Making Changes During Medicare Advantage Open Enrollment Period

Person holding question mark, wondering what changes they can make during Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period is often overlooked, but it shouldn’t be! Not happy with your Medicare Advantage plan? This window of time offers you an opportunity to review and adjust your Part C plan. Let’s discuss what you can and can’t do during the Medicare Advantage Open Enrollment Period.

What Is the Medicare Advantage Open Enrollment Period?

The Medicare Advantage Open Enrollment Period (MA OEP) is a helpful time for beneficiaries who are currently enrolled in Medicare Advantage (Part C) plans. Running annually from January 1 through March 31, this period provides a unique opportunity for Medicare Advantage enrollees to make certain changes to their healthcare coverage that aren’t typically allowed at other times of the year.

Medicare Advantage is an alternative to Original Medicare (Parts A and B) offered by private insurance companies. These plans often include additional benefits, such as prescription drug coverage, dental, vision, and wellness programs. However, healthcare needs and preferences can change, and the MA OEP allows for adjustments to be made to better fit your current situation.

During the MA OEP, if you are enrolled in a Medicare Advantage plan, you can:

  • Switch to a different Medicare Advantage plan (with or without drug coverage).
  • Disenroll from your Medicare Advantage plan and return to Original Medicare. If you choose to do this, you can also join a Medicare prescription drug plan (Part D).

It’s important to note that these changes can only be made once during this period. Once you have switched plans or returned to Original Medicare with or without a Part D plan, your choice is locked in for the rest of the year unless you qualify for a special enrollment period due to specific circumstances such as moving out of your plan’s service area or losing other credible insurance coverage.

Understanding the options available during this period is important. Perhaps the Medicare Advantage plan you chose isn’t meeting your expectations, or your health needs have changed, requiring different services or network providers. Maybe you’ve found another plan offering better coverage, lower costs, or added benefits like fitness programs or health wellness incentives. The MA OEP is the perfect time to make these assessments and changes.

It’s not just about switching plans. It’s about making sure your current plan is the best fit for your health and financial needs. Reviewing the plan’s network of doctors and hospitals, out-of-pocket costs, drug coverage, and additional benefits should be part of your annual healthcare review. This period is your opportunity to reassess these aspects and ensure your Medicare Advantage plan aligns with your needs. As you consider your options, remember that this period is about making informed decisions that contribute to your long-term well-being and financial stability.

Woman deciding which path she wants to take while making changes during the Medicare Advantage open enrollment period

What Can’t I Do During Open Enrollment?

While the Medicare Advantage Open Enrollment Period offers a valuable opportunity to modify Medicare Advantage plans, it’s equally important to understand the actions that are off-limits during this time. Recognizing these limitations will help you avoid unnecessary confusion and ensure that your healthcare coverage meets your needs throughout the year. Here are the key restrictions to keep in mind during the MA OEP.

Switching from Original Medicare to a Medicare Advantage plan: If you are currently enrolled in Original Medicare (Part A and Part B), the MA OEP does not permit you to join a Medicare Advantage plan. This action is reserved for the Annual Election Period (AEP), which runs from October 15 to December 7 each year.

Joining a Medicare Part D plan if you are in Original Medicare: For beneficiaries enrolled in Original Medicare, the MA OEP does not allow you to add a Medicare Part D plan. Like switching to a Medicare Advantage plan, this change can only be made during the AEP or under certain special enrollment circumstances.

Switching from one Medicare Supplement (Medigap) policy to another: Medigap policies are additional insurance plans that work with Original Medicare to cover costs like deductibles and coinsurance. The MA OEP is specifically designed for beneficiaries enrolled in Medicare Advantage plans. It does not provide an open opportunity for those with Medigap policies to switch to a different Medigap policy. That being said, you can apply to change your Medigap plan at any time of the year. The catch is that, in most cases, you’ll be required to go through medical underwriting. Check with your Medicare advisor about the rules in your state.

Making multiple changes: Another limitation of the MA OEP is that you are allowed to make only one change during this period. Whether you’re switching from one Medicare Advantage plan to another or dis-enrolling to return to Original Medicare, you need to carefully consider your choice. Once you’ve made a change, you won’t be able to make another until the next MA OEP or unless you qualify for a special enrollment period.

Review Your Medicare Advantage Plan Today

Healthcare decisions are personal and impactful. As you navigate these choices, don’t hesitate to seek guidance and support. At Carolina Senior Benefits, we are dedicated to helping you understand your options and make informed decisions about your Medicare coverage. Our team of experienced advisors is here to provide personalized advice, clarify any confusion, and help you find the coverage that best suits your individual health and financial needs.

If you have any questions about the Medicare Advantage Open Enrollment Period or if you need assistance evaluating your current plan and exploring other options, we encourage you to get in touch. Let us help you make the most of this open enrollment period to ensure your healthcare coverage brings you peace of mind throughout the year.