If you're already on Medicare, it’s the one
time of the year you can enroll in or change your Part C and Part D plans.
Updated
September 1, 2019 Danielle
Roberts
Danielle K. Roberts
is a Medicare insurance expert and co-founder at Boomer Benefits.
The Medicare Fall
Annual Election Period (AEP) is a short period in which Medicare beneficiaries
can enroll in, drop, or change Medicare Advantage plans and Part D plans. This
period occurs every year between October 15th and December 7th. Any changes
made during the AEP take effect on January 1st of the following year.
The AEP is also
commonly called the Fall Open Enrollment Period by Medicare beneficiaries.
However, this can cause confusion since there are many other enrollment windows
containing the phrase “open enrollment”. Using the term Annual Election Period
for the fall window can help you to keep them straight.
This is an important
time for Medicare beneficiaries as it’s the one time of the year you can enroll
in or change your Part C and Part D plans. Therefore, you should prepare for
Medicare’s Fall Annual Election Period so you can make a well-informed decision
each year.
Review Your Annual
Notice of Change
Medicare
beneficiaries who are enrolled in a Medicare Advantage plan or Part D plan will
receive an Annual Notice of Change (ANOC) each year from their current
insurance provider. You should receive your ANOC by the end of September.
This notice will
inform you of any changes being made to your plan for the following year. These
changes may include premium increases or decreases, dropped or added benefits,
copay and coinsurance changes, and even medications that will no longer be
offered on next year’s drug formulary.
You’ll want to review
your ANOC carefully. Be extra thorough when looking through the drug plan
changes. These changes, if overlooked, can be detrimental to your out-of-pocket expenses in the following year. If
your plan drops one of your drugs from its formulary, you may pay considerably
more for that drug the following year unless you change plans.
No one wants to pay
100% out-of-pocket for expensive brand name drugs for an entire year while you
wait for the next AEP. Doing your homework to review your ANOC can help to
prevent unwelcome surprises in January.
After Reviewing Your
Annual Notice of Change
After you have
thoroughly reviewed all the upcoming plan changes, you can then begin to
research other plan options. Even if the changes to your current plan are
minimal, it’s good to research other available plans, as there may be a plan
that appeals more to you than your current plan. Remember, one plan’s changes
may be for the better, while your plan could change for the worse.
Researching plans
with a Medicare broker who represents multiple carriers is the most efficient
way to do this. A broker can compare several other plans alongside your current
plan to see which option is the most cost-effective for you.
Verify Accepted Plans
with Your Doctors
Since Medicare
Advantage plans have networks of doctors, you will want to verify with your
doctors that they will still be accepting your current plan next year.
Technically, doctors can exit plan networks at any time during the year.
However, they tend to do so more towards the end of the year.
If you plan on
changing Medicare Advantage plans, you will also want to verify with your
doctors that they accept the new plans you’re considering. Pick your favorites
and then call your doctors’ offices to see if they participate in the networks
for any of these other plans.
Once you have a list
of the top plans that the majority of your doctors accept, you will be able to
narrow down your options before choosing your new plan.
Once Your New
Medicare Advantage Plan Takes Effect
As of 2019, The
Center for Medicare and Medicaid Services (CMS) brought back the Medicare
Advantage Open Enrollment Period (MAOEP). This period runs from January 1st
until March 31st each year.
This window gives you
the opportunity to change your Medicare Advantage plan once more. You are able
to drop your plan completely and return to Original Medicare or enroll in a new
one. Think of this period as a chance to try the plan out before you commit to pay
for it for an entire year.
For instance, if
during the AEP you find a plan you think you like and you enroll in it, but
later find out at the beginning of the next year that an important doctor of
yours isn’t in-network with your new plan, you’ll have a chance to make a
one-time plan change.
Note that the MAOEP
is only for Medicare Advantage plans, not Part D plans. Also, in order to use
the MAOEP, you must already be enrolled in a Medicare Advantage plan. This
period isn’t for people who are on Original Medicare and want to switch to
Medicare Advantage.
What the Annual
Election Period Isn’t For
Like we mentioned
before, many Medicare beneficiaries refer to the AEP as the Open Enrollment
Period. Because they are so used to calling it this, they confuse this period
with the Medigap Open Enrollment window.
The Medigap Open
Enrollment is a one-time window that begins the day your Part B becomes
effective and ends six months later. This may be the only period you’ll ever
have to enroll in a Medigap plan without having to answer health questions.
This is considered the best time to enroll in a Medigap plan because you can’t
be turned down for pre-existing conditions.
Because these two
enrollment periods hold similar names, beneficiaries start thinking that the
Fall Open Enrollment Period is another time where they can apply for a Medigap
plan without having to answer health questions. However, that simply isn’t
true.
You can apply for a
new Medigap plan any time during the year. However, unless you’re in your
one-time open enrollment window, you will likely have to answer health
questions to do so in most states. The AEP is only for enrolling in Medicare
Advantage plans and Part D plans, not for guaranteed Medigap plans.
The Annual Election
Period doesn’t have to be stressful. As long as you take the time to prepare
and research before it starts, you’ll have the knowledge to make an easy,
well-informed decision during Medicare’s Fall Annual Election Period.
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