If you’re unsatisfied with the Medicare insurance plan you currently have, or you’d like to explore the options available to you, Medicare gives you the opportunity to make changes to your coverage during certain enrollment periods during the year. The Open Enrollment Period is the annual opportunity for Medicare beneficiaries to make certain changes to their health care coverage.
OEP begins every year on October 15th and ends on December 7th. Open Enrollment occurs after Medicare Advantage and Medicare Part D plan enrollees receive their Annual Notice of Change (ANOC) letter at the end of September. The ANOC informs beneficiaries of all plan changes regarding coverage and costs that will take effect in the new year. If you are enrolled in a Medicare Advantage or Medicare Part D plan, you should carefully review your ANOC to ensure that you’ll continue to get the coverage you need at a price you can afford. If you determine that your plan will no longer meet your needs, you can explore your options during OEP.
Many Medicare enrollees make changes to their coverage during OEP, and you may lower your costs or increase your coverage – or both – by switching plans.
What changes can you make to your Medicare benefits during OEP?
During OEP, Medicare beneficiaries can make the following changes:
- Switch from Original Medicare Parts A and B to a Medicare Advantage (Part C) plan
- Switch from a Medicare Advantage plan back to Original Medicare Parts A and B
- Switch from their current Medicare Advantage plan (with or without prescription drug coverage) to a new Medicare Advantage plan (with or without prescription drug coverage).
- Drop your Medicare Advantage plan and revert back to Original Medicare – and sign up for a Medicare Part D prescription drug plan
- Switch from their current Medicare Part D plan to a different one
If you make any of the changes mentioned above, the change goes into effect on January 1st of the coming year.
What are some reasons to switch Medicare coverage during OEP?
Thousands of Medicare beneficiaries make changes to their Medicare benefits every year during OEP. If you’ve been thinking about whether or not to switch your coverage, you might want to consider some of these reasons why it can be to your advantage:
- Your health care needs are changing. If you’ve recently become ill or have had an injury that requires more comprehensive insurance coverage, you may need additional benefits. For example, Original Medicare Parts A and B don’t cover prescription drugs, vision, dental, or hearing care which you might need now.
- You may need a different prescription drug plan because your current plan doesn’t cover the drugs you need, or you may want to lower your costs.
- You might need to reduce your out-of-pocket expenses. Switching over to a zero-or low premium Medicare Advantage plan may help reduce your out-of-pocket costs. Medicare Advantage plans also offer an annual out-of-pocket maximum limit.
- If you want to have access to health care providers that you prefer, you may need to shop around for a Medicare Advantage plan that either allows you to use providers outside the network or one that includes your providers.
Other enrollment periods
Medicare also has the following enrollment periods you should be aware of as you decide to enroll in Medicare or make changes to your coverage:
Initial Enrollment Period
This is a seven-month period of enrollment for those who are eligible to enroll in Medicare for the first time. The period of time depends on the date of eligibility.
General Enrollment Period
The GEP is your chance to sign up for Medicare if you’ve missed your Initial Enrollment Period. The GEP starts January 1st and ends March 31st. If you enroll in Medicare during that period, your coverage will be effective on July 1.
Medicare Advantage Open Enrollment Period
This MA-OEP runs from January 1st to March 31st every year. Medicare beneficiaries can leave their Medicare Advantage plan and switch to a different Medicare Advantage plan, or drop their MA plan and return to Original Medicare.
Special Enrollment Periods
Medicare allows those who qualify for Special Enrollment Periods to enroll in a Medicare Advantage or Part D plan or switch from one plan to another. You may qualify if you move, if your current plan ends its coverage, or you become dual-eligible for Medicare and Medicaid, among other life events.
Five-star special enrollment
Between December 8 and November 30, you can use the Five-Star Special Enrollment Period one time to switch from a Medicare Advantage Plan, Medicare Prescription Drug Plan (PDP), or Medicare Cost Plan with a 5-star rating is available in your area.