Medicare Annual Enrollment

Medicare Annual Enrollment Period (AEP)

What is AEP? The Medicare Annual Enrollment Period, also known as the Annual Election Period, runs from October 15th to December 7th every year.  AEP allows you to make changes to your current Medicare coverage. 

What Changes Can I Make During AEP?  During AEP, you can do the following:

  • Switch from a Medicare Advantage Plan back to Original Medicare
  • Disenroll from Original Medicare and enroll in a Medicare Advantage Plan
  • Change from one Medicare Advantage plan to another
  • Sign up for a Medicare Part D Prescription Drug Plan (PDP)
  • Change from one Prescription Drug plan to another
  • Cancel your current Prescription Drug coverage

Why Should I Change My Medicare Coverage During AEP?  Medicare Advantage and Prescription Drug benefits can change each year.  Some common changes are an increase in premiums, your doctor is no longer participating in the network, some of your medications are no longer covered, or another Advantage Plan has better dental or vision coverage.

How Will I know What Has Changed?  You will receive an Annual Notice of Change (ANOC) in September from your current carrier.  Your ANOC will explain how your current coverage will change for 2022, including whether your monthly premiums will change. 

Do My Medigap Plan Benefits Change During the Medicare Annual Enrollment Period?  No, your Medigap (also known as a Medicare Supplement) benefits do not change during AEP.  Your Medigap plan will cover the same benefits from year to year.  What may change is your premiums.  Rate increases usually happen, annually, on the anniversary date of your policy. Some plans may increase rates more than once per year.  Your carrier sends out a letter the month before your anniversary date that informs you of any premium increases.  If you want to compare the same plan with other carriers to see if they offer the same benefits at a lower premium, we can help. 

Can I Get a Medigap Plan if I Switch from a Medicare Advantage Plan to Original Medicare?  If you cancel your Medicare Advantage Plan and switch back to Original Medicare within the first 12 months of joining you will have “Trial Rights” to purchase a Medigap Plan.  If you don’t qualify for Trial Rights, you can still apply for a Medigap plan, but the insurance company will take your health into account in deciding whether to issue you a policy and in what your monthly premium will be.

What is the Difference Between the Medicare Open Enrollment Period and the Annual Enrollment Period?  The Medicare Open Enrollment Period (OEP) can refer to many different enrollment windows.  Usually when someone is talking about OEP they are referring to the Annual Enrollment Period.

How Do I Prepare for the Medicare Annual Enrollment Period (AEP)?  We have put together some things to consider when choosing your coverage as well as an AEP checklist, both are below.  We are also here to help you understand your current plan as well as any plans you may be considering.  Our services are 100% free to you.  Don’t end up enrolling in a plan you don’t want and are stuck with until next AEP.  Give us a call today, or complete our online form, and we will call you to discuss the available Medicare Plans in your area. 

What To Consider When Choosing Medicare Coverage During AEP:

  1. Did your monthly premiums increase?  Your ANOC will list your premium changes for the 2022 plan year.  A significant increase is a good sign that you need to call us to talk about your plan options.
  2. Are your medications still listed on your drug formulary? A new year can also bring changes to your prescription coverages-the pricing tiers that your medications are placed in, your copays for different prescriptions, or your deductible.  In addition, some Medicare Advantage prescription drug plans now require prior authorization for certain brand name drugs.  You can always contact us to find out whether your current plan will cover your current medications for the upcoming year and how much you will pay for them. 
  3. What are your predicted annual medical costs?  Make a list of doctor visits and procedures you expect for next year.  Then estimate what you will pay for them out of pocket with your current plan.  Add in a years’ worth of premiums and you’ll have a good estimate of what your healthcare costs you in a year.  You can do the same calculation with other Medicare plans you are considering to compare the overall costs of one plan to another.  Or you can call us to schedule an appointment to do the comparisons for you.  This is one of the many things that we do each year with our clients. 
  4. Is your doctor still in-network with your current plan?  A new year can also bring changes to the doctors that are in-network with your Medicare Advantage Plan.  You will want to confirm that your current providers will be in-network with your current plan in 2022.  If they aren’t, you will want to call us to discuss your plan options for 2022.  You will want to look at Medicare Advantage Plan that have your current providers listed in their network.  Another option is to switch back to Original Medicare and enroll in a Medigap plan.  Although you’ll most likely have to complete a health assessment to enroll, there aren’t any provider networks with Medigap plans.  You can see any provider that accepts Medicare. 
  5. Do you plan on traveling anywhere this year?  If you live in two places, or plan to travel out of state, you will want to consider a plan with a nationwide network or look at Original Medicare and a Medigap plan as they do not have provider networks.
  6. Does your coverage include vision, dental and hearing benefits?  Medicare doesn’t cover routine dental, vision, and hearing services, but some Medicare Advantage Plans do.  You can also buy dental, vision, and hearing coverages separately.
  7. What is your current plans rating?  The Centers for Medicare and Medicaid Services has a star rating system to help consumers compare Medicare plans.  Medicare Advantage and Prescription Drug Plans receive an overall star rating of one to five stars-with five being the best-on factors such as customer service, member experience and member complaints.  Medicare Advantage Plans are also rated on preventative care to help their members stay healthy and management of chronic conditions.  If your current plan gets low marks, you may want to consider another option.

Your AEP Checklist:

  1. Make Sure You Are Eligible to Make Coverage Changes:  There are many different enrollment periods when it comes to Medicare.  Each is just as confusing as the other.  It is important to understand what you can and can’t do during each.  Otherwise, you could make a move that could negatively impact your Medicare benefits forever.  If you are newly eligible for Medicare, or delayed coverage for one reason or another, and are not yet signed up for Part A and Part B, this is NOT the enrollment period for you.  You will not be eligible to make changes at this time unless you are within your Initial Enrollment Period or are eligible for a Special Enrollment Period.  You will need to wait until the General Enrollment Period or enroll in Original Medicare.
  2. Decide if Your Current Coverage is What You Want:  We encourage you to look at the coverage you currently have.  Think about your current health and what parts of your current plan that you are using the most.  Then look at how you may be able to supplement, or reduce, your total out of pocket costs.  One of the complaints we hear from our clients is how the dental benefits included in some Medicare Advantage Plans were not as comprehensive as they thought.  If you attempted to use them and were unhappy with what you ended up spending out of your pocket, you may want to compare plans or consider disenrolling in your Medicare Advantage coverage and going with a Medigap plan and stand-alone dental coverage. 
  3. Contact Us to Compare Plans for 2022: This may be the most important step.  Just like you compare your auto insurance premiums, you should also compare your Medicare premiums.  You may be able to find a plan with the same benefits for a lower monthly premium.  Or you may be able to find a plan with more benefits for the same monthly premium you are paying now.

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