Navigating the Medicare Annual Enrollment Period (AEP): What You Need to Know

Each fall, Medicare beneficiaries face a crucial time for their health coverage—the Medicare Annual Enrollment Period (AEP). Running from October 15 to December 7, this period can be overwhelming with a flood of mail, phone calls, and TV commercials all urging you to make changes. While some have advisors to guide them, many try to make sense of it all on their own. At Moser Insurance Group Inc., we’re here to be your trusted Medicare advisor and help you navigate the options available during this important time.

What Can You Do During the Medicare Annual Enrollment Period?

The AEP is your opportunity to make key changes to your Medicare coverage. Here’s what you can do:

1. Change Your Prescription Drug Plan (PDP):

Prescription Drug Plans, or PDPs, are subject to yearly changes. This means that costs related to premiums, co-pays, and coinsurance can vary from year to year. Moreover, the formulary (the list of drugs covered by the plan) may change, impacting the cost of your medications. Preferred pharmacies might also change, which could affect where you get your prescriptions filled and how much you pay. Given these potential changes, it’s wise to review your PDP annually. The recent legislative changes through the Inflation Reduction Act have added further complexities, making it even more crucial to evaluate your plan’s projected costs for the upcoming year.

2. Change Your Medicare Advantage (MA) Plan:

Like PDPs, Medicare Advantage plans operate on one-year contracts, with changes potentially occurring at the start of each new year. These changes might include adjustments in premiums, benefits, and the network of healthcare providers. While most plans strive to maintain stability, network changes can sometimes occur, which might mean that your preferred doctor or hospital is no longer in-network. The AEP is the ideal time to review these changes and switch to a plan that better meets your needs if necessary.

3. Sign Up for a Medicare Advantage Plan:

If you currently have Original Medicare (with or without a Medigap supplement), AEP is your chance to explore Medicare Advantage options. Medicare Advantage plans can often offer additional benefits like dental, vision, and wellness programs, which aren’t covered under Original Medicare. If you’ve never tried an MA plan, you can even take advantage of a one-year trial. If you decide that Medicare Advantage isn’t for you, you have the right to return to your Medigap plan (same company and plan) within a year without the need for underwriting. Keep in mind that if you switch to an MA plan and need prescription drug coverage, you’ll need to find a plan that includes it, as Medicare Advantage cannot be paired with a separate drug plan. Also, remember to notify your Medigap insurance company to cancel your supplement coverage before January 1, or you could be responsible for those premiums.

4. Dis-enroll from a Medicare Advantage Plan and Sign Up for a Medicare Supplement:

If you’re considering moving from a Medicare Advantage plan to a Medigap supplement, AEP might be the right time. Most states require medical underwriting for this change, meaning your health status will be considered before approval. Therefore, if you’re healthy enough to pass underwriting, this can be a strategic time to make the switch. It’s important not to alter your Medicare Advantage plan or enroll in a new PDP until you’ve been approved for your Medicare Supplement plan to avoid gaps in coverage.

What You Can’t Do During AEP

While AEP provides flexibility, there are some actions you cannot take:

– You cannot change your Medicare Supplement plan from one company to another during AEP.
– You cannot change the effective date of your plan to start before January 1 of the following year.
– You cannot make changes after the December 7 deadline, so it’s important to act within the AEP timeframe.

Need Help? Contact Moser Insurance Group Inc.

Understanding your options during the Medicare Annual Enrollment Period is essential to ensuring you have the best coverage for your needs. At Moser Insurance Group Inc., serving Greensboro, High Point, Winston-Salem, Lexington, Burlington, Raleigh, Charlotte, Asheboro, Archdale, Trinity, and Randleman, NC, we’re here to help. Whether you need to review your current plan, explore new options, or have questions about Medicare coverage, our team of experienced agents is ready to assist you.

Don’t navigate the maze of Medicare alone. Contact us today to schedule a consultation and let us help you make informed decisions during this important time.