Before you choose a Medicare health plan, it’s important to weigh your options thoroughly. However, there are instances when you might want to switch plans to secure more affordable premiums or improved coverage. Whether or not you can make changes depends on the type of plans you have and any special circumstances that might apply to you.
In this article, we’ll explore three enrollment periods that could give you the opportunity to modify your Medicare plans.
Annual Election Period
The Annual Election Period (AEP) is a crucial timeframe for all Medicare beneficiaries, running annually from October 15 to December 7. During this window, you have the opportunity to adjust your Part C (Medicare Advantage) or Part D prescription drug plans. This period also allows you to enroll in Part C or Part D for the first time or to switch back from a Part C plan to Original Medicare.
The significance of AEP lies in the fact that Part C and Part D plans are based on yearly contracts, which means that plan details can change annually. Although you might be satisfied with your current plan, it’s possible that it could alter in the coming year—such as changes to your in-network doctors or prescription coverage.
AEP provides a chance for everyone to review and select new Part C or Part D plans for the following year. Any changes you make during this time will take effect on January 1.
If you’re new to Medicare Part D or considering a switch from Original Medicare to a Medicare Advantage plan, AEP is the time to make those changes. Additionally, if you choose to drop your Part C plan and return to Original Medicare, you can do so. Just be aware that adding a Medicare Supplement plan may require passing medical underwriting.
Special Enrollment Periods
Special Enrollment Periods (SEPs) are reserved for unique life events and aren’t available to everyone. These periods are designed to accommodate significant changes in your life that affect your Medicare coverage. One common scenario is when someone delays enrolling in Medicare past age 65 but has maintained creditable coverage. They can then use an SEP to sign up for Medicare when their existing insurance plan ends.
Other life events that could qualify you for an SEP include:
- Relocating to a new city, state, or zip code.
- Moving into or out of an institution such as a skilled nursing facility.
- Changes in Medicaid eligibility, either gaining or losing it.
- Your current plan leaving your service area.
- Insolvency of your current plan.
- Violations of Medicare rules by your current insurance provider.
- Diagnosis of a chronic condition.
- Opting for Medicare Advantage for the first time and wanting to revert to Original Medicare within the first 12 months (known as a “Trial Right”).
This list isn’t exhaustive, and the timeframe for making changes during an SEP can vary based on the specific circumstance. If you’ve experienced any major life changes, consulting with one of our licensed insurance agents can help determine if you qualify for an SEP. We’re here to assist you in evaluating your eligibility and finding a plan that suits your needs.
Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period (MA OEP) occurs annually from January 1 through March 31. During this period, those already enrolled in a Medicare Advantage plan have the chance to make a one-time change. This means you can switch to a different Medicare Advantage plan or opt to return to Original Medicare.
Any changes you make during the Medicare Advantage OEP will take effect on the first day of the following month. For instance, if you make a change to your Part C plan on January 26, your new plan will start on February 1.
For those considering returning to Original Medicare, it’s important to evaluate your options for a Medicare Supplement (Medigap) plan. Without guaranteed issue rights, you’ll need to pass medical underwriting to qualify for a Medigap plan. If you have chronic conditions or recent health issues, enrolling in a Medigap plan might be challenging, making Medicare Advantage a potentially better option.
Navigating Medicare enrollment periods can be complex. Our agents at Carolina Senior Benefits are here to guide you through the process, helping you understand which enrollment periods are most important and ensuring you don’t miss any key deadlines. Contact a local Medicare advisor today to explore your options and create a personalized enrollment plan.
