For nearly 68 million Americans enrolled in Medicare, two significant annual enrollment periods provide critical opportunities to adjust their healthcare coverage. These periods are known as the Medicare Open Enrollment Period and the Medicare Advantage Open Enrollment Period. While both enrollment periods allow beneficiaries to change their coverage, they have distinct differences in timing and available options. Understanding these differences can help you make the best decisions for your health coverage.
Medicare Open Enrollment Period: A Broad Range of Changes
When is Medicare’s Open Enrollment Period?
The yearly Open Enrollment Period for Medicare occurs from October 15 to December 7. This is the primary annual enrollment period for those enrolled in Medicare Parts A and/or B, whether using Original Medicare or a Medicare Advantage plan.
Who Can Make Changes During Medicare Open Enrollment?
This period is open to anyone already enrolled in Medicare. You can change your healthcare coverage if you are signed up for Original Medicare (Parts A and B) or a Medicare Advantage (Part C) plan. This period allows you to explore various options to adjust your plan according to your healthcare needs.
What Can You Do During Medicare Open Enrollment?
Medicare Open Enrollment offers the most flexibility in terms of changes. During this period, you can:
Original Medicare to a Medicare Advantage plan
You can select a Medicare Advantage plan that offers extra benefits, including vision, dental, and wellness services, which are not provided under Original Medicare.
Medicare Advantage plan to Original Medicare
If you’re unhappy with your Medicare Advantage plan, you have the option to revert back to Original Medicare.
Switch between Medicare Advantage plans
If you are currently part of a Medicare Advantage plan, you have the option to change to a different plan that offers distinct coverage.
Join or switch to a Medicare Prescription Drug Plan (Part D)
You can sign up for a Part D plan or switch between different Part D plans.
Drop Medicare drug coverage
If you no longer need drug coverage, you can drop your Part D plan.
Switch between Medicare Advantage plans with and without drug coverage
If you have a Medicare Advantage plan that doesn’t include drug coverage, you can switch to one that does, or vice versa.
Do You Have to Make Changes?
No, you are not required to make changes during Medicare Open Enrollment. You have the option to maintain your current coverage if your existing plan meets your healthcare needs and budget. However, the Centers for Medicare & Medicaid Services advises all beneficiaries to review their plans each year to guarantee they are obtaining optimal value for their healthcare needs.
When Do Open Enrollment Changes Take Effect?
Any changes made during Medicare Open Enrollment will take effect on January 1 of the following year as long as you submit your changes before the December 7 deadline.
Medicare Advantage Open Enrollment Period: Adjusting Your Medicare Advantage Plan
When is the Medicare Advantage Open Enrollment Period?
The Medicare Advantage Open Enrollment Period occurs from January 1 to March 31 each year. This period applies explicitly to those already enrolled in a Medicare Advantage plan and allows you to make changes.
Who Can Make Changes During Medicare Advantage Open Enrollment?
This enrollment period is only for individuals already enrolled in a Medicare Advantage plan. If you are enrolled in Original Medicare or do not have a Medicare Advantage plan, this enrollment period does not apply to you.
What actions are available to you during the Medicare Advantage Open Enrollment period?
During the Medicare Advantage Open Enrollment Period, you can:
Change from one Medicare Advantage plan to a different one.
You can switch between Medicare Advantage plans, whether or not they offer prescription drug coverage.
Cancel your Medicare Advantage plan and revert to Original Medicare.
If you decide you no longer wish to continue with your Medicare Advantage plan, you have the option to revert to Original Medicare. You will also have the option to join a separate Medicare Prescription Drug Plan (Part D) if needed.
What Can’t You Do During Medicare Advantage Open Enrollment?
There are certain things you are not able to do during the Medicare Advantage Open Enrollment Period. First, you may not use this time to switch from Original Medicare to Medicare Advantage. You cannot sign up for a Medicare Prescription Drug Plan (Part D), if you are on Original Medicare. Finally, you also can’t move between different Medicare Prescription Drug Plans while you are enrolled in Original Medicare.
When Do Changes Made During the Medicare Advantage Open Enrollment Period Take Effect?
Changes made during this period will take effect the first day of the month following your enrollment in a new plan. This ensures that your new coverage begins promptly after your changes are processed.
Key Differences Between the Two Enrollment Periods
- Timing: Medicare’s Open Enrollment Period occurs from October 15 to December 7, while the Medicare Advantage Open Enrollment Period occurs from January 1 to March 31.
- Eligibility: The Medicare Open Enrollment Period is for anyone enrolled in Medicare, whereas the Medicare Advantage Open Enrollment is only for those with a Medicare Advantage plan.
- Options for Changes: Medicare’s Open Enrollment offers broader options for changing your coverage, including switching between Original Medicare and Medicare Advantage plans, changing drug coverage, and more. On the other hand, the Medicare Advantage Open Enrollment focuses on changes for those already enrolled in a Medicare Advantage plan, such as switching plans or returning to Original Medicare.
Conclusion
While the Medicare Open Enrollment Period and the Medicare Advantage Open Enrollment Period provide opportunities to adjust your Medicare coverage, they serve different purposes and occur at different times of the year. Understanding each period’s unique benefits and restrictions is key to ensuring that you make the best decisions about your healthcare coverage. Be sure to review your plans carefully during each enrollment period to ensure that your coverage continues to meet your needs.
