Part A and Part B) and add a Medicare Part D (prescription drug) plan if desired
Medicare Advantage plan → Original Medicare
 
  1. Switch to a different Medicare Advantage plan*
Medicare Advantage plan → Medicare Advantage plan
 
*with or without prescription drug coverage
 
If you have Original Medicare (with or without Medicare Part D prescription drug coverage), you can’t make any changes to your Medicare coverage during MA OEP like you can during AEP. Read more about the differences between AEP and MA OEP.
 
Now that we know the two changes you can make during MA OEP, let’s discuss why you might want to make either of those changes.
 

Why might I switch from a Medicare Advantage plan to Original Medicare?


Medicare Advantage plan → Original Medicare
 
  1. Cost – Some Medicare Advantage plans may provide additional benefits at lower premiums. However, you can’t get any additional supplemental coverage like a Medicare Supplement insurance policy if you have a Medicare Advantage plan. This could leave you without financial protection against many unexpected out-of-pocket expenses like copayments and deductibles. In this case, some may want to switch to Original Medicare and add a Medicare Supplement insurance policy.
 
  1. Doctor and hospital choice – Generally, you have to stick to a network of providers when you are enrolled in a Medicare Advantage plan. With Original Medicare paired with or without a Medicare Supplement insurance policy, you get to choose any doctor or hospital that accepts Medicare. This can be helpful for snowbirds or Seniors who may travel out of their Medicare Advantage plan networks throughout the year.
 
  1. Your plan is not renewed – Medicare Advantage plans are not guaranteed renewable. This means you may have coverage one year but not the next.
 
  1. Changes in network – Medicare Advantage plans usually have a network you have to stay in. The doctor, hospital, and specialist you prefer, however, have the ability to leave your Medicare Advantage plan or exit your plan’s network meaning you may need to search for a new provider in the network.
 
  1. Your Medicare Advantage plan is no longer available – Your Medicare Advantage plan’s carrier could exit marketing. In this case, enrollees would need to find new coverage for the coming coverage year.
 
This is not a comprehensive list of reasons you might change from one Medicare Advantage plan to Original Medicare with or without a Medicare Supplement insurance policy during MA OEP.

Why might I switch from one Medicare Advantage plan to another Medicare Advantage plan*?

 
Medicare Advantage plan → Medicare Advantage plan
 
Reasons you may want to switch from one Medicare Advantage plan to another Medicare Advantage plan during MA OEP include: 
 
  1. Your Medicare Advantage plan carrier has decided to stop participating in Medicare – You might be happy with your plan, however, if your plan carrier stops participating in Medicare, it will no longer be available. You might seek out a Medicare Advantage plan with similar features in this case.
 
  1. You want a plan with more, fewer, or different features – A common instance follows: You may have a Medicare Advantage plan that does not include prescription drug coverage, and want to switch to one that does include prescription drug coverage.
 
Prescription drug coverage options vary by Medicare Advantage plan, as each Medicare Advantage plan is privately managed by the insurance carrier. Evaluate the drug coverage that’s included in the Medicare Advantage plan you’re considering to make sure your prescription drug coverage needs are met and continue to be met.
 
This is not a comprehensive list of reasons you might change from one Medicare Advantage plan to another Medicare Advantage plan during MA OEP.
 
*with or without prescription drug coverage
 

Important things to remember during AEP.

It can be difficult to decide whether Original Medicare or a Medicare Advantage plan is the best fit for you.
 
You may want to consider the following when choosing the Medicare coverage option that’s best for you:
 
  • Networks

    • Is being able to pick any provider that accepts Medicare important to you?
    • Are the doctors and hospitals you prefer in the plan’s network?
 
  • Market longevity

    • When was the carrier founded?
    • How long has the carrier offered Medicare Advantage plans?
 
  • Stability

    • What is the carrier’s A.M. Best score? This helps prove their financial strength and ability to pay claims.
    • How much premium in force does the carrier have?
    • What is the carrier’s reputation like?
 
 
If you are unsatisfied with the way you receive the Medicare coverage you’re entitled to … you can change it.
How you receive the Medicare coverage you’re entitled to is up to you. You are able to make changes to how you receive Medicare coverage during certain enrollment periods.
 
MA OEP is an enrollment period that pertains to Seniors who are enrolled in a Medicare Advantage plan. It takes place every year from January 1 to March 31.
 
MA OEP allows Seniors enrolled in a Medicare Advantage plan to make a one-time change to the way they receive their Medicare benefits by either switching from a Medicare Advantage plan to Original Medicare or switching from one Medicare Advantage plan to another Medicare Advantage plan (with or without prescription drug coverage).
 
The coverage you need is entirely dependent on your lifestyle and factors like budget, age, and health. Learn more about Medicare, including enrollment periods, at medicare.gov. Or, speak to a licensed insurance agent to ensure you get one-on-one guidance tailored to your needs.
 
Sources:
  1. Medicare.gov, Special circumstances (Special Enrollment Periods), accessed September 2021