AEP and OEP – When Can You Enroll In or Change Your Medicare Coverage?

Medicare AEP OEP

AEP vs OEP Don't Make a Move Without Careful Consideration

Whether you’re a new or a current Medicare enrollee, it’s likely that you have questions regarding what your plan (or your proposed future plan) covers, and whether or not a different Medicare health care coverage option would be better for you and your specific needs.

Just like most other areas of our lives, our health – and thus, our health care needs – can change. This is particularly true as we get older, when we are more apt to face more physical challenges as time goes on.

With that in mind, even if you have been enrolled in Medicare for your health insurance coverage for some time now, it could be to your advantage to review your present (and your anticipated) health care needs, and compare them with the various Medicare plan options that are available in the market place today. And, if you do find that a different plan suits you better, there are some important rules that you must follow as you make any changes going forward.

How the Medicare Annual Election Period Works (AEP)

Each year, the Medicare Annual Election Period, or AEP, starts on October 15th and runs through December 7th. During this time, there are a number of changes that can be made with regard to Medicare plans. This is the case, regardless of whether you are currently enrolled in Original Medicare (which is Medicare Part A and Part B), or in a Medicare Advantage (Medicare Part C) plan.

For instance, during the AEP, you can move from Original Medicare to Medicare Advantage, or vice versa. You may also switch from one Medicare Advantage plan to another Medicare Advantage plan that may better suit your needs and / or your budget.

Likewise, you may also switch from one Medicare Part D prescription drug plan to another, or alternatively, you may join or leave a Medicare Part D plan altogether. Provided that you make any of these changes during the Medicare Annual Election Period, you new coverage (or the termination of your current coverage) will take effect on the following January 1st.

The Medicare Advantage Disenrollment Period is Gone

There used to be a period during the year that is referred to as the Medicare Advantage Disenrollment Period. This ran between January 1st and February 14th every year, and during this time you can leave your Medicare Advantage (Medicare Part C) plan.

In 2019, The Medicare Advantage Disenrollment Period (January 1 – February 14 every year) will be replaced with a different arrangement. It’s called the Open Enrollment Period (OEP).  This will be effective starting in 2019,

During this time, you’ll be able to:

  • Switch to a different Medicare Advantage plan
  • Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B
  • Sign up for a stand-alone Medicare Part D Prescription Drug Plan (if you return to Original Medicare). Most Medicare Advantage plans include prescription drug coverage already. Usually you can’t enroll in a stand-alone Medicare Prescription Drug plan if you already have a Medicare Advantage plan, but there are some situations where you can. Call your Medicare Advantage plan if you have questions.
  • Drop your stand-alone Medicare Part D Prescription Drug Plan

If you decide to drop your Medicare Advantage plan and opt for a Medicare Part D Prescription Drug plan, you may also need to purchase a Medicare Supplement insurance plan at that time. Medicare Supplement insurance – which is also oftentimes referred to as Medigap insurance because it fills in many of the coverage “gaps” in Medicare’s benefits – is a separate policy from Parts A and B of Medicare. BE CAREFUL.  Use an agent or call a Medicare Supplement insurance company (Mutual of Omaha, United Healthcare/AARP, Blue Cross and Blue Shield, to name a few) to understand your enrollment options BEFORE you drop your MAPD plan and go with a stand-alone Part D plan.  Depending upon your particular state rules, you may have to go through medical underwriting to purchase one.  This means that if you have an adverse health condition, you may be required to pay a higher amount of premium – or you could even be turned down – for the coverage that you want

Re-read that prior paragraph.  This gets tricky.

If you do qualify, there are ten different Medicare Supplement insurance plans to choose from. Each of these is named after a different letter of the alphabet, where Plan A offers the most basic set of “core” benefits and Plan F offers the most comprehensive.

Unlike Medicare Parts A and B, Medicare Supplement is not offered directly through Medicare, but rather via private insurance carriers that have been approved by Medicare to offer them. So, while the benefits on the plans of each letter must provide identical coverage (regardless of where they are purchased), the premiums that are charged can differ from one insurer to another.

Therefore, before purchasing a Medicare Supplement insurance plan during the Medicare Open Enrollment Period (or at any other time), it is important to be sure that you compare plans and prices from several different insurers.

Similar to with applying for Medicare Supplement coverage, if you have opted to leave a Medicare Advantage plan and return to Original Medicare, you are also allowed to join a Medicare Part D prescription drug plan at this time.
As with Medicare Supplement, Medicare Part D plans are also offered through private insurance carriers. So, the premiums that are charged on these plans can differ – sometimes substantially – depending on the plan you choose. In addition to that, the benefits that are covered can be different on differing Medicare Part D prescription coverage plans.

If you leave a Medicare Advantage plan during the Medicare Open Enrollment Period, your current coverage will remain in force until the end of the current month. Your new coverage will then take effect on the 1st of the following month.

Where to Go From Here?

If you are still unsure as to which type of Medicare coverage is the best for you, it can be helpful to discuss your needs with an insurance professional who specializes in Medicare health plans. You can also find information about all of the Medicare plan types on the Medicare website, which can be accessed by going to: www.Medicare.gov.  My advice?  Get with a reputable independent Medicare insurance agent and review your options before dropping ANY coverage you have during the OEP.