Beginning October 15th, seniors will be able to choose their Medicare plans for the new year during Medicare’s Annual Election Period (AEP). Selections must be made by December 7th for coverage that takes effect January 1st. The enrollment process will be a little different than previous years. This time around, seniors will 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 budgetary or healthcare needs.
That flexibility is welcome and will ensure that Medicare meets the health-care needs of its millions of beneficiaries better than ever before. Medicare covers about 60 million Americans. Seniors become eligible for all four of the program’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, and more.
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 recent years, Congress didn’t make those 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. But they couldn’t switch to another Medicare Advantage plan — their only alternative was enrolling in traditional Medicare.
Of course, traditional Medicare probably wasn’t right for them, either. Otherwise, they would’ve chosen it in the first place. So they were stuck for the remainder of the year with two suboptimal options for coverage. Thankfully, that won’t be the case anymore. Starting next year, beneficiaries who enroll in a Medicare Advantage plan 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 also 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 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 Medicare Advantage plan would be best for them — or whether they’d be better off enrolling in traditional Medicare. Those who live in a FEMA-declared disaster area during the Annual Election Period may qualify for a Special Election Period (SEP) outside of the normal October 15th to December 7th enrollment window. So seniors unable to enroll due to FEMA declared disasters such as fire, volcano, hurricane, and more can ask an insurance professional if a SEP has been announced.
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.