The Medicare Enrollment Period

Beginning October 15th, seniors will be able to choose their Medicare plans for the new year during Medicare’s Annual Election Period (AEP)–otherwise known as Open Enrollment. Selections must be made by December 7th for coverage that takes effect January 1st. The enrollment process will be a little different moving forward. Seniors now have the chance to “test-drive” plans at the beginning of the year and select a different plan if they discover that their initial choice doesn’t meet their budget or healthcare needs.

The added flexibility is welcomed while ensuring the program meets the requirements of its millions of beneficiaries. Medicare covers about 63 million Americans (2021). Seniors become eligible for all four of Medicare’s components — Parts A, B, C, and D — when they turn 65. Part A pays for hospital stays. Part B covers doctor visits, same-day surgeries, and potent medications administered in physicians’ offices. Part D is Medicare’s optional prescription drug benefit.

Part C, also known as Medicare Advantage, is administered by private insurance carriers and places a cap on the out-of-pocket expenses not available on Parts A and B of Original Medicare. Part C typically includes the prescription drug benefit at no additional cost. There are other extra benefits that save money and appeal to a consumer living a healthy life. Currently, more than 20 million Americans are enrolled in more than 2,300 different Medicare Advantage plans, each with its own mix of benefits, monthly premiums, copays, out-of-pocket spending, etc.

With all these options, deciding on a plan can be tricky. Beneficiaries and their families must consider myriad lifestyle factors, how much they can afford to spend, and what their future health needs may be. In past years, Congress didn’t make these decisions any easier. Since 2011, seniors who chose a Medicare Advantage plan have had 45 days to “disenroll” if they determined that it wasn’t the right fit for them. Thankfully, that won’t be the case anymore. Now beneficiaries who enroll will have the ability to switch to another Advantage plan at any point within the first three months of the new year. That’s twice as long as they had to evaluate their plans under the previous set of rules.

The change gives seniors much more flexibility and can make open enrollment less stressful. If they conclude that they picked the wrong plan initially, they won’t be penalized. They’ll have a full array of other Medicare Advantage plans to choose from. Traditional Medicare won’t be their only fallback option. Seniors may find all these options empowering — and overwhelming. Fortunately, help is available. Medicare.gov contains a wealth of information that can offer assistance to beneficiaries filtering through their options.

Seniors can also consult licensed health insurance agents and brokers. Many of these professionals have decades of experience in the field and are specially trained to educate consumers about their insurance options. According to research from the Kaiser Family Foundation, nearly three-quarters of agents and brokers spend a significant portion of their time explaining coverage to clients and investigating consumer insurance options.

Agents and brokers can help seniors determine which plan and benefits package would be best for them. At the end of the day, Medicare covers nearly one in five Americans. This open enrollment season, that sizable population will find that they have more choices and more flexibility than they have in previous years. Savvy seniors should take advantage.

This article was originally published in the Orlando Sentinel on October 9, 2018 and written by Janet Trautwein.