Preparing for the Medicare Annual Enrollment Period
by Susan R. Tolbert, Licensed Health Agent
The Medicare Annual Enrollment period is from October 15th to December 7th. During this time period Medicare beneficiaries can make changes in Original Medicare, Medicare Advantage plans, and Medicare Prescription Drug plans. Enrollment, dis-enrollment, or plan changes selected during this period will go effective on January 1st.
Below is a list of what can be done during the Medicare Annual Enrollment period:
- Change from Original Medicare to a Medicare Advantage plan (or vice versa)
- Switch from one Medicare Advantage plan to another Medicare Advantage plan
- Switch from a Medicare Advantage plan that doesn’t have drug coverage to one that does offer drug coverage (or vice versa)
- Join a Medicare Prescription Drug Plan
- Drop Medicare Prescription Drug coverage
- Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan
Medicare Advantage plans, Medicare Advantage Prescriptions Drug Plans, and Medicare Prescription Drug Plans are required to send their members any changes to their plans prior to October 1st for the upcoming year effective date of January 1st. This information is called the “Annual Notice of Change”. This allows beneficiaries the opportunity to review their plan, as well as to compare and consider other plans available to them in the area in which they reside.
Below are some of the key areas in which beneficiaries evaluate their Medicare Advantage and Medicare Prescription Drug plans:
Medicare Advantage
Customer service and overall satisfaction with the plan
Members’ experience with claims, questions, and assistance with trouble shooting problems
Doctor networks
Plan co-pays, co-insurance, and out-of-pocket maximums
Plan logistics (understanding and using the plan, access to information)
Plan features and added benefits, like wellness, dental, hearing, vision
Premium considerations
Medicare Prescription Drug Plans
Formulary and changes to the formulary
Assigned tiers to medication
Deductible and co-pays or co-insurance
Customer service
Premium considerations
Pharmacy providers
Mail order service options and delivery
Overall customer service and communication to members
Ease of use and handling problems
To prepare for the Annual Election Period, evaluate your specific needs in a plan and changes in your own health or medications that may have occurred in the last year. Review any changes your plan may be making and compare that plan to other plans available to you with the help of your licensed Medicare agent. Medicare can be confusing and agents are here to help guide through the array of options and answer any of your questions or concerns.
Note regarding Special Enrollments:
There are some circumstances that allow members to join, switch, or drop plans at different times of the year and these include moving outside of your plan’s service area, gaining or losing Medicaid coverage, qualifying for Extra Help, losing other creditable prescription drug coverage or living in a nursing home.
Note to Medicare Supplement Plan Policy Holders:
Individuals on Medicare supplement plans can apply to move to a different Medicare supplement plan or carrier at any time during the year. Medicare supplement plan policy holders are not restricted to the fall Medicare Annual Election period.
The Medicare Annual Election period is still important to Medicare supplement plan policy holders for a couple of reasons. The first being that most individuals on a Medicare supplement plan usually have a Medicare Prescription Drug plan, and this time period is the one time each year that members can make changes to their drug plan. Secondly, if any one on a Medicare Supplement plan would like to move to a Medicare Advantage plan it would need to be during the fall Medicare Annual Election Period as it would require dis-enrolling from Original Medicare and then joining a Medicare Advantage Plan. Also, if the Medicare Advantage plan includes prescription drug coverage, you will be automatically dis-enrolled from your stand-alone Medicare Prescription Drug plan.
For any questions about the Medicare Annual Enrollment Period, your options, or how changes made may affect your coverage, please contact susan@newbrookeinsurance.com