3 Steps to Prepare for a Successful Medicare Open Enrollment Period
Foreword from Denise Austin
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Creator of Fit Over 50 Magazine
From going to the gym without a workout itinerary to shopping for health insurance – having a strategy prior to starting will put you in the best position to succeed. To help you put your best foot forward, Ensurem has written this guide on how to prepare for the Medicare Annual Enrollment Period.
“Medicare’s Annual Open Enrollment period is from October 15 – December 7. Follow these tips to ensure you’re not paying too much or missing out on necessary benefits.”
Did you know Medicare plans change each year? And while you may be happy with your current coverage, you could end up paying more than you need or missing out on important benefits if you’re not prepared.
It’s important you review these changes annually before the Annual Enrollment Period begins to ensure that doesn’t happen.
In this blog post, we outline three detailed steps you should take to prepare for a successful AEP – and one bonus step you can take to combine all three. But first, let’s talk about what this enrollment time is all about.
What is Medicare’s Annual Enrollment Period?
The Medicare Annual Enrollment Period (AEP), is a seven-and-half week period when Medicare members can add, drop or switch plans for the following year. More specifically, according to the Centers for Medicare & Medicaid Services (CMS), during AEP, Medicare beneficiaries can:
- Drop their Original Medicare (Parts A & B) plan and switch to a Medicare Advantage (Part C) plan
- Drop their Medicare Advantage plan and switch back to Original Medicare plan
- Switch Medicare Advantage plans
- Join, drop or switch prescription drug (Part D) plans
For many Medicare beneficiaries, this enrollment period is the only time you can make changes to your Medicare coverage outside of your Initial Enrollment Period (three months before and after your 65th birthday) – unless you qualify for a Special Enrollment Period or the annual Medicare Advantage Open Enrollment Period in January (more on that below.)
Medicare annual enrollment dates to remember:
- October 15 – December 7: Medicare Annual Enrollment Period
- January 1: Coverage begins and changes implemented
- January 1 – March 31: Medicare Advantage Open Enrollment Period
How is Medicare AEP different from Medicare Advantage OEP?
Sometimes the Medicare AEP is also referred to as Medicare open enrollment, when in fact there is an entirely separate Medicare Advantage Open Enrollment Period (OEP) that happens every year between January 1 and March 31.
Starting in 2019, this open enrollment replaced the Medicare Advantage Disenrollment Period (January 1 – February 14).
According to CMS, during this period, Medicare Advantage members only can make one of the below changes:
- Switch to another Medicare Advantage Plan
- Disenroll from a Medicare Advantage Plan and go back to Original Medicare – you would have until March 31 to join a separate Medicare prescription drug plan to add prescription coverage.
Now that you know the basics about Medicare AEP, let’s talk about how to prepare for it.
How is Medicare AEP Different from Marketplace OEP?
Medicare Annual Enrollment Period is sometimes confused with the annual open enrollment for the federal Health Insurance Marketplace®, which is associated with healthcare insurance plans governed under the Affordable Care Act. While the two enrollment periods may overlap, it’s important to understand that they are not related.
Most seniors over the age of 65 should not concern themselves with the health insurance marketplaces or their open enrollments. In fact, it’s illegal for someone to knowingly sell you a major medical plan from the Marketplace if you have Medicare.i
3 Steps to Preparing for Medicare’s Annual Enrollment Period
While AEP doesn’t start until October 15, Medicare.gov releases its annual “Medicare & You” handbook on October 1. Starting the same day, you’ll have access to the site’s Medicare Plan Finder where you can search current Medicare Plans.
Ensurem also offers a similar tool where you can search Medicare Advantage plans available in your area.
This means you don’t have to (and you shouldn’t) wait until October 15 to prepare. In fact, you should start with the first step below as early as September.
Step 1: Needs Analysis
Sometime in September your plan should send you an Annual Notice of Change (ANOC). Before you review this document, it’s important to assess your needs.
A lot can change in a year. Knowing where you stand coming into a new year will help you make the right decisions. Here’s what you should know:
How’s your overall health?
- Has your health status changed at all?
- Did you struggle to get the care you needed this year or the quality you expected?
- Are you visiting the doctor more or less than you anticipated?
If your health has gotten worse or you had difficulty getting the care you needed this year, you may benefit from a more comprehensive Medicare plan.
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Yet, if your health has gotten better and you visited the doctor less than you anticipated, you may benefit from a less comprehensive Medicare plan.
Are you comfortable with your healthcare costs?
- Have your financial circumstances changed?
- Are you dishing out more co-pays or deductibles that you didn’t expect?
- Do you have difficulty meeting your premiums?
If you’re uncomfortable with your healthcare costs, you have options. Focus on choosing a Medicare plan that has cheaper premiums but still covers the benefits you need. Or consider purchasing a Medicare Supplement plan to cover the out-of-pocket costs.
Has your flexibility changed?
- Will you be traveling more or less than you did?
- Do you have plans to move?
- Do you need to change doctors or specialists for any reason?
Different Medicare plans offer different flexibility options. For example, some offer benefits to those traveling internationally and some are state-specific. Knowing your flexibility needs will help you choose the right plan.
Are you happy with your prescription drug benefits?
- Have you started or stopped any medications?
- Did you have to dish out more than you expected on prescriptions?
If you were unable to cover the cost of your medications, you should consider purchasing a prescription drug plan or (if you already have one) changing drug plans.
After you’ve assessed your needs, you’re ready to review changes to your current coverage.
Step 2: Review Changes
As previously mentioned, Medicare plans change. Fortunately, you should receive your insurer’s new plan documents sometime in September. These documents include the Evidence of Coverage (EOC) and Annual Notice of Change (ANOC).
Review these documents closely to understand what changes are being made and whether the plan will continue to meet your needs in the next year.
This is also a good time to review the “Medicare & You” handbook. This document is published yearly by the Center for Medicare & Medicaid Services (CMS). It includes important information regarding things like the enrollment process, your coverage options and your rights.
At this time, you may decide that you are in fact happy with your plan(s). If that’s that case, feel free to kick back and relax. You don’t have to take any action to keep your current coverage.
Yet, if you think your plan won’t continue to meet your needs, or you are unsure what your best move is, then you should take the next step to compare your options.
Step 3: Compare Plans
Since you’ve reviewed your current plan(s) and have an idea of how the changes may affect your needs, you’re ready to start comparing your options.
CMS lists several resources to help when comparing options:
- View a listing of plans in your area using Medicare.gov’s Medicare Plan Finder. Remember, this tool is updated on October 1.
- Refer back to the “Medicare & You” handbook to ensure you fully understand your options.
- Call 1-800-Medicare (1-800-633-4227), TTY: 1-877-486-2048 to speak with an agent 24/7.
- Get free no obligation, personalized health insurance counseling by contacting your State Health Insurance Assistance Program (SHIP).
Combine All 3 Steps with just ONE Simple Step
If analyzing your changing healthcare needs, assessing your coverage changes and comparing option sounds overwhelming, you’re not alone. Many beneficiaries find the process of comparing plans too challenging.ii
Those who do, oftentimes feel it’s helpful to work directly with a licensed insurance agent for guidance. Doing so can help you combine all three of the steps mentioned above.
During a free, no-obligation consultation, they’ll complete a needs analysis for you, review plan changes with you and compare plans available in your area – finding you coverage that not only meets your health care needs but also fits within your budget.
In addition, working with a licensed agent who specializes in insurance options for older adults who not only has Medicare expertise, but also has access to other non-Medicare insurance plans can help provide you with full, 360-degree coverage.
Ensurem’s licensed insurance agents, for example, are contracted with the nation’s top-rated* insurance companies and can help you enroll in a wide variety of seven different types of insurance coverage including vision, dental, hospital indemnity, final expense life insurance and more.
Ready, Set, Go!
If you don’t elect to make any changes to your Medicare plan during the annual open enrollment period, you could be stuck with inadequate or costly coverage for the next year.
That’s why you should assess your needs, review your coverage and compare your options before Medicare Annual Enrollment Period begins – whether you do so on your own or with a licensed agent. By completing this annual Medicare review you’ll be ready to make the right decisions.
Want more advice on preparing for Medicare Open Enrollment? Give us a call at 844.847.3800 to speak with a licensed insurance agent.
Ensurem Trusted Expertise
Education is crucial in finding the right Medicare solution for you. With so many Medicare resources out there, it can be difficult finding a source you can trust. That’s why Ensurem has a Compliance Program dedicated to ensuring our Medicare content meets Centers for Medicare & Medicaid Services (CMS) regulations. So, you can rest assured you’re getting the information you need to make the right coverage decisions.
*Ensurem only offers products from insurance carriers with an A.M. Best Rating of B++ or higher and/or, where applicable, a CMS Star Rating of 4/5 or higher.
i”Medicare & the Marketplace”, Centers for Medicare & Medicaid Services, https://www.medicare.gov/about-us/medicare-the-marketplace
ii“How are Seniors Choosing and Changing Health Insurance Plans”, Kaiser Family Foundation, https://www.kff.org/medicare/report/how-are-seniors-choosing-and-changing-health-insurance-plans/
Denise Austin, 65, Ensurem Ambassador
Best-Selling Author, Creator of Fit Over 50 Magazine
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