Active Medicare beneficiaries can traditionally only adjust their policy details once per year during Medicare’s annual open enrollment period (AEP). Each year, Medicare distributes an Annual Notice of Change (ANOC) to beneficiaries which discloses any changes to your coverage. This can include changes to covered medications and services, medical networks, and cost-sharing responsibilities.
The ANOC serves as an essential reminder to secure sufficient benefits before the opportunity to make adjustments closes for the year. When the AEP arrives, you can feel confident in your Medicare choices.
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Understanding the Medicare Annual Enrollment Period
The Medicare annual enrollment period lasts from October 15th through December 7th. During this time, members can freely make the following changes:
- Switch from Original Medicare to Medicare Advantage
- Join, drop, or switch to a different Medicare Advantage plan
- Join a Medicare Part D plan or Medicare Advantage drug coverage (MA-PD)
- Switch from one Medicare drug plan to another
The AEP differs from your initial enrollment period (IEP), which only occurs once per lifetime. Your IEP begins three months before you turn 65 and ends three months after your birthday, giving newly eligible beneficiaries ample time to select between and enroll in Medicare Part A, Part B, Part D, or Medicare Advantage.
Benefits of Reviewing Your Medicare Coverage
Medicare coverage details and affiliated costs change yearly, as do many people’s personal lives, financial needs, and health status. Therefore, reviewing your plan during your AEP should help you identify coverage gaps, discover additional benefits, save money, and assure you of whether to stay on the same policy or choose a new one.
Identify Coverage Gaps
Coverage gaps occur when you must pay out of pocket for some or all of a Medicare-eligible service. When reviewing your ANOC, you may find various coverage gaps that bare greater relevance than years prior. For example, if you have developed a condition requiring expensive prescription drugs, going without Medicare Part D could now significantly affect your financial and medical well-being.
You may encounter coverage gaps when changes occur in your:
- Medical status
- Medicare cost-sharing responsibilities
- Policy details
Moving to a new city or state may also trigger unforeseen discrepancies. Even if you do not find comprehensive coverage within your price range, shopping around can help uncover policy add-ons better suited to your ever-changing needs.
Discover Additional Benefits
Likewise, reviewing your plan can give you insight into additional benefits you may not have known about before, such as:
- Expanded prescription drug formularies
- Hospice care
- Wellness services (grocery credits, gym memberships, OTC drugs, and more)
New coverage discoveries occur most frequently with Medicare Advantage and Medicare Part D plans, as these vary widely depending on the overseeing insurer and policy structure.
For example, maybe you have had access to dental benefits through your Medicare Advantage plan you have not yet taken advantage of. Or, after reviewing your coverage details at the AEP, you may just decide you want more benefits altogether and need to change your policy.
The cost of Medicare fluctuates from year to year. For example, though rates tend to increase gradually over time, Part B monthly premiums actually decreased by $5.20 from 2022 to 2023. By reviewing the policy details and changes listed on your ANOC, you can make informed decisions about whether or not your financial contributions justify the coverage you receive and if you should find a new policy.
Patient cost-sharing responsibilities also change annually. For example, 12 of 16 Medicare Part D plans raised coinsurance rates for non-preferred drugs to above 40% for 2023. People affected by this could save money by finding different Part D or MA-PD policies with more favorable rates or enrolling in a compliant Medigap plan during their AEP.
Discover New Plans
Assessing your needs and reviewing your options will often reveal new plans you did not know existed. In 2023, qualified individuals can enroll in one of 3,998 Medicare Advantage plans nationwide, many of which could offer better coverage, lower out-of-pocket fees, and more favorable medical networks than they currently have access to.
Likewise, 801 standalone Medicare Part D plans exist, ranging from 19-28 available policies per state. Though the number of options may overwhelm some people new to Medicare, setting aside a couple of hours every year during your AEP to compare prices and coverages could save you money and time and better suit your overall health in the long run.
When It’s Time For a Change in Your Medicare Coverage
After reviewing your options, follow these steps to switch to a new Medicare plan:
- Compare policies. Use Medicare’s Plan Finder tool to search for a Part D policy, or call 1-800-MEDICARE or your State Health Assistive Program (SHIP) for information on Medicare Advantage plans in your area.
- Call the affiliated insurance provider. Confirm that your preferred hospitals, doctors, and pharmacies qualify for in-network coverage and that your new formulary includes all necessary prescription drugs.
- Enroll directly through Medicare. Doing so through 1-800-MEDICARE offers the most protection against potential issues later on down the line.
Finally, remember that even if you stay on the same plan, assessing your options will give you peace of mind knowing you have the best available coverage for the subsequent year.