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Medicare Plans

Medicare OEP 2020: How Mrs. Jones Made Changes to Her Medicare Advantage Plan

by My Senior Health Plan
written by My Senior Health Plan

The new year is upon us and so is Medicare Open Enrollment Period (OEP) 2020. Yes, just when Annual Enrollment Period 2020 has finished, it’s time for OEP 2020! We know the Medicare system can be difficult, so today we’re going to follow Mrs. Jones through the Medicare Open Enrollment Period.

Mrs. Jones is a little confused since the Medicare rules can be complicated. But we’re here to help!

What is Medicare Open Enrollment Period?

Mrs. Jones wasn’t happy with the Medicare Advantage Plan she chose in the fall during AEP, and she’s been waiting for January 1st so she can make a change to her Medicare coverage. She has until March 31st, and she’s allowed to make just one change to her plan.

During the Medicare Open Enrollment Period, she:

CAN switch from one Medicare Advantage plan to another Medicare Advantage Plan

CAN disenroll from a Medicare Advantage Plan and return to Original Medicare (with or without a Part D drug plan).

But Mrs. Jones:

CAN’T switch from Original Medicare to a Medicare Advantage Plan

CAN’T add or switch a Medicare Prescription Drug Plan (if enrolled in Original Medicare).

If Mrs. Jones was in the first three months of her Initial Enrollment Period, she would also be able to:

Change to another Medicare Advantage Plan (with or without drug coverage)

Or go back to Original Medicare (with or without a drug plan).

What kinds of changes can be made during OEP?

Mrs. Jones changed her Medicare Advantage Plan during AEP. That plan became active on January 1st. But just a month after her new plan began, she realized that plan doesn’t cover her prescription drug needs.

Fortunately for Mrs. Jones, she can make a change because it’s Open Enrollment Period. She’s choosing to switch from the Medicare Advantage Plan she chose during AEP to another Medicare Advantage Plan that covers her prescription drug needs. This is a one-time change for Mrs. Jones that will go into effect on March 1st.

But what if her new Part D plan begins, and she finds she doesn’t need the coverage? Unfortunately, she’ll have to wait until AEP on October 15th to make additional changes.

But she may qualify to change her coverage during a Special Election Period (SEP). Here’s how.

What is a SEP?

A Special Election Period is a time when you can make changes to your Medicare Advantage and prescription drug coverage outside the typical AEP and OEP periods.

SEPs are granted for many different circumstances. A few of these are:

  1. A change of address that impacts your coverage
  2. Residency in an area affected by a FEMA-sanctioned emergency or natural disaster during a previous enrollment period (either for the beneficiary or caregiver)
  3. Moving into or out of an institution.

 

Also, if you lost your previous insurance, whether it’s Medicaid or employer-provided, you may be eligible to enroll in Medicare Advantage during an SEP.

Medicare is complicated, but MySeniorHealthPlan.com is here to help you confidently navigate your health insurance decisions.

If you have questions or need to talk to a licensed Medicare specialist, visit our website or call (877) 255-6273. You’ll be able to talk to a knowledgeable member of our team who will help you find the right plan for you.

 

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Senior woman showing digital tablet to friend at table
Medicare Plans

Medicare OEP 2020: How to Make Changes to Your Medicare Advantage Plan

by My Senior Health Plan
written by My Senior Health Plan

Medicare Open Enrollment Period (OEP) 2020 will begin on January 1st. If you are enrolled in a Medicare Advantage Plan (maybe you signed up for a new plan during AEP 2020?) and wish to adjust your coverage, you may qualify to make a one-time change to your existing policy.

Medicare OEP 2020. What is it?

OEP is the Medicare election period that runs from January 1st to March 31st each year. It allows Medicare beneficiaries enrolled in Medicare Advantage Plans to:

  • Switch from one Medicare Advantage plan to another Medicare Advantage plan
  • Disenroll from a Medicare Advantage plan and return to Original Medicare, with or without a Part D drug plan

 

Note: According to Medicare.gov, the following are changes that you cannot make during OEP.

You will not be able to:

  • 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.

 

Also, if you’re within the first three months of your Initial Enrollment Period, you have the option to

  1. Change to another Medicare Advantage Plan (with or without drug coverage) OR
  2. Go back to Original Medicare (again, with or without a drug plan)

Let’s look at an example.

During AEP, Sylvia enrolled in a Medicare Advantage Plan. The plan will activate January 1st. However, early in February, she decides she could benefit from Medicare Advantage Plan D.

Being in the OEP window and having had her existing plan since January, Sylvia can make the one-time change. Her new policy will go into effect on March 1st.

However, that’s not where Sylvia’s story ends. Her plan activates March 1st, but after a couple of weeks (and still within the OEP), she finds that the new plan isn’t a good fit for her needs.

Unfortunately, Sylvia will have to wait until October 15th when AEP begins again—unless, of course, she qualifies for Special Election Period (SEP).

What is SEP?

SEP allows seniors to make changes to their Medicare Advantage and Medicare prescription drug coverage under particular circumstances.

Examples of when you may qualify for SEP include the following.

You’re moving to a new address that affects your coverage (e.g., moving back to the States after living overseas or moving to a new address that isn’t in your existing plan’s service area).

You’re living in an area where a weather event has occurred—one that FEMA has determined as an emergency or major disaster. Due to the weather situation happening during another valid election period (e.g., AEP), you may qualify for SEP.

Additionally, the weather-related SEP is available to beneficiaries who depend on friends or family members living in the affected areas to manage their healthcare needs.

You will lose your other insurance coverage. For example, if you are no longer eligible for Medicaid, you may qualify for SEP and the opportunity to sign up for a Medicare Advantage Plan. Also, if you no longer have coverage from your employer (or union), SEP will allow you to apply for Medicare Advantage coverage.

Tapping into your Medicare resources

Medicare election periods from OEP to SEP can get complicated. However, you have access to resources—from your insurance specialist to online information (such as the Medicare.gov website). The key is to keep an eye on election period dates that apply to you, take action early and, if necessary, ask for help.

Need to adjust your Medicare Advantage coverage during OEP? The MySeniorHealthPlan.com team can answer all your questions and guide you through the process.

Call today toll free: 877.255.6273

 

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Medicare Plans

Reinstating the Medicare Advantage “Open Enrollment Period”

by Jagger Esch
written by Jagger Esch

If you or a loved one receives Medicare coverage, you know how complicated and confusing enrollment periods can be. Enrollment periods are only confusing because the term “Open Enrollment Period” is used correctly and incorrectly to describe times when a plan change is possible

Reinstating “Open Enrollment Period”

The Medicare Advantage Open Enrollment Period was discontinued in 2010. In 2019, the OEP will make a return.

From 2011-2018 Medicare beneficiaries were given only the Medicare Advantage Disenrollment Period (MADP), during this time beneficiaries could disenroll from their Medicare Advantage plan and switch only to Original Medicare. Now all that is changing.

The Medicare OEP will begin on January 1st and end on March 31st. During this time Medicare beneficiaries can disenroll from a Medicare Advantage plan and enroll into another Medicare Advantage plan. You also have the option of switching back to Original Medicare, with or without Part D coverage.

It’s important for beneficiaries to know that they won’t be able to switch Part D prescription drug plans. If you are currently enrolled in a stand-alone Prescription Drug Plan you will need to change your policy during the Annual Enrollment Period from October 15 through December 7.

Medicare Supplement Open Enrollment Period

New terminology needs to be set up to make things easier for Medicare beneficiaries. It doesn’t need to be complicated, and it should be simplified.

The Medicare Supplement Open Enrollment Period is for Medicare beneficiaries that are new to Medicare Part B. This period lasts 6 months and begins on the first day of the month that you turn 65 or older and enrolled in Medicare Part B.

So, if you turn 65 on April 8 and don’t join Medicare until May 20, your Medicare Supplement Open Enrollment will start on June 1, which is the first day of the month in which you are both 65 and Enrolled in Medicare Part B.

Incorrectly Called “Open Enrollment Period”

The Annual Enrollment Period (AEP) happens every year from October 15 through December 7, this enrollment period is commonly called the Open Enrollment Period. It’s incorrect to refer to the AEP as the OEP, but people do.

When a Medicare beneficiary turns 65, they become eligible for the Initial Enrollment Period (IEP), this gives beneficiaries 7 months to enroll in a Medicare Advantage plan. IEP is commonly mistaken for an Open Enrollment Period. It’s clear that they are confusing the IEP with the Medicare Supplement Open Enrollment Period, while they are similar, they aren’t the same.

Other Coverage Changes in Medicare 2019

April of 2018, Medicare recipients will start to receive new Medicare ID cards that no longer have a Social Security number displayed on them. This is to help prevent fraud and identity theft among seniors. As required by the Medicare Access and CHIP Reauthorization Act (MACRA) all beneficiaries will have a new Medicare ID card by April 2019. The new cards will display a random ID number and you can shred the old card.

Then the Bipartisan Budget Act of 2018 (BBA 2018) will help close the donut hole one for brand-name drugs. This means that beneficiaries will only pay 25% of the cost of brand-name drugs. The cost of closing the donut hole for brand-name prescriptions is being shifted to the drug manufactures instead of insurance companies or beneficiaries.

So many good things are happening in 2019, it only makes sense that there is some less than desirable news. A new premium bracket for the highest-income Part B and Part D enrollees with go into effect. Under the BBA 2018 enrollees with an income of $500,000 or more ($750,000 for married couples) will pay a higher premium for Part B and Part D coverage.

Annually by September 30th, Medicare Advantage recipients will receive an Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing insurance carrier for their Medicare Advantage and Medicare Prescription drug plan providers.

CMS shares plan changes for the following year in October, several months before the new year. Medicare.gov is an awesome resource for Medicare beneficiaries, you can use it to compare plans, look up information and learn more about Medicare.

 

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