You might be wondering, “Can I change my Medicare plan at any time?” or “When can you enroll in or change Medicare plans?” The changing color of the autumn foliage is a great reminder for Medicare’s Open Enrollment Period and that it's your annual opportunity to modify your healthcare options for the coming year.
During Open Enrollment, which runs Oct. 15–Dec.7 each year, you have the chance to join, switch, or drop Medicare Advantage and Medicare Part D drug plans. The annual Open Enrollment period does not apply to Medigap or Medicare supplement plans. The choices you make during Open Enrollment could save—or cost—you hundreds of dollars out of pocket and even impact your health. Here are three ways to ensure you’re well-prepared for Medicare's Open Enrollment Period.
Step 1: Review your Annual Notice of Change
Medicare plans change every year, so it’s important to re-evaluate how well your plan fits your needs annually. You should have recently received your plan’s Annual Notice of Change (ANOC) in the mail prior to the start of Open Enrollment—usually in September. It summarizes the changes in your plan’s cost and coverage in the coming year.
When reviewing your ANOC, there are some key components you should review to consider how any changes could affect you. These include:
- Premium: Are you going to pay more, less, or the same amount each month for your current plan?
- Deductible: Is the amount you have to pay out of pocket before your plan covers your claims going to increase, decrease, or stay the same?
- Maximum out-of-pocket cost: Will there be a change to the maximum amount you will have to pay for the year before your plan starts to cover all costs?
- Copayment/coinsurance: Will the amount you have to pay out of pocket for each service—or, in some cases, drugs—change?
- Network: Are there any changes to which providers, facilities, and pharmacies are in your network?
- Drug coverage: If you have Medicare Part D, have drugs you may need been added or removed from your plans drug list? Have any been moved to a different tier, changing the price you can expect to pay?
- Other Changes: Will there be new services covered, previous services ending, or other changes to services under your plan?
As you can see, the ANOC is an important document that makes it easier to determine if your current Medicare plan still works for your needs, lifestyle, and budget. If you don’t receive your ANOC by September 30, you should contact your plan right away to request it.
Step 2: Assess your coverage needs
Once you’ve reviewed the ANOC and past year’s needs, then you can assess your coverage options for Medicare Advantage and/or Medicare Part D. Here are a few things you should consider in order to answer the question “Should I switch Medicare plans during Open Enrollment?”
- Think about your health care needs over the past year. Has your health status changed this year, requiring you to see a new specialist or receive a new set of services? Is your plan continuing to meet your needs?
- Are Medicare Advantage plans worth it? Are the providers and services you need covered by the plan? This includes preferred doctors/specialists, treatments, and supplemental benefits. When comparing plans, be sure you understand the limitation on each benefit.
- Does Medicare pay for prescriptions that matter to your health? Does the plan you’re considering cover all the drugs you think you will need in 2021? Be sure to ask about any restrictions, such as quantity limits, or whether your drugs require prior approval from the plan.
- What out-of-pocket costs will you incur when you see a doctor, require a hospital stay, or pick up prescriptions at the pharmacy? Most plans have an annual out-of-pocket-maximum, but prescription drug costs are not included in that amount.
Step 3: Get trusted advice
What is the average cost of supplemental insurance for Medicare? Which type of care is not covered by Medicare? There are many considerations when choosing a Medicare plan, and it is normal to feel overwhelmed by the information and decision making. Here are three resources where you can talk to trained, trusted Medicare counselors free of charge:
- For help understanding your Medicare options and how to save money on costs, you can contact your local State Health Insurance Assistance Program (SHIP) by calling 877-839-2675 or visiting shiptacenter.org. SHIPs use trained volunteers to offer trusted, unbiased Medicare counseling.
- People with Medicare also can compare 2024 coverage options and shop for plans using Medicare Plan Finder or by calling 1-800-MEDICARE to talk with a customer support representative. TTY users should call 877-486-2048. The Medicare Support Hotline is available 24/7, except for some federal holidays.
- To get Medicare support from a trusted expert who can explain information in clear, easy-to-understand terms, you can also reach out to one of NCOA’s partners who meet our stringent Medicare Standards of Excellence.
We encourage you to begin shopping early for coverage this Open Enrollment Period. And if you use any of the three trusted resources above, you won't have to navigate it alone.