Open Enrollment and What it Means to You

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This column is assuming you have read the past column or two and/or have a basic knowledge of Medicare Advantage (MA) plans. Remember, MAs are an alternative to cover people on Medicare. Unlike traditional Medicare, MAs are offered through private insurance companies and they would administer your health care benefits for you.

Now we are past the Medicare Annual Enrollment Period (AEP) from 11/15 – 12/31, but you can still make certain changes to Medicare plans through the Open Enrollment Period (OEP). The OEP starts on 1/1 and lasts through 3/31. Remember, during the AEP you can make changes to your Medicare Prescription Drug Plans and Medicare Advantage Plans. You can move from Traditional Medicare to a Medicare Advantage Plan (MA) or back again. The AEP period is best described as a time period of wide open, wholesale changes.

On the other hand, the OEP allows a one time change of “like plans”. For example, if you have a Medicare Supplement which does not have drug coverage you can make a one time move to a MA plan that does NOT include drug coverage. You can also move from an MA which includes drug coverage to another MA that includes drugs. (like plan to like plan). There are other changes that you can make in addition to these two examples.

One area of caution: if you wish to change from one MA plan to another you should not contact the company you are leaving to dis-enroll. If you dis-enroll by contacting your current company that would become your one time change and you would not be allowed to move to the company desired; you would just loose your current MA and go back on to traditional Medicare.

This whole subject is confusing to most people. So, do not feel alone if the Medicare options confuse you. Just like other aspects of life, gather information from more than just one “quality” source before making any decisions. If you have the opportunity to attend a seminar providing information, you might wish to do so. Just know that the seminar givers are usually providing information only on the company they sell.

If you would like information of how MA plans work in comparison to traditional Medicare, feel free to contact our office at 693-1060. As always, if we can provide further information, feel free to call our office.

Wishing you and yours a New Year of peace, happiness and good health.

Written by

Steven A. Buttice is the president of Medical Reimbursement & Management Services, Inc., a firm specializing in issues affecting seniors, including seminars and consultation on Medicare Plans, Long Term Care and other types of insurance, claims issues, and sales/service of insurance products since 1984.

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