Medicare Open Enrollment - What to Do and How To Do It

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Medicare open enrollment is your once-yearly chance to switch Medicare Advantage plans, switch from original Medicare to Advantage, or switch Part D Plans. Image ©Fotokia/Getty Images

You only have one chance a year to make changes to your Medicare coverage. The annual Medicare open enrollment period is that chance.

Whether this is your first Medicare open enrollment or you’ve been doing it for years, it pays to take time each autumn and study your options. The number and types of plans available in your area change each year, bringing new options and eliminating previous options.

The benefits and costs associated with a plan you’ve had for years can change. This is your chance to do something about it.

When Is Medicare Open Enrollment?

Medicare open enrollment starts October 15 and ends December 7, Pearl Harbor Day. The changes you make during open enrollment take effect January 1 the following year.

You don’t have to wait until October 15 to start planning for open enrollment. You can start doing research on plan options when you get each year’s “Medicare & You” booklet in the U.S. mail or by email. The booklet alerts you to changes in Medicare that might impact your coverage or plan choices.

You’ll likely get information from you current Medicare Advantage and Medicare Part D drug plans as well as Social Security in the mail around that same time.

What You Can Do During Open Enrollment

  • Switch back and forth between Original Medicare and a Medicare Advantage Plan.
  • Switch from one Medicare Advantage plan to another.
  • Enroll in a Medicare Part D drug plan.
  • Switch from one Medicare Part D drug plan to another.
  • Drop your Medicare Part D drug plan completely, perhaps because you switched to a Medicare Advantage plan that includes drug coverage.

What if You Miss Open Enrollment?

If you miss open enrollment, you won’t be allowed to make changes to your Medicare coverage until next year’s open enrollment.

Your current Medicare coverage choices will roll over to next year.

There are a few exceptions that will allow you to make coverage changes outside of open enrollment. Some things, such as moving outside of your Medicare Advantage plan’s service area, trigger a special enrollment period allowing you a brief period to make changes even though it’s not open enrollment.

From January 1 through February 14, you can change your mind about your Medicare Advantage plan and switch back to Original Medicare. You can’t switch to another Medicare Advantage plan or join an Advantage plan you don’t already belong to, though.

How To Prepare for Open Enrollment

  1. Gather information about your current coverage so you’ll be able to compare and contrast the new offerings with what you have now. You’ll need information on the premiums, deductibles, copay or coinsurance amounts, which of your drugs are on your plan’s drug formulary and how much they cost.
  2. Go to the Plan Finder tool at Medicare.gov to get information about which plans will be offered in your area next year, what they’ll cost and how their quality scores stack up.
  1. Compare what you have now with what you’d have next year if you kept the same coverage. Are your premiums or cost-sharing going up? Are your drugs all still covered at the same level on the plan’s drug formulary? Are your doctor and hospital still in-network if you have a Medicare Advantage plan?
  2. Look at the other Medicare coverage options in your community. Check the drug formulary of each plan you're interested in. Do any of them have better coverage for your particular drugs? Can you find a plan with a lower premium but similar coverage? Can you find a plan with a similar premium but better coverage? Do the plans you’re considering have good quality scores? Make sure to check out Medicare Advantage and Medicare Part D provider networks to make sure you’ll be satisfied with the doctor, hospital and pharmacy choices.

How To Make Changes During Open Enrollment

If you decide to change your Medicare coverage during open enrollment, you have several options for how to do that.

You can sign up for most plans on the Medicare.gov website.

You can sign up with the plan directly by:

  • Visiting its website
  • Telephone
  • Filling out a paper application and mailing or faxing it to the health plan
  • Attending a community meeting put on by the health plan to educate Medicare recipients—and to market the health plan to them. Often, these plans will allow you to enroll in the plan during the meeting. Not all plans hold community meetings, and some communities don’t have any meetings.

How to Get Help

If you’re having difficulty understanding the rules of Medicare open enrollment, how to accomplish your Medicare open enrollment goals, or comparing plans, you have several resources for help. Learn more in “Get Help With Medicare Problems & Medicare questions.” 

If you’re having trouble understanding how Medicare Advantage plan types differ, learn more in “HMO, PPO, EPO & POS—What’s the Difference & Which Is Best?

If you need clarification about what a particular plan does or doesn’t offer, contact the health plan.

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