As the weather finally starts to cool off, that means a few big events are approaching. Yes, the state fair is here, but also for individuals almost 65 or older this is also a very important time for them. It’s Medicare’s Annual Open Enrollment.
During the Medicare Annual Enrollment Period, also known as the Annual Election Period, you can make changes to your current Medicare coverage. The Medicare Annual Enrollment Period, or AEP, runs from October 15th to December 7th every year.
When is the Medicare Annual Enrollment Period for 2022?
The Medicare Annual Enrollment Period also known as AEP will occur between October 15th and December 7th. The changes made in this period will be effective for the upcoming year starting January 1st, 2022.
What can be made during the Medicare Annual Enrollment Period?
- Switch from Medicare Advantage back to Original Medicare
- Change from one Medicare Advantage plan to another
- Sign up for a Part D prescription drug plan
- Change from one Part D prescription plan to another
- Cancel your prescription drug coverage
Any changes you make during the Medicare Annual Enrollment Period will take effect on January 1st of the following year.
What Benefits are There to changing Medicare Coverage During the Annual Enrollment Period Window?
Medicare Advantage and Part D benefits change each year. This means your premiums can increase and your benefits may change. Some common reasons you may want to change your coverage is due to your premiums increasing, the Advantage plan no longer has your doctor in the network of your plan, or the drug formulary drops your medication off the list of covered drugs.
Medicare enrollees will receive an Annual Notice of Change in September from your carrier. The ANoC will explain any changes happening to your current policy that will take effect for the upcoming year.
If you’re unhappy with the changes shown in your ANoC, you can change your coverage during the Annual Enrollment Period.
Things to Consider When Choosing Medicare Coverage Annually?
- Did my monthly premiums increase?
- Are my medications still listed on my drug formulary?
- What are my predicted annual medical costs going to be?
- Is my doctor still in my plan’s network of providers?
- Do I plan on traveling this year?
- What ancillary benefits do I have?
- What are my plan ratings?
Did my monthly premiums increase?
Your ANoC explains how your current coverage will change the following year—including whether you’ll see an increase or not in your monthly premiums. Look at the premium for your current plan and compare it with the premium amount shown on your ANoC. A significant increase is a good sign it may be time to shop around for a new plan.
Are my medications still listed on my drug formulary?
A new year can also bring changes to your drug formulary, the pricing tiers that medications are placed in, or the copays required for various types of prescriptions. Find out whether your prescription plan will cover your current medications in the upcoming year, and how much you’ll pay for them. If you take expensive medications, it’s a good idea to explore other prescription plans available in your area to see if they have lower copays.
What are my predicted annual medical costs going to be?
Make a list of the doctor visits and procedures you expect for next year. Then estimate what you will pay for them out of pocket with your current Medicare coverage. Add in a years’ worth of premiums and you’ll have a good estimate of what your healthcare will cost you next year.
Is my doctor still in my plan’s network of providers?
A new year can also bring changes to your Medicare Advantage plan’s network of doctors. Confirm that your current providers will still be in your plan’s network for the upcoming year. If they aren’t, you will have to change plans or providers or pay much higher out-of-pocket costs to stay with the same doctors and the same plan.
Do I plan on traveling anywhere this year?
If you travel frequently, you may delay getting care until you are at your primary home. Make sure your plan has providers and pharmacies near where you live. If you live in two places or plan to travel out of state, consider a plan with a nationwide network, or go with Original Medicare, which does not have provider networks.
Does my coverage include vision, dental and hearing benefits?
Medicare doesn’t cover routine dental, vision, and hearing services, but some Medicare Advantage plans do. You can also buy dental, vision, and hearing coverage separately. Consider your needs and the available coverage as part of your overall evaluation of Medicare plans.
What are my current plan ratings?
The Centers for Medicare and Medicaid Services has a star rating system to help consumers compare Medicare plans. Medicare Advantage and prescription drug plans receive an overall star rating of one to five stars—with five being the best—on factors such as customer service, member experience, and member complaints. Medicare Advantage plans are also rated on preventative care to help people stay healthy, and management of chronic conditions. If your current plan gets low marks, you may be happier with another option.
Having a checklist makes it easier when the time comes to sign up or change plans. There are so many different enrollment periods when it comes to Medicare. Each is just as confusing as the other. It’s important to understand what you can and cannot do during each enrollment window. Otherwise, you could make a move that could negatively impact your Medicare benefits forever.
Your Medicare Annual Enrollment Period Checklist
- Make sure you are eligible to make coverage changes.
- Decide if your current coverage is still what you want and whether it makes sense to change. Keep in mind that changing policies can often require underwriting on your health. While it may seem like a good deal, changing plans can often open a can of worms if underwriting does not approve you.
- Contact a licensed agent to enroll before December 7th. After that date, you cannot make changes to your policy for another year.
Step 1: Make sure you are eligible to make coverage changes
If you’re newly eligible for Medicare or delayed coverage for one reason or another and are not yet signed up for Part A and Part B this is NOT the enrollment period for you. You won’t be eligible to make changes at this time unless you’re within your Initial Enrollment Period or are eligible for a Special Enrollment Period. You’ll need to wait until the General Enrollment Period to enroll in Original Medicare.
Step 2: Decide if your current coverage is what you want
We encourage you to take a deeper look into the coverage you currently have. Think about your health situation, and what you are currently getting the most use out of.
Step 3: Contact an agent to compare plans for the upcoming year
This may be considered one of the most important steps. Oftentimes, you may be able to find a lower premium, but a licensed, knowledgeable agent will be able to tell you whether it would make sense or not.