What Is the Medicare Advantage Open Enrollment Period?

As we are just coming out of what is arguably the most important Medicare enrollment period, you might think all the fun is over! That might be true unless you are enrolled in a Medicare Advantage plan now or starting in January.

If you meet that description, you should be aware of the Medicare Advantage Open Enrollment Period that begins on January 1.

What Can I Do During the Medicare Advantage Open Enrollment Period?

The Medicare Advantage OEP begins January 1 and runs through the end of March. During this 3-month period of time, you can do one of two things if you’re unhappy with your current Medicare Advantage (Part C) plan.

First, you can make a one-time change to a different Medicare Advantage plan. You can switch to a different plan within the same insurance company or switch companies altogether. You may want to do this for a number of reasons. You might have found out your provider doesn’t accept your plan, or the benefits were not what you thought they were. Either way, you can switch to a new plan of your choosing.

Second, you can leave Medicare Advantage and return to Original Medicare (Parts A and B). If you elect to go this route, you’ll need to take a few things into consideration. Unless you get your prescriptions through VA healthcare or TRICARE for life (for veterans and their families), you’ll need to enroll in a separate Part D plan. Be sure to do this even if you are not taking prescriptions, as you’ll be penalized if you don’t. Most Advantage plans include prescription coverage, so you’ll need to purchase a new Part D policy if you disenroll from your Advantage plan.

In addition, most people who do not enroll in Medicare Advantage plans often enroll in a Medicare Supplement plan instead. A supplement, also known as a Medigap plan, will help pick up the costs that remain after Parts A and B have paid their share. Not having a Medigap plan in place could leave you with thousands of dollars in out-of-pocket costs. However, depending on your situation, you may not be able to get a Medicare Supplement.

In most states, the only way to enroll in a Medigap plan after your Initial Enrollment Period (when you’re first eligible to enroll in Medicare) is to pass medical underwriting. This means that the insurance company will ask you a series of questions related to your health. They may also take a look at your health records. Depending on your answers to those questions, they will either approve or deny your application. This is an important consideration if you plan to drop your Medicare Advantage plan during OEP. Even if you don’t love your Advantage plan, it’s often a better alternative than having Parts A and B only.

Lastly, you may need to consider another policy to help with your dental, vision, and hearing costs. Routine and preventive services related to those three things are not covered by Medicare. Unless you’re willing to pay completely out-of-pocket, you should consider an insurance policy.

If you make any changes during OEP, the change goes into effect on the first day of the following month. For example, if you enrolled in a new MA plan on January 2, the new plan will begin on February 1.

What Can’t I Do During the Medicare Advantage OEP?

We’ve talked about what you can do during OEP, but as a reminder, this enrollment period is not open to anyone. You must be enrolled in a Medicare Advantage plan. You cannot choose to enroll in an MA plan for the first time, nor can you enroll in a Part D plan for the first time or change your current Part D plan.

This enrollment period does coincide with the General Enrollment Period (GEP). The GEP is for anyone who did not enroll in Original Medicare when they turned 65 and did not qualify for a Special Enrollment Period. If you enroll in Parts A and B during the GEP, you are also allowed to enroll in other coverage like a Medicare Advantage or Part D prescription drug plan.

If you are unsatisfied with your Medicare Advantage plan, call the agents at Local Medicare Specialists. They can compare the plans in your area and help you decide if there is a better fit for you. Remember, this period only lasts until March 31. After that, you cannot change your plan until the following year!