7 Things You Can Do During the Medicare Annual Open Enrollment Period

Medicare’s Open Enrollment occurs every year from October 15-December 7. You can enroll in Medicare health and drug plans during this 54-day window.

From switching drug plans to dropping your Medicare Advantage plan, here are seven things you can do during the Medicare Annual Open Enrollment Period.

Reminder! The Medical Annual Enrollment Periods ends December 7 – make changes to your health and drug plans before it's over. Call our office at 217-423-8000 to get started!

1. Change from one Part D plan to another.

If you already have a Medicare Part D drug plan, you can drop it and choose a different one. This is the most common action our clients take during the Annual Open Enrollment Period.

Why would I change drug plans?

Medicare Part D drug plans can (and do) change each and every year. A drug plan can change its premium, copays, deductible, and formulary.

The bottom line is if you don’t do a drug comparison every year, you could end up spending a lot more on your prescriptions than you did the year before.

For example, if you have the 2020 Mutual of Omaha Rx Value drug plan (about $23), you will automatically be enrolled in the 2021 Mutual of Omaha Rx Plus plan (about $74). It's a $50.90 premium increase in 2021 unless you change plans between October 15-December 7.

This is why we recommend all clients do a drug comparison every year.

2. Connect with an agent to confirm your Medicare plan for 2021.

During the Medicare Annual Open Enrollment Period, you want to connect with your agent to confirm your Medicare plans for 2021.

Medicare Advantage and Medicare Part D plans can change each year, so even if you loved your plan this year, you may not love it next year. In addition, these plans aren’t one-size-fits-all. Just because your relative or neighbor loves their particular plan doesn’t mean it will fit your needs.

For example, when we run a drug plan comparison, we take into account the following:

• Your zip code
• Your preferred pharmacy
• Your prescriptions, including dosage and frequency

Even if you take the same exact prescriptions as your friend, going to a different pharmacy could change your results dramatically. An out-of-network pharmacy could cost you thousands more per year versus a plan’s in-network, preferred pharmacy.

It’s always important to take time every year between October 15-December 7 to make sure you have the least expensive plan for the following year.

Why do I need a Medicare agent?

We’ve seen thousands of clients, and even the doctors and lawyers get confused by Medicare Part D, let alone the rest of us!

There are around 30 different plans to choose from for 2021, and a mistake as silly as going to Walgreens instead of CVS could cost you hundreds of dollars per year. (Not that CVS is better than Walgreens - each drug plan has a list of in-network preferred pharmacies, and if you don’t go to that pharmacy, you will pay a lot more.)

Our licensed insurance agents can walk you through the plan comparison process (and even do it for you!) to make sure you have the best plan. They’ll also talk you through your expected monthly costs, and they’ll confirm which pharmacy you need to use to save as much as possible.

Why would you handle all of this on your own when we have trained experts that are AHIP-certified and ready to help you?

3. Enroll in a Medicare Part D prescription drug plan.

If you don’t have drug coverage, you can enroll in a Medicare Part D drug plan.

Why would I enroll in Part D?

Most individuals enroll in Part D when they’re first eligible for Medicare. However, if you haven’t yet enrolled in a Part D drug plan, doing so will help you avoid penalties.

The late enrollment penalty is an amount that's permanently added to your Medicare drug coverage (Part D) premium.

You may owe a late enrollment penalty if at any time after your Initial Enrollment Period is over, there's a period of 63 or more days in a row when you don't have Medicare drug coverage or other creditable prescription drug coverage. You’ll generally have to pay the penalty for as long as you have Medicare drug coverage.

The longer you go without drug coverage, the higher your permanent penalty is.

4. Opt out of Medicare drug coverage.

If you have a Medicare Part D drug plan, you can drop it and opt out of Medicare drug coverage entirely.

Why would I opt out of Medicare drug coverage?

Some people choose to go without Medicare Part D drug coverage, despite the penalty for doing so. We do not recommend doing this.

However, some opt out of Medicare drug coverage because they get their prescriptions covered elsewhere. For example, Meds by Mail is provided to those eligible for CHAMPVA, and you most likely don’t need Medicare drug coverage when you are covered through Meds by Mail.

When you meet with your agent, they will gather information about your existing coverages and will help you determine what you need to be adequately covered.

5. Switch to Original Medicare from a Medicare Advantage plan.

If you have Medicare Advantage, you can drop it and switch to Original Medicare, which is Parts A and B. 

Why would I switch to Original Medicare?

If you tried out a Medicare Advantage plan and didn’t like it, you can switch back to Original Medicare.

In our experience, there are two reasons individuals want to drop their Medicare Advantage and go back to Original Medicare:

1. The networks: their favorite doctor or hospital does not accept the plan.
2. The out-of-pocket costs: unlike Medicare Supplements, you basically pay-as-you-go with MA. Many don’t realize how many out-of-pocket costs there are until they start using the plan.

6. Switch to a Medicare Advantage plan from Original Medicare.

If you have Original Medicare, or Parts A and B, you can switch to a Medicare Advantage plan during Open Enrollment.

You forfeit your Original Medicare coverage and instead choose a private health insurance plan from an insurance carrier. If you switch to a private Medicare Advantage plan, you are still required to pay the Medicare Part B premium of $144.60 in 2020.

Why would I switch to Medicare Advantage?

Medicare Advantage plans have a lot to offer, including:

• Very low premiums
• Extra benefits, like dental and vision benefits and free gym memberships
• One plan for everything versus Original Medicare, a Medicare Supplement, and a Medicare Part D drug plan

Many individuals eligible for Medicare enjoy the premium savings and find value in the “extras” these plans offer. It’s also nice to have one plan card instead of multiple cards for multiple plans.

If these are important to you, you may consider switching to Medicare Advantage.

Keep in mind the Medicare Advantage plan options available in Macon County for 2021 are not very competitive in our expert opinion. That’s why we recommend almost all of our clients opt for a Medicare Supplement with a Medicare Part D drug plan.

We will continue to monitor the available plans over time, and we hope that in the future, more carriers will come to Macon County!

Read More: 6 Simple Ways to Tell If Medicare Advantage Is Right For You

7. Change from one Medicare Advantage plan to another.

If you currently have a Medicare Advantage plan, you can drop it and choose a different one.

To switch to a new Medicare Advantage Plan, simply join the plan you choose during Open Enrollment. You'll be disenrolled automatically from your old plan when your new plan's coverage begins.

Why would I change Medicare Advantage plans?

Medicare Advantage plans can change their coverage and benefits each and every year. For example, you may find out your plan’s premium or out-of-pocket maximum is increasing.

By doing a fresh plan comparison for 2021, you can see if there is a more competitive plan on the market.

Oftentimes, there’s nothing wrong with your current Medicare Advantage plan. However, there may be better options available, and that’s why you would want to make a change.

Conclusion

All of the changes you make during this year’s Open Enrollment go into effect on January 1, 2021. If you want to make changes after Open Enrollment ends, you do have a limited window from January 1 to March 31, which is called the Medicare Advantage Open Enrollment Period (OEP).

The agents here at Sams/Hockaday are prepared to help you make the best Medicare plan decisions for 2021. Call us at 217-423-8000 today to get started!