What’s the Medicare Open Enrollment Period?
Medicare health and drug plans can make changes each year – things like cost, coverage, and what providers and pharmacies are in their networks. Between October 15 and December 7, all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.
During this time, current Medicare users can choose to re-evaluate part of their Medicare coverage (their Medicare Advantage and/or Part D plan) and compare it against all the other plans on the market. After re-evaluating, if you find a plan that is a better fit for your needs, you can then switch to, drop or add a Medicare Advantage or Part D plan. Medicare Advantage is also known as a “Part C” plan.
You cannot use Open Enrollment to enroll in Part A and/or Part B for the first time.
What you can do during the Open Enrollment Period (OEP):
- Anyone who has (or is signing up for) Medicare Parts A or B can join or drop a Part D prescription drug plan.
- Anyone with Original Medicare (Parts A & B) can switch to a Medicare Advantage plan.
- Anyone with Medicare Advantage can drop it and switch back to just Original Medicare (Parts A & B).
- Anyone with Medicare Advantage can switch to a new Medicare Advantage plan.
- Anyone with a Part D prescription drug plan can switch to a new Part D prescription drug plan.
How do people know if they need to change plans?
People in a Medicare health or prescription drug plan should always review the materials their plans send them, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC). If their plans are changing, they should make sure their plans will still meet their needs for the following year. If they’re satisfied that their current plans will meet their needs for next year and it’s still being offered, they don’t need to do anything.
Why should I consider re-evaluating my current Medicare coverage during Open Enrollment?
Unfortunately, choosing health insurance is no longer a one-time decision for most Medicare beneficiaries. Each year, insurance companies can make changes to Medicare plans that can impact how much you pay out-of-pocket—like the monthly premiums, deductibles, drug costs, and provider or pharmacy “networks.” A network is a list of doctors, hospitals, or pharmacies that negotiate prices with insurance companies. They can also make changes to your plan’s “formulary” (list of covered drugs). Given these yearly changes, it is a good idea to re-evaluate your current Medicare plan each year to make sure it still meets your needs. Below are some additional benefits of re-evaluating your coverage during Open Enrollment:
- You can switch to better prescription drug coverage. Using Open Enrollment to switch your drug coverage—or add drug coverage for the first time—can make crucial medications that you need less expensive. It can also ensure that your drug plan still covers the drugs you need (as your prescriptions may not be included on your plan’s formulary for next year).
- You can save money and keep your doctor in-network. Switching your Medicare Advantage or Part D plan can potentially save you hundreds of dollars a year—especially if your current plan’s out-of-pocket costs will increase next year. Research shows that the average consumer can save $300 or more annually if they review their Part D coverage. One way to lower your medical costs is to check that your current doctors, hospital, and pharmacy are “in-network” with whatever Medicare Advantage or Part D plan you choose. If your insurance company has changed your plan’s provider or pharmacy network for next year (and your doctor or other resources will no longer be included), you can use Open Enrollment to switch to a plan that will include your current doctors, hospital and/or pharmacy in-network, thereby lowering your medical costs.
- You can find a higher quality plan. Finally, check the quality of your plan using the Medicare 5-star ratings system. Plans with a 5-star rating are considered high quality and those with fewer than 3 stars are considered poor quality. If your current plan is ranked as less than a 3, consider using Open Enrollment to switch to a higher rated plan.
For more Medicare plan information or to compare plans call 1-800-MEDICARE or go to Medicare.gov.