Medicare Annual Open Enrollment Explained: Your Comprehensive Guide

What Is Medicare’s Annual Open Enrollment Period?

The Medicare Annual Enrollment Period, also known as AEP, happens every year between October 15th and December 7th. During this time, you can:

• Enroll in a new Medicare Advantage Plan (Part C).
• Switch from one Medicare Advantage Plan to another.
• Sign up for a Part D Prescription Drug Plan or switch your existing plan.
• Drop a Medicare Advantage Plan and return to Original Medicare (Parts A and B).
• Make no changes, allowing your current plan to roll over into the next year.

It’s a time to reassess your healthcare needs, evaluate plan changes, and ensure you’re getting the coverage that’s right for you.

What Can You Do During AEP?

Here are some common scenarios and what actions you can take during AEP:

1. If You Have Original Medicare (Parts A & B):

• Enroll in a Part D Prescription Drug Plan if you don’t already have one.
• Switch to a Medicare Advantage Plan (Part C), which often includes additional benefits like dental, vision, and hearing coverage.
• Make no changes and let your Original Medicare roll over into the following year.

2. If You Have a Medicare Advantage Plan (Part C):

• Switch to a different Medicare Advantage Plan, particularly if your doctors or medications are no longer covered.
• Drop your Medicare Advantage Plan and return to Original Medicare. Many beneficiaries who do this choose to add a Medicare Supplement (Medigap) Plan and a standalone Part D Prescription Drug Plan.
• Stick with your current plan, as long as it’s available for the following year.

Important Tip: Review the Annual Notice of Change (ANOC) sent by your plan in October. It outlines any changes to benefits, premiums, or coverage for the coming year.

Things to Keep in Mind When Switching Plans

Medicare Advantage Plans:

If you’re switching from a Medicare Supplement Plan to a Medicare Advantage Plan, cancel the Supplement Plan once the Advantage Plan takes effect. Medicare Advantage becomes your primary coverage, so continuing to pay for a Supplement Plan would be unnecessary and costly.

Before selecting a Medicare Advantage Plan, consider:

• Provider Network: Are your doctors and preferred hospitals in-network?
• Medications: Are your prescriptions covered?
• Out-of-Pocket Costs: Review deductibles, co-pays, and out-of-pocket maximums.

Prescription Drug Plans (Part D):

When shopping for a Part D plan, use the Medicare.gov Plan Finder tool. Input your medications to find the plan that offers the best coverage and lowest out-of-pocket costs.

Effective Date:

Any changes made during AEP will take effect on January 1st of the following year. It’s crucial to plan ahead and ensure your new coverage meets your needs.

Beware of Misleading Advertisements

During AEP, you’ll encounter a flood of marketing from insurance companies. While many ads highlight attractive benefits like dental, vision, and transportation services, they often leave out crucial details about costs and restrictions.

To avoid surprises:

• Research plans thoroughly.
• Verify coverage for your doctors, medications, and preferred healthcare services.
• Work with a trusted insurance professional who can guide you through the process.

Common Misconceptions About AEP

1. Can You Switch Medigap Plans During AEP?

Many people mistakenly believe that AEP is the only time to change Medigap (Medicare Supplement) plans. This is not true. You can switch Medigap plans at any time during the year, provided you pass medical underwriting (unless you qualify for a guaranteed issue right).

In fact, changing Medigap plans outside of AEP can be more efficient since carriers are less overwhelmed with applications during non-peak times.

2. Can You Avoid Health Questions When Switching Medigap Plans?

No, unless you qualify for a special enrollment period or have a guaranteed issue right, you’ll need to answer health-related questions when switching Medigap plans. AEP does not waive this requirement.

How We Can Help

At Bluewave Insurance, we’re here to simplify the process for you. Whether you’re considering a Medicare Advantage Plan, switching Part D coverage, or exploring Medigap options, we’ll help you:

• Compare plans that fit your healthcare needs and budget.
• Ensure your doctors and prescriptions are covered.
• Understand the benefits and limitations of each plan.

Ready to Make Changes?

The Medicare Annual Open Enrollment Period is your opportunity to optimize your coverage for the upcoming year. Don’t wait until the last minute—start exploring your options today.

If you’re unsure where to begin, give us a call at 800-208-4974. We’ll guide you through the process and ensure you’re confident in your decision.