Medicare Open Enrollment Returns: What You Need to Know About Insurance after 65

By Stephanie Frisch

The Medicare Open Enrollment Period is back.

Not to be confused with the Medicare Annual Election Period (AEP), Open Enrollment Period (OEP) was shelved a decade ago. Now, not only will Medicare beneficiaries have the AEP to make Medicare plan choices, but they will also have an additional timeframe from January through March to make changes to their coverage.

On April 2, the Centers for Medicare & Medicaid Services (CMS) issued a final ruling that will result in some updates for Medicare Advantage (also known as MAPD) plans, as well as to the Medicare Part D prescription drug (also known as PDP) program.

Today, AEP is open from Oct. 15 to Dec. 7 each year. During this timeframe, those who are enrolled in Medicare are allowed to make changes to their plans, which include switching from Medicare Advantage to Original Medicare or making a move from one Medicare Advantage plan to another.

The new rules include the introduction of a revised open enrollment period (OEP). This means, in 2019, the enrollment period will run from Jan. 1 to March 31, and during this timeframe, Medicare Advantage enrollees will be allowed to dis-enroll from their current plan and move to a different Medicare Advantage plan. Or, they can move back over to Original Medicare (Medicare Part A and B) essentially dropping their MAPD plan by enrolling in a Medicare Part D prescription drug plan (PDP).

So what is the difference between AEP and OEP? The OEP is not an extension of the AEP, which will still occur between Oct. 15 and Dec. 7 each year. Additionally, the OEP does not provide the same flexibility as the AEP where you can make any changes you want.

The new regulations will provide Medicare enrollees an additional timeframe to decide how and where to obtain their benefits. Under these new rules, however, enrollees may only move to a differing Medicare Advantage plan one time.

Confused? To clarify: During the 2019 OEP, you’re able to make “like-plan” changes between Jan. 1 and March 31 (The same plan change you made during AEP):

MAPD to MAPD
MAPD to Original Medicare and a Part D
Original Medicare and a Part D to MAPD
The OEP limits people to just one change during the three-month window. Policy effective dates will be first of the following month after you sign.

Keep in mind that every year your prescription drug coverage can change. Insurance companies can raise your monthly premium, change the price of your medications, or stop covering them all together.

Also, look for a notice in the mail every year in late September. That notice is referred to as the, “Annual Notice of Change”. If there are changes to your premium or coverage, the ANOC shows what the 2018 cost was, and then it shows you the 2019 cost. The same process happens with Medicare Advantage plans. Using the help of a licensed insurance professional helps you make your way through the Medicare “maze” and make the right decision for your needs for the New Year.

Stephanie Frisch is the owner of Insurance 101 Services and is an independent Insurance broker dedicated to helping others make “educated decisions” about their insurance choices when it comes to Medicare. For answers to your questions, or an in-home, no-fee consultation, call (949) 351-2443.