Medicare changes ahead for 2019

Have you ever enrolled in a Medicare Advantage plan, just to discover in January that your doctor doesn’t accept your new coverage, or to realize you should have stayed in a particular network? As a result, you had to remain in a plan that was less suitable for your specific needs for an entire year.

In 2019, changes to Medicare may improve the healthcare options and flexibility for beneficiaries. In 2010, lawmakers and the Centers for Medicare and Medicaid Services (CMS) eliminated the Medicare Open Enrollment Period (OEP), but it is now being reinstated and made available to all Medicare beneficiaries.

How To Benefit From Medicare Changes

The Medicare Advantage Disenrollment Period (MADP) ran from January 1 through February 14 every year. During this period, beneficiaries could only disenroll from their Medicare Advantage coverage and revert back to Original Medicare. The MADP is now being replaced with the new Medicare OEP, which will run from January 1 through March 31, enabling Medicare Advantage enrollees to switch from one Medicare Advantage plan to another.

If you recently purchased a Medicare Advantage plan and realized a different plan would be better for your healthcare needs, the return of the Medicare Open Enrollment Period will benefit you.

What you can do during the Medicare Open Enrollment Period:

• Leave your current Medicare Advantage plan and revert to Original Medicare Part A & Part B, with or without a stand-alone Medicare Part D prescription drug plan.
• Swap out your current Medicare Advantage plan for a different one.
• Keep in mind, you can only do this once!

The Complexity of the “Open Enrollment Period”

The open enrollment period may cause some confusion because the CMS terminology for their various enrollment periods is quite similar.

• The Medicare Supplement Open Enrollment Period is for beneficiaries who have just turned 65 and are signing up to Medicare Part B for the first time.
• The Medicare Annual Election Period (AEP) allows all Medicare Advantage and Medicare Part D beneficiaries to change their health coverage for the upcoming year. This period runs annually from October 15 to December 7.
• Many beneficiaries confuse the Initial Enrollment Period (IEP) with the Medicare Supplement (Medigap) Open Enrollment Period. The IEP provides beneficiaries with seven months to enroll in a Medicare Advantage plan, namely the three months before, the month of and the three months after they turn 65 and become eligible for Medicare Part B.

The Open Enrollment Period Explained

Discussing the Open Enrollment Period can be confusing, since there are many different enrollment periods referred to as an “Open Enrollment Period”, correctly and incorrectly. The new annual Open Enrollment Period available from January to March, beginning in 2019, is for Medicare Advantage plan recipients.

These changes are for the better for beneficiaries, enabling them to switch from an unsuitable Medicare Advantage plan to a more suitable plan. However, it’s important for you to realize that you won’t be able to switch Part D plans during the Medicare OEP. Medicare-eligible beneficiaries who are enrolled in stand-alone Part D Prescription Drug plans must make changes to their Part D plans during AEP (October 15 through December 7 of every year).

By the end of September each year, Medicare Advantage recipients should 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. As a beneficiary, it is your responsibility to note changes when you receive this information and adjust your coverage accordingly.

CMS posts plan changes for the following year sometime in October, several months before the new year. Medicare.gov is a valuable resource that Medicare beneficiaries can use to compare plans, look up information and learn more about their Medicare options.