What are the important dates to remember?

 

 

 

• October 15th to December 7th > Open Enrollment / Annual Enrollment Period (AEP)

 

 

• January 1st > All new plan enrollment

 

 

 

Who is Open Enrollment for?

 

A.) Those already in Medicare and for those that want to drop, add, or switch a drug plan or a Medicare Advantage plan.

B.) Those who have been on original medicare for a while and never signed up for a drug plan or an advantage plan

 

Who is it NOT for?

 

 

 

 

• New to Medicare, haven’t enrolled (these people can completely ignore this open enrollment and focus on their own personal timeline based on their medicare situation)

 

 

 

 

Is there a plan type that has nothing to do with the Open Enrollment?

 

 

Yes! The Medigap plans.

 

 

Common misconception: You get 6 months when you first add part B of Medicare to buy a Medigap plan w/o having to answer health questions in most states. After that, you can apply for a Medigap plan anytime but you have to go through health underwriting EXCEPT for the states of Connecticut, New York, Vermont, and Massachusetts. And you can be denied or rated up in price in most states so it’s something you need to buy definitely before you think that you need it.

 

What are the changes you can make this Open Enrollment?

 

1.) Add a part D drug plan or a medicare advantage plan if you’ve never had one .

 

 

→ If you have a stand-alone drug plan, maybe you enrolled when you first got medicare, whether or not you even have a Medigap plan, you usually have a stand-alone drug plan when you have original Medicare. This is the time of the year that you can switch your part d drug plan, drop it all together, switch to an advantage plan which bundles in the drug coverage.

 

 

2.) Switch your part D plan or advantage plan.

 

 

3.) Shop for a different advantage plan or drop it all together for a Medigap plan. (If you signed up on an advantage plan when you’re first new to medicare)

 

 

If you’ve been wanting to drop your advantage plan and buy a Medigap plan. There’s a special process that you need to follow. You can’t just drop your advantage plan anytime of year. You want to follow the correct process because you aren’t guaranteed to get accepted on your Medigap plan when you drop your advantage plan unless you happen to still be in your first 12 months on the advantage plan and in which case you may be allowed to drop your advantage plan based on a “first year trial right”.

 

 

What’s a first year trial right?

 

 

It is a law that lets you try an advantage plan for one year when you enroll an advantage plan for the first time. You can utilize the first year trial right to drop at any time in that first year on the plan. However, for everyone else, you have to wait until the open enrollment period to drop your advantage plan.

 

 

→ Adding the Medigap plan in this case is tricky because you need to know that you’re going to qualify. The best way to accomplish this when you’re on a Medicare advantage plan is to leave your existing plan in place while you go through the process of applying for a Medigap plan. Now, once you get approval, you receive the policy in the mail, then, you can go ahead and cancel your advantage plan and you’ll need to complete this process prior to Dec 7th. During this process, you also need to choose and enroll in a stand-alone drug plan to replace the drug coverage that you had on your advantage plan. This way, you’re making sure that you still have drug coverage and it will automatically kick you off your existing advantage plan.

 

BONUS TIPS!

 

1.) When you enroll in a drug plan or advantage plan, the plan communicates with medicare electronically. This causes the existing plan that you’re on to automatically get cancelled. So, in case you make a plan switch and you forgot to cancel the old plan anytime you’re switching advantage plans or drug plans, you don’t have to worry about this! The old plan gets cancelled automatically.

 

 

2.) Be sure that you’re very very careful if you happen to have insurance through a retiree plan or union plan! Sometimes enrolling in a part D plan or advantage plan can cancel out that insurance and it could be impossible to get it back so be mindful of that. Usually, people with a retiree plan don’t add part D drug coverage because you would already have drug coverage through the retiree plan.

 

 

If getting free help sounds like something that you’re interested in, book a call with me using this calendar link: calendly.com/decodingmedicare