Medicare will add a new Open Enrollment Period for people enrolled in a Medicare Advantage plans to switch or drop their plan in 2019. The new Medicare Advantage Open Enrollment Period (MA OEP) replaces the Medicare Advantage Dis-enrollment Period and gives people more options for enrolling in a plan that best suits their needs. The MA OEP will run from January 1 – March 31, 2019.
Medicare Open Enrollment Different From Annual Election Period
Every year Medicare beneficiaries have the chance to enroll in a Medicare Advantage plan or switch plans during the Annual Election Period which occurs from October 15 through December 7 in 2018. Enrollments in Medicare Advantage medical and Part D prescription drug plans during the Annual Election Period become effective January 1, 2019.
The old Medicare Dis-enrollment Period allowed individuals enrolled in a Medicare Advantage plan to get out of the plan and return to Original Medicare. It did not allow the person to switch to a different Medicare Advantage medical plan. The prevailing wisdom was that Medicare beneficiaries thoroughly researched their current plan and any alternatives during the Annual Election Period and there would be little reason to change after the plan’s start date of January 1.
Initial Coverage Election Period
Beginning in 2019, when a new Medicare beneficiary exercises their initial coverage election period, usually after they turn 65 and have enrolled in Part A and Part B, they will also get a Medicare Open Enrollment Period. It will begin the month of entitlement for Parts A and B and ends the last day of the 3rd month of entitlement.
Annual Notice of Change
Unfortunately, changes to the Medicare Advantage plans are not always obvious to the member until they go to use the health insurance. Doctors and drugs may have been dropped from the current plan. The Medicare Advantage plans send out an Annual Notice of Change to current plan members, but they can be difficult to read. Consequently, the plan may have changed enough so that it no longer fits the individual’s health care needs. Other Medicare beneficiaries enroll in a Medicare Advantage without really focusing on the details until they have to use the plan in the New Year.
The new Medicare Open Enrollment Period gives Medicare plan members a chance to switch plans or drop the health plan altogether.
- MA OEP begins January 1 and runs through March 31, 2019
- You can switch Medicare Advantage Prescription Drug Plans (MA-PD) to a Medicare Advantage (MA) medical plan only – Or – move from a MA to a MA-PD.
- You can leave the Medicare Advantage plan and return to Original Medicare
- If you drop your MA or MA-PD altogether, you will have a Special Enrollment Period to enroll in a Part D Prescription Drug Plan (PDP).
The new MA, MA-PD, or PDP will become effective the first of the month after enrollment. If a MA-PD plan member switches their plan on February 15h through the MA OEP, the new plan will become effective March 1. Medicare Advantage plan members can only make one change during the MA OEP.
Open Enrollment Only For Medicare Advantage
You must have been enrolled in a Medicare Advantage medical plan to take advantage of the MA OEP. If you never enrolled in a MA or MA-PD, you can’t join one during the MA OEP. You can’t switch standalone Part D Prescription drug plans during the MA OEP. Additionally, if you go from a MA-PD to a MA plan, you can’t add a standalone Part D Prescription Drug plan. The MA OEP doesn’t apply to Medicare Savings Accounts (MSAs) or Cost Plans.
What About Medicare Supplements?
If you drop your Medicare Advantage plan you will not necessarily have a guarantee issue right to enroll in a Medicare Supplement plan. In other words, if you are outside of your Medicare Supplement guarantee issue period – the 6 month window after you are entitled to Part A and enrolled in Part B of Original Medicare – you will have to submit to medical underwriting to get a Medicare Supplement plan. There are other qualifying events for guarantee issue of a Medicare Supplement plans that may apply. However, don’t assume that by dropping you Medicare Advantage plan and returning to Original Medicare that you can enroll Medicare Supplement plan with no questions asked.
If you elect to switch plans during the MA OEP do as much research as possible. Just because the plan premium went up doesn’t mean your current Medicare Advantage isn’t the best choice. Research the doctor network and drug formulary of the alternative plans. This is one of the main reasons why people change plans: their doctor is no longer in-network. The Medicare Plan Finder Tool is a great place to start to find plans in your area and to check if your prescription drugs are covered. If there is a 5 Star rated Medicare Advantage plan in your area, then you can switch to it at any time.
If the cost of the Medicare Advantage plan is straining your budget, look into getting extra help through the Medicare Savings program and the Low Income Subsidy for the Part D prescription drug plans through Social Security. The new Medicare Advantage Open Enrollment Period should really help a lot of people. But the right decision is based solid homework to compare the various plans in your area.
There are a variety of different enrollment periods for Medicare beneficiaries.
- Initial Coverage Election Period when you first become eligible for Medicare
- Annual Election Period October 15 – December 7
- The new Medicare Advantage Open Enrollment Period January 1 – March 31
- Special Election Period that can occur when an individual moves outside the coverage area or become eligible for a Medicaid program
- Open Enrollment Period for Institutionalized Individuals
All these different enrollment periods have different rules and conditions pertaining when they can be used and some overlap with one another. Talk with a local nonprofit, government agency or insurance agent about your particular situation and which enrollment period applies to you if you have questions.