Managing the Medicare Open Enrollment Period

by Danielle Kunkle Roberts, Co-Founder Boomer Benefits

The Annual Medicare Open Enrollment Period (OEP) from October 15th – December 7 is the time of year when beneficiaries can make changes to their drug plan or Medicare Advantage (Part C) plans.  It occurs because the federal government updates the premiums, deductibles and limits for Part D every year.

When these things change, the insurance companies must re-design their plans for the following year accordingly. Since your benefits are changing, Medicare allows you an enrollment period to change to a different Part D (or Medicare Advantage) plan for next year if you want to.

This time of year is often confusing to people because they are bombarded by so many television commercials and mail solicitations. They know they need to be doing something, but they aren’t always sure what.

To save you a bit of sanity, here’s what you should know about the Medicare OEP:

The OEP Does Not Affect Medigap Plans.

People enrolled in drug plans will have changes to their benefits. One thing that does not change, though, is their Medigap plan. That’s because Medigap plans do NOT change their benefits from year to year. While all Medigap plans may have rate increases from year to year, they do not change their benefits. The good news: you won’t need to worry about your Medigap plan during the OEP.

Since there is no annual enrollment period for Medigap plans, this means that you can apply to change your Medigap plan at ANY time of year. Most people only change if they find another Medigap plan offering the same coverage for a lower premium. Changing plans will require you to answer health questions in most states though, so speak with an agent to determine whether you are eligible.

Review your Change Notice from your Insurance Company

Your Part D Insurance Company will mail you a notice in September called the Annual Notice of Change. This letter outlines what things are changing with your plan for next year. The changes are in response to Medicare’s new limits. Pay close attention to the new monthly premium, the plan’s deductible (if any), and your copays for your medical services and/or prescriptions.

The letter will also outline any drug formulary changes for next year. Make sure that none of your medications are affected. If you see that your current plan is dropping coverage for one or more of your medications, then you’ll want to check into changing to a different plan that will cover all or most of your mediations.

The Last Application Turned IN is the Winner

Sometimes people may make a change early in the enrollment period. Then later on they find out about a different plan that they like better. That’s okay. Medicare will enroll you in whichever plan you enrolled in last.  All plans will have an effective date of January 1st.

Changing from a Medicare Advantage Plan to a Medigap Plan + Part D

If you are currently enrolled in a Medicare Advantage plan and you wish to change to a Medigap plan, be cautious about which plan you apply for first. Medigap plans require medical underwriting. In most cases, there is no guarantee that you will be accepted by the Medigap company. For this reason, you should apply for the Medigap plan first before you enroll in a new Part D plan or cancel your Medicare Advantage Plan. There’s nothing worse than being declined by a Medigap company after you have already dis-enrolled from your Medicare Advantage plan. You don’t want to be rushing to find other coverage or to re-enroll in the Advantage plan.

Many people don’t realize that enrolling into a Part D plan will automatically dis-enroll you from your Medicare Advantage plan if that plan has Part D rolled in. So wait to enroll in the new Part D plan after you’ve learned that you are accepted by the Medigap plan.

Where to Get Help

There are a number of resources to help through the OEP. Medicare’s website has a tool which you can use to shop for the most cost effective drug plan. If you are not computer savvy, you can call them at 1-800-MEDICARE for help running the drug analysis.

There are also some great insurance agencies like ours which specialize in Medicare insurance products and help thousands of people with these changes every year. An agent can guide you through the process at no charge to you. So if you get started and then feel overwhelmed by questions, reach out for help!

Danielle Kunkle Roberts is the co-founder of the Boomer Benefits, a health insurance agency that specializes in Medicare-related insurance products. Her agency is licensed in 45 states. Read more about them at https://boomerbenefits.com and listen to her interview on Community Health Radio for more tips for this enrollment period.

Posted in Health, News.