Every year beginning on Oct. 15 and running through Dec. 7 those already on Medicare can make changes to their coverage as needed. This is known as the Medicare annual enrollment period.
Changes made during this period become effective as of Jan. 1 of the following year.
Changes you can make
During the Medicare annual enrollment period, you can change any aspect of your Medicare coverage. Potential changes include:
Switch from Original Medicare Parts A and B to a Medicare Advantage plan (Part C).
Switch from one Medicare Advantage plan to another.
Switch from coverage under a Medicare Advantage plan and go back to Original Medicare Parts A and B.
Move to a Medicare Advantage plan that offers prescription drug cover to one that doesn’t, or vice versa. If you switch to a plan that doesn’t include prescription drug coverage you will need to enroll in a Medicare Part D plan to get that coverage.
Switch from one Medicare prescription drug plan to another.
Consider a Medigap or other Medicare supplement plan.
Any of these steps, or others, should only be taken after analyzing your needs in light of your current Medicare arrangement.
If you make a change from a Medicare Advantage plan that includes prescription drug coverage to either another Medicare Advantage plan, or to Original Medicare Parts A and B, be sure that you have creditable prescription drug coverage. Failure to have this coverage either at the initial Medicare enrollment period or later on can result in costly, permanent penalties.
If you wish to enroll in a Medicare Supplement plan (Medigap), you cannot have this coverage and a Medicare Advantage plan in place at the same time. The Annual Enrollment period is a valid time to switch to a Medigap policy if you wish to do so, but it is a good idea to have another Medicare Advantage option in mind as well. This is because you will likely be subject to a medical examination in order to qualify for most Medigap plans. This could result in denial or coverage, or at least a much higher cost than you may have anticipated.
It is not uncommon for Medicare Advantage and Medicare prescription drug plans to change over time. This may include a change in procedures or medications covered. Providers may move in or out of the plans provider network. Plans may also increase premiums or change deductible levels.
Each year, generally by September, plan providers will send you an Annual Notice of Change (ANOC) letter. The ANOC letter will detail any changes in plan cost and coverage. You should read this letter thoroughly. If you have not received one you should contact your plan provider immediately to request your letter.
Changes in your situation
Your health situation and coverage needs may have changed since you initially enrolled in Medicare or since last year’s annual enrollment period. For example:
You may have developed a health condition requiring specialized treatments or medications.
Perhaps you have changed or added a doctor.
You will be needing specific surgical procedures in the near future and over time.
These or a range of other changes in your healthcare needs can be a good reason to review your Medicare coverage and perhaps look to make changes in some of all components of your coverage.
Changes in plan coverage
Medicare plans may change their coverage options from time-to-time. Perhaps a hospital, doctor or pharmacy that you have used in the past, or that you’d like to use in the future, is no longer part of the plan’s network. In the case of a Medicare prescription drug plan or drug coverage under a Medicare Advantage plan, drugs may move in or out of the plan’s list of formularies.
Changes in your lifestyle or personal situation
Other aspects of your lifestyle or personal situation can change over time. Perhaps you plan to travel or even live in another location for a portion of the year. You will want to be sure that doctors, healthcare facilities and other providers in these other locations are included in your plan’s coverage network.
A change in your financial situation is a good reason for you to review your current Medicare coverage and look for a less expensive coverage that still meets your needs.
Other enrollment dates
Beyond the Medicare Annual Enrollment period for those already on Medicare, there are two other key enrollment periods to be aware concerning Medicare.
The initial enrollment period occurs over a seven month period surrounding your 65th birthday. The three months prior, the month of your birthday and the three months after constitute your initial Medicare enrollment period. If you are enrolled in Social Security at the time you will automatically be enrolled in Medicare.
There is an open enrollment period for Medicare Advantage plans each year from Jan. 1 to March 31. During this period you can switch between Medicare Advantage plans or switch back to Original Medicare Parts A and B. You can switch between Advantage plans with or without drug coverage and you can join a separate Medicare prescription drug plan if needed.
For those already on Medicare, the annual enrollment period is an important time to review and evaluate your current Medicare coverage to ensure that you have the best coverage for your personal situation at the best cost. Be sure to take advantage of this opportunity to either change coverage options if needed or determine that your existing coverage is still your best option.