What is the Medicare Advantage Open Enrollment Period?
Every year, seniors aged 65 (and others with certain medical conditions) can sign up for healthcare coverage during the Medicare Open Enrollment Period that runs from October 15 to December 7. They can opt for either Original Medicare or Medicare Advantage.
January 1 to March 31 is the annual Medicare Advantage Open Enrollment Period. If you are signed up to a Medicare Advantage healthcare plan, this is your opportunity to:
- Change or modify your existing Medicare Advantage plan
- Switch to Original Medicare
What is Medicare Advantage?
Original Medicare is provided by the federal government. Medicare Advantage is healthcare coverage offered by private insurance providers. It is also called ‘Part C’.
With a Medicare Advantage plan, you receive the Part A and Part B coverage given by Original Medicare. You also receive additional services not covered by Original Medicare.
Compare Original Medicare and Medicare Advantage Coverage at a Glance
| Coverage | Original Medicare | Medicare Advantage |
Part A
| Yes | Yes |
Part B
| Yes | Yes |
Part C
| No. Maximum eye care coverage is 1 pair of corrective eyeglasses or contact lenses after cataract surgery only. | Most health plan providers offer coverage. Check with yours for details. |
Part D
| Offered separately at additional cost. | Yes. This is covered by most Medicare Advantage plans. |
| Can I go to any doctor or hospital? | Yes. You can go to any doctor or hospital in the U.S. that accepts Medicare. | No. You can only go to a doctor or hospital in your provider company’s network. Exceptions may be made for emergency care or dialysis. |
| Can I buy Medicare Supplement Insurance (Medigap)? | Yes | No. It is illegal for a Medicare Advantage plan provider to sell you a Medigap policy. |
Why would I need to change my existing healthcare plan?
If you are satisfied with your current healthcare coverage, you don’t need to do anything.
On the other hand, there can be any number of reasons to revise your healthcare coverage.
You might feel the need for additional healthcare services, especially when it comes to deteriorating eyesight or hearing.
Or, you may decide to switch to a better healthcare provider. If you currently have a Medicare Advantage plan and your new doctor is not on the plan provider’s network, then you will need to change your plan provider.
How do I change my healthcare coverage during the Medicare Advantage Open Enrollment Period?
Start by writing down how your healthcare needs may have changed. You could write:
- I’ve moved, and my closest hospital is not on my current plan provider’s network
- I’ve registered with a new doctor who is not on my current provider’s network
- My doctor has prescribed a new medication that’s not on my current provider’s drug list
- My teeth are troubling me a lot. I need better care options for them
- I want more Telehealth services
- I want better balance among my premiums, copays, and deductibles
- I want to switch to Original Medicare
Speak to a Licensed Insurance Agent
Once you’ve got your reasons down, speak to a licensed health insurance agent. A good agent will listen to your concerns, compare different plans, and guide you towards the one that meets your needs best.
When you’ve chosen your new plan, you or your licensed health insurance agent may have to call your current provider and have your insurance plan records updated.
What if I want to drop Medicare Advantage entirely and just have Original Medicare?
If you want to switch from Medicare Advantage to Original Medicare, you can go to Medicare’s plan finder to learn more about your coverage options. You can also call 1-800-MEDICARE (1-800-633-4227) for help.
Annual Review is Recommended
Healthcare coverage plans tend to change from year to year. This is especially true for a plan’s formulary, or the prescription drugs it covers. Pharmaceutical companies are always working to improve existing drugs, or develop new ones to treat new illnesses. When older drugs are phased out and new ones brought in, healthcare coverage will be revised accordingly.
Telehealth is also growing in popularity, and healthcare coverage providers will take such developments into account when creating new plans.
Any new development can bring about a change in healthcare coverage, so it’s a good idea to conduct a yearly review of both your own healthcare needs and your plan’s coverage to see if they’re continuing to be a good match.
If yes, great. If no, then it’s time to start researching your options.
You can start by giving us a call at (800) 941-1106 and our trusted agency partners will give you all the information and guidance you need.
You can also send an email to info@theintracare.com and we’ll respond to your query right away.