Medicare Open Enrollment Period: Important for You?


By Greg Durette

greg duretteAs with many situations, in order to give a good answer to the original question, one must first ask another. In this case, the question(s) you would have to ask first are:

Did you sign up for a new Advantage Plan or a stand-alone Part D prescription drug plan during the last Annual Enrollment Period (AEP)?

Do you have an existing Advantage Plan or a stand-alone Part D prescription drug plan that renewed with a January 1st effective date?

If the answer to either of these questions is yes, then the Medicare Open Enrollment Period (OEP) is very important to you as it is happening right now.

The OEP runs from January 1st to March 31st. It was preceded by the AEP which runs from October 15th to December 7th each year. During the AEP, you can sign up for or switch Advantage plans, Prescription plans and Supplement plans which can be invaluable should you find your circumstances do not match with the plan you currently have. The OEP gives Advantage plan stand-alone prescription drug plan holders the option to make certain changes to the plan they selected in the AEP.

These allowed changes are:
• Cancel your stand-alone Part D prescription drug plan
• Drop your Medicare Advantage Plan and return to Original Medicare
• Enroll in a stand-alone Medicare Part D prescription drug plan
• Elect to change from one Medicare Advantage Plan to another

Let’s a look at each option. First, why would someone elect to cancel their stand-alone Part D prescription plan? The only reason one could have would be it was being replaced by other qualifying coverage. If you cancel without replacing, penalties will accrue and be waiting for you when you do put this coverage back in place.

Second, there are a few rare circumstances when it makes sense for someone to cancel the Advantage plan and return to Original Medicare known as Part A and Part B. Usually this would have something to do with provider networks which are insufficient for the beneficiary. Again, this rare circumstance would require you to also enroll in a stand-alone Part D prescription drug plan in order to avoid accruing the future penalties.

So, enrolling in a stand-alone Part D prescription drug plan is a requirement if you do not have qualifying coverage elsewhere in order to avoid these penalties. If you neglected to get that done during the AEP, now is the time to take care of this.

Last, some folks have a change of heart once they see the detailed materials of the Advantage plan they enrolled in during the AEP. Perhaps you find your HMO plan does not have the providers you need but, PPO plan does. Or, perhaps the terms of coverage are better in a plan different from your current plan.

You are not required to give any reason to switch plans provided you do so before the OEP expires on March 31st.

All of the available options for your particular situation should be thoroughly discussed with your insurance agent/broker. This will ensure you have all the facts about the choices you may be thinking about taking and get all your questions answered.

Greg Durette is a local agent for Florida Blue and brings his nearly 37 years of experience to help folks navigate the complexities of Medicare. He can be reached at 850-842-2400.