What is Medicare Open Enrollment?

Medicare Open Enrollment

Medicare open enrollment – also known as the annual election period or annual coordinated election period – refers to the annual period (October 15 through December 7) during which Medicare plan enrollees can re-evaluate their coverage — whether it’s Original Medicare with supplemental drug coverage, or Medicare Advantage — and make changes if they want to do so.

During the annual enrollment period (AEP), a beneficiary can make changes to various aspects of coverage.

If you’re enrolled in Medicare, you can:

Switch from Original Medicare to Medicare Advantage, or vice versa.
Switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you want to switch to a Medicare Advantage plan, you must meet some basic criteria.

You must be enrolled in Medicare Part A and B.
You must live in the plan’s service area.
You cannot have End-Stage Renal Disease (some exceptions apply; ESRD patients will be able to enroll in Medicare Advantage plans as of 2021, under the terms of the 21st Century Cures Act).

The annual open enrollment does not apply to Medigap plans, which are only guaranteed-issue in most states during a beneficiary’s initial enrollment period (a one-time, six-month window which begins when they’re at least 65 and enrolled in Medicare Parts A and B), and during limited special enrollment periods.

There is also another open enrollment period that only applies to people who have coverage under Medicare Advantage plans. The Medicare Advantage open enrollment period runs from January 1 to March 31, and allows Medicare Advantage enrollees to either switch to Original Medicare (plus a Part D plan if they want one) or switch to a different Medicare Advantage plan. Enrollees are only allowed to make one change during this three-month window — they can’t switch to a Medicare Advantage plan in February and then switch to a different one in March, for example.

Missed Open Enrollment? No Problem!

Did you miss the deadline to sign up for Health Insurance next year? No worries! You can still obtain health coverage even after the deadline.How is that done you ask? Here are some simple answers.
OEP – The Medicare Advantage Open Enrollment Period (MA OEP) is another enrollment period allowing people currently enrolled in a Medicare Advantage plan (MAPD or MA) an opportunity to change Medicare Advantage plans- or drop their Medicare Advantage plan, return to original Medicare Part A and Part B coverage and join a stand alone Medicare Part D prescription drug plan. The enrollment period runs from January 1-March 31 every year.SEP – You may qualify for a Special Enrollment Period (SEP). One way to qualify is if you recently had a qualifying event happen in your life. You’ll only have 60 days after that event, though, to get enrolled in a plan.

Qualifying events include:

Another way to qualify is a life circumstance. They include:

The last way you may qualify for an SEP is if you lose coverage. An example of an occurrence of this happening is during a divorce where a spouse can change plans. Another example of this is for employees recently covered by a parent or the death of a spouse/parent who originally provided you coverage.So don’t lose hope – you may qualify with one of the events listed above!

SilverCare Solutions, LLC is a licensed brokerage firm providing services for all of New York State. We support both public and private companies and act as an extension of your team. We help to mitigate the complexities with your Medicare retiree’s coverage. We serve as an intermediary between the carrier and the group to ease administrative burdens: we aggressively seek answers to questions or problems that may arise.

Have further questions? Need help figuring out what to do? Please do not hesitate to contact SilverCare Solutions.