My local Medicare insurance agent told me the Medicare Open Enrollment starts in January? I thought Open Enrollment started on October 15 and ended on December 7. Is she wrong?
Your Medicare insurance agent is correct. The 2022 Medicare Advantage Open Enrollment Period (OEP) is here!
Although the Annual Election Period (AEP) ends on December 7 every year, that does not necessarily mean that you’re completely out of luck if you still want to make a change after December 7. With the AEP occurring around the holidays, it’s no wonder some folks simply miss it. Never fear, the OEP is here!
During the Medicare Open Enrollment Period (OEP), some avenues could still allow you to make changes to your Medicare coverage without penalty and without having to wait until the AEP next year. It’s also known as the Medicare Advantage Open Enrollment Period (MAOEP)
The OEP runs from January 1st through March 31st every year. During this time, if you don’t like the plan you bought, or something else changed between last year and this year, you can make a few changes. For example, let’s say you didn’t pay attention to the packet of plan changes your insurance company mailed to you in September, and you were surprised by a new, higher copay you had to pay at the pharmacy. Or maybe your doctor’s copay went up, or they are no longer in your network. Now’s the time to consider a change.
What Can You Do During the OEP?
- Switch to a different Medicare Advantage plan.
- Drop your Medicare Advantage plan and return to Original Medicare, Part A and Part B. This means if you do this, you can use the OEP to sign up for a stand-alone Medicare Part D Prescription Drug Plan (again, only if you return to Original Medicare and go Bare-with-Medicare).
- Simply drop your stand-alone Medicare Part D Prescription Drug Plan. I can’t think of a reason why you’d do that, but you can.
What Can’t You Do During the OEP?
- Switch from Original Medicare to a Medicare Advantage plan.
- Switch from one stand-alone Medicare Part D Prescription Drug Plan to another.
If you decide to drop your Medicare Advantage plan and buy a Medicare Part D Prescription Drug plan during the OEP, you’ll be bumped off of your Medicare Advantage plan and default back to Original Medicare A and B for your medical insurance coverage. I can’t think of very many reasons why you’d do this, but I suppose if you really didn’t like your Medicare Advantage plan and wanted to get rid of it, you could. As such, you may also need or want to purchase a Medicare Supplement insurance plan at that time. However, if that’s your plan… be very careful. I cover Medicare Supplement in depth in Chapter 4.
Buying a Medicare Supplement (Medigap) During the OEP
Depending upon the rules of your particular state, you may have to go through medical underwriting to purchase a Medicare Supplement plan outside of a special window when you turn sixty-five. Medicare Supplement plans are not like Original Medicare Parts A and B, Medicare Part D, or Medicare Part C (Medicare Advantage plans) in that Medicare Supplement insurance companies can deny you coverage based on your health. A Medicare Supplement policy is a separate policy from Original Medicare Parts A and B. Medicare Supplements are offered by Medicare Supplement insurance companies. These companies can deny you coverage or, at the very least, accept you but charge you a much higher premium. If you get denied coverage for a Medicare Supplement plan, you’ll only have Original Medicare Parts A and B and a Medicare Part D Prescription Drug plan to fall back on, until the AEP (October 15-December 7th), when you can enroll in a Medicare Advantage plan once again.
My advice is that if you want to go that way, you’ve got to apply and receive your acceptance or denial from the Medicare Supplement insurance company before you apply for a Medicare Part D Prescription Drug Plan and drop your Medicare Advantage plan.
In essence, you generally have a very small window to buy a Medicare Supplement plan with no medical questions to answer, and the Medicare Supplement insurance company must accept your enrollment. Said differently, Medicare Supplement plans have very narrow timeframes within which you can apply for coverage and not be subject to medical underwriting.
Don’t Ever Drop a Medicare Supplement Without Confirmation of Replacement Coverage
If you’re on a Medicare Supplement already, be very, very sure you know what you’re doing. Many people use a Medicare Supplement for a few years then move to a Medicare Advantage plan. Some people move from one Medicare Supplement plan to another to get a cheaper rate. Whatever you do, don’t drop a Medicare supplement plan before you get confirmation on your next insurance policy!
I’ve Switched Medicare Advantage Plans During the OEP. Now What?
If you leave a Medicare Advantage plan during the OEP, your current Medicare Advantage coverage will remain in force until the end of the current month. Your new coverage will then take effect on the first day of the following month.
Can I Buy Another Medicare Advantage After I’ve Already Bought One During the OEP?
Nope. You can only make a change one time during the OEP. In other words, once you have made a change to your Medicare coverage using your OEP, that’s it for the year. You may not go back in during this same time frame and make more changes.
Here’s an example of what you can’t do during the OEP. Let’s say you move from a Medicare Advantage plan back to Original Medicare on February 1st and pick up a Medicare Part D Prescription Drug Plan to cover your prescription drugs. That’s it for the year. You’re out of your OEP choices. Even if you change your mind, you cannot change your plan again on March 1 of the same year and go back into a Medicare Advantage plan. In that scenario, you’d have to wait until the AEP rolls around between October 15 and December 7.
That said, you better have a really good reason, and you better understand what benefits you will have in your new plan, as well as what you may be giving up, before switching plans—and from there, you can determine whether or not a change will truly be beneficial for you.
The Medicare Advantage OEP and Medicare Supplements
The basic rule is this: don’t drop Medicare Advantage in favor of a Medicare Supplement plus a Medicare Part D Prescription Drug Plan before you get accepted to enroll in a Medicare Supplement plan, if that’s what you’re planning to do. If you’re okay with moving away from a Medicare Advantage plan and going back to Original Medicare plus a Medicare Part D Prescription Drug Plan, you can do that during the OEP. If you want to change from your current Medicare Advantage plan and choose another one, you can do so—one time—during the OEP.
Sherry, I hope that helped you!
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To your wealth, wisdom, and wellness!
Author Bio: Matt Feret is the author of the Prepare for Medicare book series and launched prepareformedicare.com to help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development and strategy for over 20 years. Matt holds a BA from Virginia Tech and an MHA from Washington University in St. Louis.