Cancer Support Community North Texas

Medicare + Open Enrollment

Oct 22

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Many Medicare beneficiaries at some point have enrolled in a Medicare Advantage plan, only to realize in January that their doctor didn’t accept their new plan, or they didn’t realize they had a network of doctors they could only see for their healthcare needs. For these Medicare beneficiaries, this meant staying in a plan that wasn’t optimal for them for an entire year.

In 2019, Medicare beneficiaries will see some beneficial changes in their healthcare options, including flexibility. In 2010 we did away with the Medicare Open Enrollment Period and now the lawmakers are reinstating it for all Medicare beneficiaries around the country.

These Changes Will Benefit Medicare Recipients

The Open Enrollment Period for residents in Texas will take the place of the Medicare Advantage Disenrollment Period (MADP) which was January 1 through February 14 of every year. This MADP only allowed beneficiaries to disenroll from their Medicare Advantage plan and switch back to Original Medicare, they wouldn’t be able to switch from MA plan to MA plan.

The return of the Medicare Open Enrollment Period will benefit many Medicare beneficiaries; especially if you forgot to change your Medicare Advantage plan or decided a different healthcare plan would be more suitable for your needs.

There are some things you’ll be able to do during the OEP, like:

  • Switch from one Medicare Advantage plan to another
    • You can only make one change, so make it count!
  • Disenroll from a Medicare Advantage plan and switch back to Traditional Medicare with or without a Part D plan.

The “Open Enrollment Period” Mix-up

The reason this gets confusing is because CMS failed to create better terminology for the different enrollment periods available to Medicare beneficiaries.

The Medicare Supplement Open Enrollment Period is for beneficiaries that are new to Medicare Part B and just turned 65. This gives beneficiaries the lowest possible premium on the most comprehensive coverage. With not health questions asked, which for cancer patients, getting the best coverage is ideal.

Then the Medicare Annual Enrollment Period (AEP) is commonly (an incorrectly) referred to as an Open Enrollment Period. This is the enrollment period that happens every year from October 15 through December 7th, during this time anyone with a Medicare Advantage plan or a Medicare Part D plan can change coverage for the following year.

The Initial Enrollment Period (IEP) is typically confused with the Medicare Supplement Open Enrollment Period. The IEP gives Medicare beneficiaries 7 months to enroll in a Medicare Advantage plan; three months before, the month of and the three months after they become eligible for Medicare Part B and are 65 years old.

The Open Enrollment Period Simplified

It can be confusing when talking about the Open Enrollment Period. Especially since there are so many enrollment periods referred to as the “Open Enrollment Period”. The reinstated Open Enrollment Period is for Medicare Advantage plan beneficiaries and will begin on January 1 and end on March 31.

The new Medicare changes of 2019 will make changing from one Medicare Advantage plan to a more suitable plan, simple.

While there’s opportunity here that allows beneficiaries to change plans, you should understand that you won’t be able to switch Part D plans during the Medicare Open Enrollment Period.

Medicare eligible beneficiaries that are enrolled in a stand-alone Part D prescription drug plan need to make changes to their Part D Prescription Drug plan during AEP (October 15 through December 7).

Each year around September 30th, Medicare Advantage beneficiaries will receive an Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing insurance carrier for their Medicare Advantage and Medicare Prescription drug plan providers.

When you receive this information, take responsibility and note changes. This will give you control, and you can adjust your coverage if needed. You need to be aware of what your plan and Medicare will cover.

CMS will post plan changes for the following year in October, several months before the new year. Medicare.gov is a valuable resource for Medicare beneficiaries, they can compare plans, look up information and learn more about Medicare.