It is common for Medicare enrollees to discover that their existing Medicare plan no longer suits their needs. Many beneficiaries reevaluate their coverage options after changes to their medical, financial or living situations. Here is what you need to know if you end up wanting to change your existing Medicare benefits.
Annual Open Enrollment Period (AEP): October 15 to December 7
From October 15th to December 7th of each year, Medicare beneficiaries can make changes to their existing Medicare benefits. Any plan changes during AEP go into effect on January 1st and apply for that calendar year. The Medicare Annual Enrollment Period enables qualifying enrollees to:
- Change to a Medicare Advantage Plan from Medicare Part A and Part B (often called “Original Medicare”)
- Change from a Medicare Advantage Plan to Original Medicare
- Change from one Medicare Advantage plan to another (with or without Part D drug coverage)
- Enroll in a Part D prescription drug plan
- Opt out of Medicare prescription drug coverage completely
Medicare Advantage Open Enrollment Period (OEP): January 1 to March 31
Medicare beneficiaries who enroll in a Medicare Advantage plan have the opportunity to make a one-time change to their benefit plans during this enrollment period.
From January 1st through March 31st, there are two changes that you can make to your Medicare coverage: you can switch from a current Medicare Advantage plan to another or drop a Medical Advantage plan and enroll in Original Medicare (Parts A and B, with or without Part D benefits). The Centers for Medicare and Medicaid Services (CMS) created this enrollment period in response to previous legislation that only allowed for disenrollment of Medicare Advantage to return to Original Medicare, as well as to provide an individual the opportunity to change their Medicare Advantage plan early in the plan year.
Special Enrollment Period (SEP)
CMS can grant a Special Enrollment Period (SEP) allowing individuals to change their Medicare coverage if they have maintained creditable coverage or experienced a life event. This Special Enrollment Period applies to those enrolled in Medicare Advantage and/or Medicare Part D prescription drug coverage.
You may qualify for a Special Enrollment Period if:
- You moved to a new location – plan options and plan service areas can vary by state or even by region.
- You are able to enroll in other forms of creditable coverage (e.g. insurance through your employer or union).
- You have lost your current coverage – this can be due to a variety of factors, ranging from lost drug or creditable coverage to losing or gaining other health insurance coverage from an employer, union or a change in Medicaid eligibility.
Rules and restrictions apply to the Special Enrollment Period, and qualifying individuals have a specific amount of time they are able take advantage of this exception to changing their Medicare coverage.
Are you looking to get more out of your Medicare benefits? Consult with a local Medicare insurance broker near you to determine the plan most suited for your needs and when to adjust your coverage. Medicare Portal can help support you in re-evaluating your coverage and changing your Medicare plan – call us for assistance today.