The Medicare OEP is back! Shelved a decade ago, not only will Medicare beneficiaries have the AEP to make Medicare plan choices, but will also have an additional time period from January through March to make changes to their coverage.
Yep. Over the last 20 years, it’s started, stopped, started, then stopped again. Guess Medicare is hitting the ‘start’ button again.
On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final ruling that will result in some updates for Medicare Advantage (also known as MAPD) plans, as well as to the Medicare Part D prescription drug (also known as PDP) program.
These updates were stuck into a large bill and passed as a part of the 21st Century Cures Act (commonly referred to simply as the Cures Act), which was designed for helping to accelerate medical product development.
Today, Medicare’s Annual Election Period, or AEP, goes from October 15th to December 7th each year. During this time period, those who are enrolled in Medicare are allowed to make changes to their plans – which include switching from Medicare Advantage to Original Medicare, or making a move from one Medicare Advantage plan to another.
The new rules will revise the Medicare Advantage program in several areas, including the re-introduction of a “new” open enrollment period (or OEP). This means beginning in 2019, the enrollment period will run from January 1st to March 31st, and during this time period, Medicare Advantage enrollees will be allowed to dis-enroll from their current plan and move to a different Medicare Advantage plan. Or, they can move back over to Original Medicare (Medicare Part A and B) essentially dropping their MAPD plan.
The OEP is not an extension of the AEP, which will still occur between October 15th and December 7th each year. Additionally, the OEP does not provide the same flexibility as the AEP where you can make any changes you want.
Those who opt to move back over to the Original Medicare program will also have the option of obtaining a Medicare Part D prescription drug plan and / or a Medicare Supplement insurance plan. Check with your insurance agent – state laws regulate Medicare Supplement plans, and many require health underwriting, so don’t go dropping Medicare coverage and simply assume you can pick up a Medicare Supplement plan. Talk to an agent. Seriously.
It is important to note an enrollee may only obtain the prescription drug plan if he or she previously had prescription drug benefits with the Medicare Advantage plan that they dis-enroll in.
The new regulations will provide Medicare enrollees more time to decide how and where to obtain their benefits. Under these new rules, however, enrollees may only move to a differing Medicare Part C / Medicare Advantage plan one time.
During the OEP, you’re able to make “like plan” changes between January 1st and March 31st
The OEP will be a one-time use election period, so you’re limited to just one change during the 3 month window. Policy effective dates will be first of the following month after you sign.
In addition to extending the time frame for choosing different Medicare benefit options, the Centers for Medicare and Medicaid Services estimates that these coming changes could result in an annual savings of roughly $295 million over the next five years (starting in the year 2019) to Medicare – and in turn, these savings can result in lower premium costs and / or additional benefits for Medicare Advantage and Medicare Part D enrollees. Where’s the proof of this? Can’t find it. Suffice to say insurance agents will welcome the additional time to get clients – new and old, in a product that meets their needs.
You’ve now got more time, in some instances, to make or amend your Medicare insurance plan choices. The best strategy is to discuss all of your potential alternatives with an expert independent insurance agent. Once you have a more in-depth understanding of the various benefits and potential costs, you can more easily decide which option will be the best for you and your specific needs.
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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.