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Medicare Annual Enrollment ~ What Can I Do?


Unless you’ve been out of the country or living under a rock, you’ve likely heard about Medicare Annual Enrollment Period. Medicare AEP for short, is the time of the year when changes can be made to your Medicare plans. AEP begins October 15th and runs to December 7th each year. Most Medicare beneficiaries know they need to be doing something during AEP each year, but they are not quite sure what. The deluge of radio and television ads cause confusing and have people guessing what they should be doing. In this article I will shed some light on Medicare AEP and what it could mean to you.

Medicare AEP exists because each year, Part D prescription drug plans and Medicare Advantage plans can re-file their benefits with Medicare, making changes to their plan options. This means the benefits and premiums on your plan can change. Therefore, Medicare grants you this time each year to change your plan if you don’t like the changes to your existing coverage.

First and foremost, you do NOT have to make a change if you like your plan. In fact, statistics show that most beneficiaries do NOT make changes to their plan each year. However, you absolutely should be reviewing the upcoming plan changes every year.


Annual Notice of Change

Each September, your Medicare Advantage or Part D Insurance plan provider will send you an Annual Notice of Change. It will tell you of any changes in premium, copays, drug formulary. The Annual Notice of Change lists the plan’s changes side-by-side from current year to following year. This makes it easy to compare changes to coverage.


What changes can I make during AEP?

· Do nothing and keep your current Medicare plan

· Switch from Original Medicare to a Medicare Advantage plan

· Switch from a Medicare Advantage plan back to Original Medicare

· Change from one Medicare Advantage Plan to another

· Enroll in, leave, or change your Medicare Part D drug plan


Should I Change My Plan?

Here are some of the most common reasons that plans change during AEP

· Your plan is dropping one of your important medications next year. Your Annual Notice of Change letter will specifically list any changes to its drug formulary for next year. The plan must disclose if they are dropping any medications. They must also tell you if a medication is moving to a more expensive tier for next year. If you take a brand name medication now that won’t be covered the next year, you may want to change during AEP to another drug plan that will.

· Your Medicare Advantage plan is dropping your doctor from its network. Advantage plans have a network of doctors. If one of your doctors is leaving the plan’s network, you can use the Medicare AEP to switch to another plan that your doctor still participates in.

· Your plan has a drastic increase in premium. Please note that the key word here is “drastic.” Inflation happens to medical insurance plans just like it does to auto insurance plans. If the only thing changing on your drug plan is a small increase in premium, you don’t have to switch. However, if your drug plan goes up considerably each month, you might look to see if another plan is cost effective. It is important to not make it more difficult than it is. I come from the belief that if the plan stays consistent and you’ve been happy with your coverage, it is best to stay with your coverage. Also, I don’t believe it’s best to change just because another plan has what I call “Fluff”! This sparkles that might cover up the fact that the regular benefits are not as competitive. Review your Annual Notice of Change to decide if there are changes that make you want to shop around. Contact your agent for questions and help if you do need to make a change.


Does My Medicare Supplement Change?

Medicare Supplements / Medigap Plans DO NOT change. Your Medigap plan has federally standardized benefits that do not change from year to year like Part D or Advantage plans do. This confuses a lot of people. The only changes you will see in a Medicare Supplement is premium amounts and that typically occurs at different times of the year depending on the carrier.


How Do I Make A Change?

I know this is all very confusing. That’s why agents like me exist to help guide you through the process. I work with my clients and referrals as their advocate. Last year during AEP many of the referrals I had were better off remaining on their existing plan. It always comes down to what is best for you! When I work with someone to determine if a change is in their best interest, I complete a thorough interview to get a picture of the Doctors they currently see and the prescriptions that they currently take. This allows me to narrow down the plans in their area that would work well. Then we take some time to discuss the plan options and what is important to them and their unique health situation. It is different for each person! There is no cookie-cutter plan that fits all! If a change is warranted, I take care of the application for enrollment and then I follow them through the process, so they don’t feel lost in the shuffle. I then, review with them each year to make sure their benefits are sufficient.

Medicare doesn’t have to be confusing with the right support! If you have not reviewed your plan recently, it would be an honor to go over your current plan and highlight your benefits for the coming year.


‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.’’

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