Traditionally, many Medicare beneficiaries have two periods to disenroll from their Medicare Advantage plan. The first period is the Annual Enrollment Period, or AEP, which runs from October 15 to December 7. This period allowed beneficiaries to drop or switch their Medicare Advantage plans and shop for a Medicare Part D plan. The second period was January 1 to February 14. During this period, beneficiaries could drop their Medicare Advantage plan and enroll in Original Medicare. It also let beneficiaries sign up for a stand-alone Part D plan.
Medicare is changing these dates for 2019. In 2019, Medicare will have a Medicare Advantage Open Enrollment Period. It will start on January 1 and will end March 31. During this time, Medicare beneficiaries currently enrolled in a Medicare Advantage plan will be able to:
• Switch to a different Medicare Advantage Plan
• Drop Medicare Advantage and enroll in Original Medicare
• Sign up for a Part D plan (If you are currently enrolled in a MAPD plan and are dropping that for Original Medicare)
• Drop a Part D plan
Medicare Advantage, or Medicare Part C, is private insurance that Medicare pays to administer your Part A and B benefits. These plans offer the same benefits as Original Medicare (Medicare Part A and Medicare Part B) and sometimes offer additional benefits such as prescription drug coverage.
Medicare Advantage functions the same way any other insurance plan would. You have the option to choose the plan that best fits your needs. For example, you have the freedom to choose between a Preferred Provider Organization (PPO) or Health Maintenance Organization (HMO) plan from most companies.
There are some downfalls to Medicare Advantage plans. These plans may not provide coverage for your preferred provider, so you may not be able to receive treatment from your doctor of choice. Also, Medicare Advantage plans are not standardized. This means that you could pay different amounts for the same services, depending on your location, your plan, and the network you choose.
If the benefits outweigh the pitfalls, and you choose to stay with your current Medicare Advantage plan, the Medicare Advantage Enrollment Period is the perfect time to shop and find the plan that best suits your needs. For example, if you are currently in a Medicare Advantage plan, but believe there might be a better one that fits your situation, January 1 through March 31 is the time to make that change.
On the other hand, if you feel the negatives of a Medicare Advantage plan outweighs the benefits, it might be time for you to switch to Original Medicare. You can also do so during this period.
When discussing Original Medicare, it is important to know that it consists of Medicare Part A and Medicare Part B. Medicare Part A covers all inpatient hospital expenses, while Part B covers your outpatient expenses. Keep in mind that without a Medicare supplement plan, you will probably have to pay out-of-pocket expenses for these medical services.
Many people prefer Original Medicare because they can receive health services from any doctor that accepts Medicare. This means there may be more variety and more of a chance that your preferred provider can perform your health services.
While Original Medicare provides the same types of coverage as a Medicare Advantage plan, there are some holes in coverage. As stated, unless you have a Medicare supplement plan, you may need to pay some out-of-pocket fees such as copayments and deductibles associated with your visit. Original Medicare also does not cover prescription drugs, so you would need to get a stand-alone Medicare Part D plan to help with high fees for your prescription drugs.
This may seem like an abundance of additional fees, but many Medicare beneficiaries find that they save more money with Original Medicare, a Medicare supplement plan, and a Medicare Part D plan.
Medicare Part D
During this Medicare Advantage Enrollment Period, you can also make changes to your Part D coverage. Some Medicare Advantage plans include prescription drug coverage, so you will not have to have this additional coverage. However, if you are dropping your Medicare Advantage Prescription Drug (MAPD) plan and are enrolling in Original Medicare, adding a Part D plan might be essential. Part D ensures that you have coverage for your prescription drugs, so you don’t pay large out-of-pocket fees.
There are a few catches to enrolling in a Part D plan during this period. While you can sign up for a Part D plan, you can only do so if you are dropping your Medicare Advantage plan and enrolling in Original Medicare. If you already have a Part D plan, you cannot switch plans because you are dissatisfied with your plan. To do this, you will have to wait until AEP, which starts October 15 each year. You can, however, drop your Part D plan if you no longer want to participate in the program.
The changes to the Medicare Advantage Open Enrollment Period do not affect Medicare supplement plans. Beneficiaries can still switch, enroll, or drop Medicare supplement plans at any time.
Many Medicare beneficiaries find that the combination of Original Medicare, a Medicare supplement plan, and a Part D plan is the perfect combination for their needs. Depending on the Medicare supplement plan you choose, often times, you can receive medical services without paying a dime out-of-pocket.
In addition, if you decide to drop Medicare Advantage and sign up for Original Medicare and a Medicare Supplement plan, and you are outside of your Medicare Supplement Open Enrollment period, you will need to go through the underwriting process to get approved for a Medicare supplement plan.
Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.