Annual Enrollment Period Dates
So always remember that the Annual Enrollment Period (AEP) last from October 15th through December 7th every year. It is the period when you can enroll, change your plan, or drop your plan. Listed below are 5 Facts you need to know to make your AEP successful.
AEP Is Primarily for Medicare Advantage and Part D Prescription Plans
Every year the current 56 million Medicare recipients get an opportunity to make changes to their plans. The only plans restricted to making changes during this period are Medicare Advantage or Part D Prescription Plans.
Let’s say you are currently enrolled in a Medicare Advantage Plan, what does this mean to you. You have several options. You can stay with your current plan and would not have to do anything. You can change Medicare Advantage Plans by choosing a different plan with your current company or switch to another company with different benefits. You can drop Medicare Advantage altogether and get a Prescription Part D Plan to go along with Original Medicare. Or you can switch to a Medicare Supplement and get a Part D Plan to go along with it (Medicare Supplements do not have Part D plans included).
Let’s say you only have a Part D plan and Original Medicare. You can change Part D plans. You can switch to a Medicare Advantage, or add a Medicare Supplement. The Supplement will take effect immediately the 1st of the following month as there are no restrictive enrollment periods for Supplements as there are with MA and Part D.
Changes to your Medicare Advantage (MA) and Part D will take effect January 1st of the following year. If you are own a MA plan and switch to a supplement, it will take effect January 1st of the following year. MA and Part D Plans last from January 1 through December 31 every year unless you qualify for some type of Special Enrollment Period (SEP).
Confused yet? Most people are!
Medicare Advantage Plans and Part D Prescription Plans Change Networks Yearly
So, with some 2200 MA plans in the United States covering most states, counties, and cities there is often many changes that take place every year.
First, we will discuss MA networks. Hospitals, Physicians, and other health facilities are under no obligation to accept a MA plan. Often the networks with MA plans change yearly if not more often. Increasingly Physicians are opting not to participate in MA plans at all because of poor reimbursement. Those that remain accepting MA plans often limit the panel, number of patients, they will accept with certain MA Plans. Why would anyone want to get paid less when there are plenty of Insurance Companies who pay more? Hospitals often change the MA patients they receive year in and year out.
Part D Plans are subject to change also. They can change their formulary to include or exclude certain medications. Part D Plans can change their preferred Pharmacy which causes you to look for an in-Network Pharmacy. Part D plans are often allowed to discontinue brand name drugs for a condition when a suitable generic becomes available.
MA and Part D Benefit Changes
Just because you had certain MA co-payments this year with your company does not guarantee you will have the same co-payments next year with the same company. Payments fluctuate year to year with some or all co-payments going up and occasionally they might also go down. You need to read carefully or contact a licensed broker to explain the benefits to you.
Part D also changes co-payments yearly. Some drug cost goes up and you might have some medications that drop to a lower tier, think generic, and prices go down. You can also consult a broker for help understanding. We often have tools available to compare for you.
Really important to remember is that ancillary benefits may also change. The Dental, Vision, gym membership, and free over the counter medications are a bonus and under no circumstance are the MA companies required to provide those benefits.
Why You Might Want to Consider a Medicare Supplement
You have heard me say it before and I will say it again; THERE IS NO BETTER PRODUCT THAN A MEDICARE SUPPLEMENT PLAN (MEDIGAP). My Mom and Dad had one and if they were still alive they would still have one. When I turn 65 in several years, I will have a Medicare Supplement. Friends and family members of mine have a Medicare Supplement. Brokers or Medicare Specialist like myself recommend them not because we get paid more (We get paid less), we recommend them because we know they are the best product that you can purchase to protect your health throughout your senior years. Ethically, we have a responsibility to look out for your best interest, not our own.
Medicare Supplements are medically underwritten when you get past 65 meaning you must answer a medical questionnaire to qualify. There are only a couple of states that do guaranteed issue part the initial enrollment, either on your birthday or your policy anniversary date. Check with a broker preferably a Medicare Specialist to see if you qualify.
Medicare Supplements do not have networks, they have little to no co-payments, there are only 11 letter plans in the United States and they are the same in each letter group. You can go anywhere in the United States to get treatment if the provider accepts Original Medicare. Several of the plans have international benefits also that you do not get with an MA Plan.
If You Make the Wrong Choice You Get a Redo
What does that mean redo? Well come January 1st if you are not happy with the MA plan you chose you can switch to a Part D plan only between January 1st and February 14th (Happy Valentine’s Day). You cannot enroll in a different MA plan, but since Part D is required you may enroll in a stand-alone Part D Plan which will automatically dis-enroll you from your MA plan. Keep in mind Original Medicare by itself comes with a steeper co-payment, but also the option of not being restricted to a network. Once you drop the MA plan you also have the option of a Medicare Supplement which can be purchased at any time.
So, when you receive the 5000 pieces of mail this AEP it would benefit you to study them closely. Don’t say the plan I am on is great and throw away the rest. The plan you have may not be the same next year. MA plans are one of the most difficult to understand because they are constantly changing. Feel free to contact one of our Medicare Specialist at 800-708-5810. Our service is always free. Go to one of our two websites https://nationalseniorsavings.com for an abundance of educational material. http://themedicareminute.org for up to the minute Medicare News. Or check out our Podcast, The Medicare Minute on iTunes, Google Play, and many other Podcast sites.