What is the Medicare Advantage Open Enrollment Period?

Beneficiaries enrolled in Medicare Advantage and not happy with their plan have a one-time opportunity to switch their plan during the Medicare Advantage Open Enrollment Period (OEP) which is from January 1^st – March 31^st. However, it is important to understand the differences between AEP and OEP, who is eligible for plan changes, and what plan changes are allowed.

Understanding the Difference Between Medicare Annual Enrollment Period (AEP) and Medicare Advantage Open Enrollment Period (OEP)

The standard Medicare Annual Enrollment Period (AEP) runs from October 15^th through December 7^th. During this time, you can make important decisions about your coverage, such adding, dropping, or switching between Medigap Plan, Medicare Advantage, and Original Medicare. Once you have chosen your plan, your coverage begins January 1^st of the following year.

The Medicare Advantage Open Enrollment Period (OEP) runs from January 1^st – March 31^st. This is new, and allows for those who enrolled in a Medicare Advantage Plan (also known as “MA Plans” or “Part C”) during AEP to make a one-time change if the plan does not suit the needs of the beneficiary. This is different from AEP that ended December 7^th. The Medicare Advantage OEP is not available for those not enrolled in a Medicare Advantage Plan.

Reasons Medicare Advantage Beneficiaries May Want to Switch Plans

All Medicare Advantage Plans come with a Summary of Benefits, however there is a lot of information to digest during AEP (remember that’s the enrollment period between October 15 – December 7 where changes can be made among Original Medicare, Medicare Advantage or Medigap Plans. There may have been some details that were just missed during the AEP shuffle.

Some Medicare Advantage beneficiaries discover doctors and specialist aren’t in their network. If that’s the case, you can absolutely choose a new doctor that is under your current Medicare Advantage plan or you can switch your Medicare Advantage plan during the OEP.

In addition, beneficiaries may discover that important medications aren’t covered under their MA plan. When you are looking to enroll, check the plan’s prescription drug list to make sure the medications you need are covered.

Medicare Advantage also has copays that could be required after a doctor’s visit or a service. Medicare Advantage plans have low monthly premiums and an annual out-of-pocket max, however some beneficiaries may have overlooked the co-pays.

What changes are allowed during the Medicare Advantage Open Enrollment Period?

According to Medicare.gov, here are the OEP allowances:

• If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage).
• You can drop your Medicare Advantage Plan and return to Original Medicare. You’ll also be able to join a Medicare Prescription Drug Plan.

Here is what is not allowed:

• Switch from Original Medicare to a Medicare Advantage Plan.
• Join a Medicare Prescription Drug Plan if you’re in Original Medicare.
• Switch from one Medicare Prescription Drug Plan to another if you’re in Original Medicare.