Medicare’s Open Enrollment Period Isn’t Just for New Enrollees
By Eileen Carafiol
From time to time, this series will highlight an important Medicare issue. Today, the Medicare issue is about the upcoming open enrollment period for Medicare Advantage and Medicare prescription-drug coverage.
“But wait a minute,” you say. “I’ve been on Medicare since I was 65, so why are we talking about ‘enrolling’ in Medicare?”
Well, in Medicare speak, no matter how long you’ve been enrolled, if you want to make a change in your coverage, you are asking to “enroll” in something different. And in the Medicare world, you can only make these changes during very specific times of the year.
You don’t need to sign up for Medicare each year. However, each year, you’ll have a chance to review your coverage and make changes during this period.
When is Medicare’s next open enrollment period?
October 15–December 7, 2019
When are changes made during this period effective?
January 1, 2020
What can I do during open enrollment?
•Change from Original Medicare to a Medicare Advantage plan.
•Change from a Medicare Advantage plan back to Original Medicare.
•Switch from one Medicare Advantage plan to another
•Switch from a Medicare Advantage plan that doesn’t offer drug coverage to a Medicare Advantage plan that does.
•Switch from a Medicare Advantage plan that offers drug coverage to a Medicare •Advantage plan that doesn’t.
•Join a Medicare prescription-drug plan.
•Switch from one Medicare prescription drug plan to another one.
•Drop your Medicare prescription drug coverage completely.
Now, let’s clarify some Medicare terms:
•The Medicare Advantage Plan is a Medicare HMO or Medicare managed-care plan. Often referred to Medicare Part C, it is not a Medigap plan.
• Original Medicare means Medicare Part A & Medicare Part B. Again, it is NOT a Medigap plan. If you drop a Medicare Advantage plan, you will also have to sign up for a Medicare prescription-drug plan (Medicare Part D).
IMPORTANT: Be aware that if you drop Medicare Advantage and return to Original Medicare, you may not be able to buy a Medigap policy. Medigap insurers can deny you coverage because of preexisting conditions or for health reasons.
Need advice before deciding whether to make a change? Medicare offers free advice through a program called the State Health Insurance Program, or SHIP, which is a part of each state’s insurance office (some states call this program SHIBA). So, if you’re from Oregon, you would Google Oregon SHIP Medicare. If you’re from Georgia, you would Google Georgia SHIP Medicare. That will get you to a page with information and a toll-free number to call. Be aware, though, that each state has its own preferences regarding whether it will provide advice over the phone or only in person.
Eileen Carafiol, MSW, MBA, is a former Medicare federal official who in her retirement occasionally teaches large lectures and small workshops on key Medicare issues.