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What Can I Do During Annual Election Period for Medicare?

What Can I Do During Annual Election Period for Medicare?

Most choose to enroll in Medicare when they become eligible at age 65. Medicare-eligible persons can usually enroll in one of two options:
 
  1. A Medicare Advantage plan; or
  2. Original Medicare with or without a Medicare Supplement insurance policy.
Each option – a Medicare Advantage plan and Original Medicare with or without a Medicare Supplement insurance policy – provides certain benefits and limitations. It’s important to research and carefully consider each option before purchasing.
 
This article will discuss what you can do during Annual Election Period (AEP).

What is the Annual Election Period (AEP)?

AEP pertains to Medicare beneficiaries looking to change their current coverage. It takes place every year from October 15 to December 7. AEP allows you to make these changes to the way you receive your 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. Join, drop, or switch a Medicare Part D (prescription drug) plan.
 
We’ll briefly discuss the reasons you might want to make each change.

1. Why might I change from a Medicare Advantage plan to Original Medicare?

  • Cost

    Some Medicare Advantage plans may provide additional benefits at lower premiums. However, many unexpected out-of-pocket expenses like copayments and deductibles can’t be covered by a supplemental policy. In this case, some may want to switch to Original Medicare and add a Medicare Supplement insurance policy.

  • Doctor and hospital choice

    You generally have to stick to a network of providers with a Medicare Advantage plan. You get to pick any doctor or hospital that accepts Medicare with Original Medicare paired with or without a Medicare Supplement insurance policy. This is especially helpful for snowbirds or Seniors who may travel out of their Medicare Advantage plan networks during the year.

  • Your plan is not renewed

    Medicare Advantage plans are not guaranteed renewable, which means you may have coverage one year but not the next.

  • Changes in network

    The doctor or hospital you prefer has the ability to leave your Medicare Advantage plan or a hospital you want to go to could go out of the plan’s network.

  • Your Medicare Advantage plan is no longer available

    Your Medicare Advantage plan’s carrier could exit marketing leaving enrollees to find new coverage for the next 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 this enrollment period.

2. Why might I change from Original Medicare to a Medicare Advantage plan?

Original Medicare covers Medicare Part A and Part B, which is great but can leave you with a lot of out-of-pocket expenses like deductibles, coinsurance, and copayments. While some Seniors choose a Medicare Supplement insurance policy to help cover some of the out-of-pocket expenses Original Medicare doesn't cover, other Seniors may opt for a Medicare Advantage plan for their Medicare coverage.
 
A Medicare Advantage plan includes Medicare Part A and Part B coverage, as well as prescription drug coverage in most cases, which isn't covered under Original Medicare. Some Medicare Advantage plans also provide additional chronic care benefits as well as some dental, vision, and hearing coverage.
 
Many Seniors choose to switch from Original Medicare to a Medicare Advantage plan for these additional benefits or because of cost. The premiums on a Medicare Advantage plan may be lower than those on Original Medicare with a Medicare Supplement insurance policy.
 
While cost is an extremely important factor for those on a fixed or limited income, like Seniors, ensuring medical coverage needs are met is also vital to help prevent unexpected costs.
 
This is not a comprehensive list of reasons you might change from Original Medicare to a Medicare Advantage plan.

3. Why might I change from one Medicare Advantage plan to another Medicare Advantage plan? 

During AEP, you may want to switch from one Medicare Advantage plan to another Medicare Advantage plan for a few different reasons, including: 
  • Your Medicare Advantage plan carrier has decided to stop participating in Medicare

    In this case, you might be happy with your plan, but it is no longer available. This might prompt you to choose a plan with similar features.

  • You want a plan with more, fewer, or different features

    For instance, 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.

Each Medicare Advantage plan is privately managed by the insurance carrier, so the prescription drug coverage options vary by Medicare Advantage plan. To ensure your prescription drug coverage needs are being met, closely examine the drug coverage included in the Medicare Advantage plan you’re considering.
 
This is not a comprehensive list of reasons you might change from one Medicare Advantage plan to another Medicare Advantage plan.

4. Why might I join, switch, or drop a Medicare Part D (prescription drug) plan?

If you’re enrolled in Original Medicare, you can:
 
  • Join a standalone Medicare Part D (prescription drug) plan,
  • Drop a Medicare Part D (prescription drug) plan, or
  • Switch from one Medicare Part D (prescription drug) plan to another.
This allows you freedom to choose a plan based on your location and needs.
 
Those who enroll in a Medicare Advantage plan but want to change their coverage can disenroll during the Medicare Advantage Open Enrollment Period (MA OEP). Read more about the difference between AEP and MA OEP.

Important things to remember during AEP.

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

    • Are your doctors and hospitals in the Medicare Advantage plan network, or do you want to be able to pick any provider that accepts Medicare under Original Medicare?

  • Market longevity

    • When was the carrier founded?
    • How long have they 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?
A licensed insurance agent can help you make informed decisions during AEP.
You can get educated on Medicare’s initial and annual enrollment periods in many ways, but you always have the option to speak to a licensed insurance agent who specializes in Medicare products.
 
Working with a licensed insurance agent can help you get personalized guidance based on your specific needs. They can also help you stay on top of the latest Medicare news and events. Agents will likely stick with you throughout the years, so they can provide special help anytime you have a new need or change.