Medicare’s annual enrollment period occurs between October 15 and December 7 each year. Annual enrollment allows you to reevaluate your healthcare needs and change or drop your Medicare Advantage (Part C) or prescription drug (Part D) benefits, or switch back to Original Medicare from a Medicare Advantage plan.
Medicare modifies coverage and updates costs yearly, as explained in the Annual Notice of Change (ANOC). You might consider other plan options during annual enrollment if any of the following situations apply to you:
- You’ve developed a chronic condition
- You want or need to switch doctors
- Your financial situation has changed
- Your prescription medication needs have changed
- You’ve moved
These are just some reasons to change your Medicare plans during open enrollment. Whatever your reason for switching your plan, know it can be done with a little research and planning.
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Understanding Your Medicare Options
Original Medicare consists of Part A and Part B, which cover inpatient hospitalizations and outpatient services, respectively. The ideal time to enroll in Original Medicare occurs when you turn 65 since you may face a penalty for delaying initial enrollment when you first become eligible.
Original Medicare does not include prescription drug coverage; however, you may buy or drop a Part D plan during the annual enrollment period. During annual enrollment, you can also purchase or switch Medicare Advantage plans, most of which offer additional benefits such as vision, hearing, dental, and prescription drug services. Follow the steps below to fully explore your Medicare benefits during annual enrollment.
My advice to individuals who are new to AEP is to take your time and shop around. Start on October 15 and take a few days to look at different plans. Review at least 3 options before making an informed decision.
1. Review Your Annual Notice of Change
Medicare issues ANOCs via mail prior to October 15 to give beneficiaries ample time to review and understand how their plan will change in the coming year before entering the annual enrollment period. ANOCs are typically mailed along with a more detailed evidence of coverage (EOC) document.
ANOCs may list new changes, such as a provider, facility, or service no longer covered by your Medicare Advantage plan. Policies also commonly make changes to their formulary, or covered prescription medications, from one year to the next. You should review your ANOC and EOC for
any changes that affect your individual healthcare needs.
2. Assess Your Healthcare Needs
Receiving a full spectrum of medical and drug benefits through Medicare is critical to your health and well-being. Consider how your healthcare needs may change in the coming year to determine whether your existing plan, with the changes outlined in the ANOC, is still the right fit.
For example, you may have developed a new health condition, lost a substantial amount of weight, or require surgery for a serious illness or chronic pain. Your plan may have dropped a physician you visit regularly or a daily prescription medication you need. Alternatively, you may be happy with your benefits but require more affordable coverage due to a financial shift in your life.
You can use the ANOC to help prioritize your healthcare needs and ensure you choose the right healthcare plan.
3. Ensure Your Prescriptions Are Covered
Medicare plans change their prescription coverage often due to fluctuating drug availability and manufacturing costs on the national market.
Ensuring your prescriptions are covered is critical, especially if you take daily medications for a serious life-threatening condition, chronic ailment, or progressive disease.
Whether you receive drug coverage through Part D or Medicare Advantage, check your ANOC for changes affecting your benefits. If you’re considering Part D, signing up while you enroll initially in Medicare is ideal since you may face a penalty for late enrollment. If drugs are included in your Medicare Advantage plan, ensure those benefits continue the following year.
4. Shop Around and Compare Plans
You may decide to shop around and compare plans if your current plan no longer serves you. Original Medicare may still work for your medical needs, but you simply need to switch or drop Part D benefits. Another option is to add or switch your Medicare Advantage plan, many of which offer drug coverage, among other benefits.
Carefully consider your top priorities when shopping for plans. For example, if you do not require frequent healthcare services and prefer to minimize out-of-pocket costs, Original Medicare could be perfect for you, with its set deductibles and premium rates. Alternatively, you may need to focus on comprehensive drug coverage or an affordable Medicare Advantage plan.
The Logistics of Enrolling
You can make changes to your Medicare coverage during the annual enrollment period by phone, by mail, in person, or online. You do not need to officially cancel your existing Part D or Medicare Advantage plan if you decide to switch, as selecting a new plan automatically activates that coverage for the next year.
Your first opportunity to enroll in Medicare Advantage is during your initial enrollment period, when you turn 65 and/or are new to Part B benefits. During annual enrollment, you may also add, drop, or switch Medicare Advantage plans, with or without drug coverage. You may contact a Medicare agent for help or find Medicare Advantage provider information through Medicare.gov.
Mark Your Calendar
Planning ahead can help you stay prepared for Medicare’s annual enrollment period. Anticipating how your healthcare needs and budget may change in the coming year and beginning research into new coverage whenever possible is critical. However, you can also stay a step ahead by exploring your options as soon as you receive your ANOC.
Review any changes on the ANOC that could impact your benefits and consider if your existing plan will still meet your upcoming healthcare needs. Use this opportunity to weigh factors, including whether you need extra coverage and can afford the cost of care next year. Reach out to a Medicare agent as early as possible during annual enrollment for seamless assistance.