What You Need To Know About Medicare Open Enrollment

Updated: Jul 17, 2022

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If you are reaching retirement age, applying for Medicare is an essential task. Like many seniors, you may be wondering if you have saved enough for your retirement years to cover the cost of living and all of your medical expenses. Answering this question and many others, the following article will specifically teach you about the Medicare Open Enrollment Period (OEP).

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What is Medicare?

Medicare is a federal program that offers coverage for individuals who are age 65 years and older. It also provides coverage for those who are under the age of 65 but are receiving Social Security Disability benefits, or for those who are under 65 and have ESRD (end-stage renal disease).

Once you determine your eligibility for receiving Medicare coverage, you will need to understand what your various options are. Medicare offers various types of coverage, and enrollees can choose to drop or add on to their plans during the Open Enrollment Period.

What is Medicare Open Enrollment?

The Medicare Open Enrollment Period allows you to choose which part of coverage you want to keep, and what you would like to drop from or add on to your plan.

Medicare offers various types of coverage, and enrollees can choose to drop or add on to their plans during the Open Enrollment Period.

During this time is when you have the chance to evaluate the current Medicare Advantage or Part D prescription drug plans and look for alternative options that may better meet your ongoing healthcare needs. If there is a plan out there that offers better coverage or more affordable rates, you will have the opportunity to switch during this Open Enrollment Period.

When is Open Enrollment for Medicare?

The official OEP for Medicare takes place every year between October 15 and December 7. Another critical factor to be aware of is that when you sign up for a new Advantage Plan or begin a new Part D prescription drug plan, these changes will not go into effect until January of the following year. This is good information to know, especially if you were expecting the benefits to begin immediately. 

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How Does Medicare Open Enrollment Work?

In order to enroll in these plans, you must sign up during the initial seven-month enrollment period after you turn 65. 

Listed below are a few more details about what you may do during open enrollment:

  • If you are signing up for Medicare Part A or Medicare Part B, or you are already enrolled, you can add or drop a prescription drug plan. 
  • If you have Medicare Part A or B, you can switch to a different Medicare Advantage Plan. 
  • If you have a Medicare Advantage Plan, you can go back to an Original Medicare (Part A or B) plan. 
  • If you are enrolled in a Medicare Advantage plan, you can switch to another Advantage plan.
  • If you are enrolled in a Medicare Part D plan, you can switch to a different Part D plan. 
What Medicare Open Enrollment Options Do You Have?

It is no secret that Medicare providers are always changing their benefits and how much they charge for monthly premiums. That is why you may want to keep looking for new health insurance options as they become available to you.

It is no secret that Medicare providers are always changing their benefits and how much they charge for monthly premiums.

During open enrollment, you have the opportunity to find a new plan that possibly better suits your needs and budget. Medicare plans often change their out-of-pocket costs from one year to the next. This change can include the price of monthly premiums, the number of deductibles, prescription costs, and plan networks. These companies may also change their formulary, which is the list of drugs that are covered under their plan.

If changes to your Medicare plan start making it difficult to pay your premium and to continue being able to afford your prescription drugs, you can have peace of mind knowing that there are more options available for you to choose among during the Open Enrollment Period.

You Have More Options for Prescription Drug Coverage

You can use the Open Enrollment Period to change your current prescription drug plan. You could also add on an initial Part D plan if needed. If the cost of your current prescriptions begins to take a toll on your budget, you have the option to enroll in a Part D plan, which can be extremely useful. Enrolling in a Part D plan can help guarantee that you can afford the prescriptions you need each day.

You Can Cut Down Costs and Stay with Your Current Doctor 

When changing from an Advantage Plan or Part D plan to a more affordable coverage option, many people are able to save money while keeping their same doctor. By choosing a new plan that uses the same network of doctors you are currently seeing, you will be able to keep the same physicians and specialists you now see, while paying a lower copayment as well. Using the Open Enrollment Period to change to a plan that includes your current physicians, hospital, or pharmacy, is extremely helpful and can significantly lower what you pay for medical care. 

You Can Find a Better Quality Healthcare Plan 

If you are interested in finding a higher quality plan, try checking out the Medicare rating system to find out if their 5-star recommendations are a good option for you. As a general rule, plans with less than three stars are of lower quality and should be avoided. It would be in your best interests to look for a 5-star plan that offers the best coverage options.

Why You Should Know About Medicare Supplement Insurance

It is important to note that when you are enrolled in a Part A or Part B plan, there can be gaps in your coverage. These gaps can cause you to pay higher out-of-pocket costs. Copayments, coinsurance, and deductibles are all your responsibility, and the higher these fees are, the more difficult it will be for you to stay within a reasonable budget. This is why a Medicare Supplement insurance plan can be quite useful. 

Also known as Medigap, a Medicare Supplement insurance plan works alongside your current plan to make up for coverage gaps. These supplement plans will pay for services that your Original Medicare plan does not cover. Also, because you depend on these services for your overall health and well-being, you really do need this form of coverage. 

Are Special Enrollment Periods Available?

It is important to know about the Special Enrollment Periods (SEPs) for Medicare, as some circumstances can prevent you from changing your Medicare plans during the Open Enrollment Period.

During open enrollment, you have the opportunity to find a new plan that possibly better suits your needs and budget.

if you have moved recently or lost your other insurance coverage, you could still make changes to your plan thanks to SEPs. Since specific rules apply to each SEP, you will need to check with a representative from Medicare or another expert to find out if your current situation qualifies. It would be in your best interests to find out more about SEPs if you missed the Open Enrollment Period due to circumstances that were out of your control.

How to Plan for Medicare Open Enrollment

There are several things you can do to help prepare yourself for Medicare open enrollment. First, look at what your current plan covers, then decide if you could benefit from making some changes. 

Then, check to see if there are any higher-rated plans available that offer better coverage options to suit your current health care needs. For instance, you might want to look for a Part D plan that covers a certain medication that your current plan does not. You can also check to see if there is a Medicare Advantage plan that has lower out-of-pocket costs.

If you are enrolling in Medicare or would like to change your plan, just remember that the Open Enrollment Period is between October 15 and December 7. This means that you should start looking at your current policy and what benefits other Medicare plans offer well before October to ensure that you are prepared to make changes when needed.

While there are special enrollment periods available, and some circumstances will allow you to change your plans after the open enrollment period ends, not everyone will be eligible to make such changes after the period ends.