Medicare Advantage Open Enrollment Period (OEP)
What is OEP?
This new enrollment period is different from the Medicare Annual Enrollment Period (AEP). AEP runs from October 15 thru December 7th. A refresher on AEP is here. The new Medicare Advantage Open Enrollment Period (OEP) is only available to those already enrolled in a Medicare Advantage plan. Learn about OEP here. Below is a synopsis of your options. During OEP you can:
- Switch from one Medicare Advantage plan to another Medicare Advantage plan. You can also disenroll from your current Medicare Advantage plan and return to Original Medicare. If this path is chosen, you can enroll in a Part D drug plan and/or one of the available Medigap plans. Learn more about Medigap enrollment periods here. Either of these 2 options can be done once between January 1 and March 31.
- If you enrolled in a Medicare Advantage Plan during your Initial Enrollment Period (definition here), you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare.
Medicare Advantage Open Enrollment Period: Why would I want to do this?
You learned something about your current Medicare Advantage plan that you do not care for; for example you:
- took the recommendation of a friend and joined the plan they enrolled in and after you did this, you are not sure you made the right choice. You do not want to be stuck in your current plan for the rest of the year.
- Were not aware of the enhancements made to several plans available this year that were not available last year. You want to change plans to take advantage of these enhancements.
- Can’t find doctors that are accepting new patients in your current plan.
- Hardly use medical services and just learned about there are several low/zero premium plans loaded with additional attractive services. You are not sure you will get the same value out of your current high premium plan.
- Your medications are not covered by your current plan. Or, you learned another plan covers your medications at a lower annual out of pocket cost (annual plan premium + annual refill costs).
- Joined a plan that only includes access to one of the area’s major hospitals (and doctors). You now recognize the value of having access to all hospitals and doctors and want a plan that has this.
- Your existing plan’s network no longer has all of your doctors/hospitals/preferred skilled nursing facilities.
- Didn’t really understand your current plan has prior authorizations on the services you may use AND other plans do not.
- Just learned about Medigap plans and the flexibility they offer and want to switch.
- Recently realized Medigap plans have only one ‘open enrollment period’ and after that passes, you have to answer health history questions if you want to join one. It make good sense to join one while you are still in the 6-month ‘open enrollment’ window.
- Just realized your preferred gym isn’t included in your current plan and is with another plan.
- Were just diagnosed with a major health issue and want to compare your health care costs with other plans. You also want more flexibility to the doctors/hospitals available through your current plan.
- Just found out your current plan’s drug formulary covers less than 3000 of the 5000+ medications CMS covers. You want a plan with comprehensive medication coverage.
Isn’t OEP the same as the Medicare Advantage Disenrollment Period (MADP).
No. With the announcement of OEP, the MADP has been discontinued.
Medicare Advantage Open Enrollment Period: What else do I need to know?
If you are going to change to a different Medicare Advantage plan, be sure it will meet your needs. We suggest you take the time to read the new plan’s ‘Evidence of Coverage’ document before you finalize your ‘change plan decision’ . Make sure the new plan will meet your needs and budget.
If you had been getting your prescription coverage through your current Medicare Advantage plan and you wish to return to Original Medicare, remember to coordinate the termination of your Medicare Advantage plan with the start date of your new prescription drug coverage.
This same thought applies if you wish to join a Medigap plan; avoid gaps in your health care coverage. Be sure you submit and have your application to you new Medigap plan approved before you terminate your Medicare Advantage plan. Be sure you understand all of the enrollment rules before you start this venture.
If you plan to stay with ‘Original Medicare’ (Part A and/or B), remember that Original Medicare does not have a cap on your annual out of pocket costs. You can eliminate this exposure with either a different Medicare Advantage plan or a Medigap plan. Be aware there is a ‘high deductible’ Medigap plan that fills this need and their monthly premiums are lower than some Medicare Advantage plans…and the plan’s deductible is often lower than a Medicare Advantage plan’s ‘out of pocket limit’.
How do I get help with this?
We encourage you to work with a Idaho based professional broker that specializes in Medicare and is licensed with all plans available to you.
We are licensed with all Medicare Advantage and Medigap plans available to Idaho residents. Contact us. We are here to help.
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