You've done your research, carefully evaluated Medicare coverage alternatives, and you've joined the more than 63 million Americans who have some kind of Medicare coverage.
And now – what is it? You've decided to modify your Medicare plan or coverage.
You're not alone. Every year, hundreds of thousands of Medicare Advantage plan members with Part B giveback features examine their Medicare coverage and decide to switch. Many beneficiaries want to increase their access to physicians or particular prescriptions, while others complain that they picked coverage based on incorrect information. Others report rejections of claims for medical procedures that they thought would be reimbursed.
However, although there are several reasons why a Medicare beneficiary would desire to move to new coverage, the possibilities for plan changes are restricted. With this in mind, we've compiled a list of your alternatives for modifying your coverage.
Annual Enrollment Period (AEP)
Every year, from October 15 to December 7, there is an Annual Enrollment Period for Medicare Advantage and Medicare Part D plans, with coverage modifications taking effect on January 1.
There is also a second Initial Enrollment Period for Medicare Advantage plans with Part B give back for persons who did not sign up when they originally became eligible. This window is open from January 1 to March 31, with coverage beginning on July 1.
There is also an Open Enrollment Period for Medicare Advantage plans from January 1 to March 31. During this time, Medicare Advantage subscribers may move to Original Medicare — including a Part D Prescription plan coverage if desired — but they can also switch to a different Medicare Advantage plan. In contrast to the autumn Annual Enrollment Period, when subscribers may change their minds many times, this yearly window allows for just one plan change.
The Medicare Advantage Open Enrollment Period is not without controversy, as some supporters argue that it offers Medicare Advantage a competitive advantage (against Original Medicare) by offering participants greater coverage choice. At the same time, the Medicare Advantage sector points out that plans must now work harder to maintain their participants since members may move to a different plan within the first three months of the year.
Changes through the Annual Enrollment Period
There are several plan adjustments that Medicare beneficiaries may desire to make from year to year.
The traditional Annual Enrollment Period for the majority of them is October 15 to December 7, with modifications taking effect on January 1. You may do the following at that time:
• Alter your Medicare coverage from Original Medicare to Medicare Advantage, or vice versa.
• Transfer from one Medicare Advantage plan to another.
• For the first time, enroll in a Part D Prescription Drug Plan (a late enrollment penalty may apply)
• Change from one Part D plan to another.
• Drop your Part D coverage (you won't be able to re-enroll until the next year's Annual Enrollment Period, and a late enrollment penalty may apply when you do).