Navigating The Medicare Annual Enrollment Period

Are you a Medicare recipient but are currently dissatisfied with the plans and options you had chosen previously? You should know that the Medicare Annual Enrollment Period (AEP) gives you a chance every calendar year to alter the format of your plan. It is important to note that the AEP is the only opportunity you […]

Are you a Medicare recipient but are currently dissatisfied with the plans and options you had chosen previously? You should know that the Medicare Annual Enrollment Period (AEP) gives you a chance every calendar year to alter the format of your plan.

It is important to note that the AEP is the only opportunity you may have to alter your Medicare plan unless you qualify for an exemption. During the Medical Annual Enrollment Period, these are the changes you are permitted to make:

1. Add, remove or alter drugs covered by your Medicare plan (Part D)

Prescription drug coverage can be altered to change the drugs covered in the course of the calendar year. A sixty days’ notice is given to the involved parties. After you have made changes, your plan will still cover the drugs until the year ends, you will lose coverage in January.

2. Add, remove or alter Advantage Plans in your Medicare cover (Part C)

Given that you opt to sign up for the Medicare Advantage Plan in the course of an AEP, you are free to go back to the Original Medicare plan during the Medical Advantage Disenrollment Period (MADP) which is between 1st January and 14th February.

3. Change from an Original Medicare plan (Parts A & B) to Medicare Advantage Plan

Or

4. Change from Medicare Advantage Plan to an Original Medicare plan

An Original Medicare coverage plan covers any visits to the doctor and hospital not excluding emergency care. On the other hand, a Medicare Advantage plan is given via a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). An Advantage Plan covers eye care, hearing, dental care, and overall health care, but need you to select a primary care physician. Also, you should only use doctors and medical institutions that are included in that medical insurance’s provider network. You should also know that Medicare will cover the Advantage Plan insurance up to some point, but it might need an extra co-payments, deductibles or premiums.

Given that you wish to switch to a new health care plan, remember to switch before you drop your current plan. Any alterations made during an AEP are effected on the 1st of January the following calendar year.

In addition to that, Supplement Insurance Plans from Medicare are different; you may enroll in one at any time of the year.

What Is the Medicare Annual Enrollment Period and When Does It Occur?

The Medicare Annual Enrollment Period, AEP in short, is the time allowance given to those who have a Medicare health plan to decide on whether they want to join, drop or change the plans provided by Medicare. Plans offered by Medicare include:

1. Part A: Hospital insurance

This plan covers you for inpatient medical care as well as home health care in some cases.

2. Part B: Medical insurance

Covers visits to the doctor, preventative medical care, and any equipment used.

3. Part C: Medicare Advantage Plan

Offers medical care options via private insurance providers.

4. Part D: Prescription Drugs Coverage

Covers the costs of your medication.

The Annual Enrollment period is from 15th October to 7th December. It happens once every year. Therefore, it is important to be ready so that you can use this opportunity to alter any issues in your current plan. Any changes made are effected on the 1st of January.

However, the AEP is not the only time in the year that you can enroll for Medicare. It is possible to sign up for Medicare in the Initial Enrollment Period (IEP). This is a seventh-month window that has three months before turning 65 years of age, the month you become 65 years of age and three months after you have turned 65 years old.

AEP is for those who have already signed up for Medicare benefits, it allows them to enforce changes in their current insurance plan.

Moreover, you can choose to talk to your insurance provider to know the options available and the changes you wish to make to your policy during an AEP.

More on Medicare Advantage Plans

A Medicare Advantage Plan, which is normally provided through a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO), is an additional choice you have on your health care plan. These advantage plans are provided by private companies; which Medicare has found as acceptable.

The regular Medicare Advantage plan offers the same cover as Hospital Insurance (Part A) and Medical insurance (Part B). These advantage plans, however, may provide added coverage like eye care, hearing, dental checkups, and/or overall health and wellness schemes. Most plans also cover prescription drugs (Medicare Part D).

Each month, Medicare pays a specified amount to the private companies providing Advantage Plans. These firms are expected to adhere to the rules made by Medicare. However, every Advantage Plan can have different costs and rules on how to access medical care.

Medicare Advantage Plan Review Is Important

If you have chosen to sign up for a Medicare Advantage Plan, you should never forget to review your cover every year to ensure that it still meets your medical needs. The thing is, some people find out that their plans change as years pass until they no longer match their needs. The following are important points to consider while doing a yearly review of your plan:

  • Does your plan lessen its benefits or heighten its costs for the following calendar year?
  • Will your current plan be accepted by your primary physician the next year?
  • Given that your Advantage Plan has prescription drug coverage, will all your drugs still be insured in the upcoming year?
  • Are you using more money than you expected on deductibles, co-payments or premiums?
  • Is it hard for you to find convenient medical physicians within the network of your current insurance provider?

Changing a Medicare Advantage Plan

It is possible for people to feel dissatisfied with the private company giving them Medicare Advantage Plan coverage, if you are one of them, you may change your current plan during the Medicare Annual Enrollment Period. This opportunity is available once a year from 15th October to 7th December. In this period, you are free to add, remove, or alter your Medicare Advantage Plan. You can also opt to change from an Advantage Plan to Original Medicare.

Improvements to Medicare In 2019

Medicare is a popular form of health insurance that has been in existence for over 50 years. It has had high rates of customer satisfaction from the 60 million people who are enrolled in it. Things are predicted to get even better. Below we have listed some ways in which Medicare is expected to improve in 2019. Some improvements are expected to affect all members, while others will only affect people enrolled in Medicare Advantage plans.

1. Donut Hole Close

To encourage beneficiaries to choose generic drugs, the Affordable Care Act (ACA) increased the participation of the individual for name brand medications. A costly part of the prescription drug coverage leaves beneficiaries with substantial medical costs to spend more for prescription drugs after they attain a specified threshold in a single year. This leads to an insurance gap, which is also known as a “donut hole.” After a member’s out-of-pocket payment attains another specified level, they get into catastrophic insurance and spend less.

The Affordable Care Act (ACA), states that the donut hole is expected to end in 2020. However, the spending bill Congress approved the closure of the donut hole in 2019 for the brand-name medications. For generic drugs, the gap is scheduled to close in 2020.

2. Therapy Cap Dropped

Beneficiaries of the Original Medicare plan will no longer be forced to pay the entire cost of their outpatient physical therapy, speech therapy or occupational therapy as Congress has completely repealed the therapy cap. This cap used to limit insurance of those named medical services.

3. More informative

Medicare is adding better information in the handbook it sends to its members every year. The updated handbook will have checklists and detailed flowcharts so that clients can have an easier time choosing policies. Their online plan finder tool will also be improved to assist users in comparing out-of-pocket costs and insurance options between Original Medicare plan and Advantage plans.

4. Added Telemedicine

This health insurance provider is slowly improving the accessibility of telehealth services, which allow members to get advice from a medical practitioner over the phone or the internet. In 2019, Medicare will start to cover telehealth programs for those with final-stage renal ailment or stroke treatment.

5. Lifestyle support options

As of January, the Medicare Advantage policies include the choice to pay for meals delivered to the beneficiaries home, transport costs to the doctor’s premises as well as safety features installed in the home like grab bars in the bathroom, ramps for those with limited mobility.

To be covered for such features, a medical practitioner will be needed to recommend advantages like home-safety enhancements and fool delivery.

6. Assistance at home

Moreover, the Medicare Advantage Plans are also expected to have the choice to cover the help needed from home health care aides, who can assist members in carrying out their day-to-day activities like putting on clothes, eating as well as personal care.

7. Test Drives

The well-known health insurance provider has set new regulations that will allow people to try the Medicare Advantage Plans for up to 3 months. In the event they are dissatisfied, they are free to change to another Advantage plan or opt for an Original Medicare plan instead. Congress mandated this flexibility as part of the 21st-century Cures Act, made to enhance medical care innovation.

New Open Enrollment Period for Medicare Advantage Plan in 2019

Starting in 2019, there will be a new chance for members to switch to another form of Medicare Advantage Plan. There will be added time to enroll or drop a plan.

1. Changes to the Medicare Advantage Disenrollment Period

The current Medicare Advantage Disenrollment Period which lasts from 1st January to 14th February each calendar year will be replaced with another type of arrangement in 2019.

During the Medicare Advantage Disenrollment Period, it’s allowed to opt out of a Medicare Advantage Plan and go back to the original Medicare plan. Moreover, it allows you to enroll for a stand-alone Prescription Drug coverage plan from Medicare.

2. The new open enrollment period for Medicare Advantage Plan

A new open enrollment period in 2019 for Medicare Advantage Plan will occur between 1st January and 31st March each year. Given that you are a beneficiary of a Medicare Advantage Plan, you will be given a one-time chance to do the following:

Change to another type of Medicare Advantage Plan.

Opt out of your current Advantage Plan and go back to the Original Medicare plan (Part A and Part B).
Enroll for a stand-alone Prescription Drug Coverage. Normally, you cannot sign up for a stand-alone medication plan if you currently have a Medicare Advantage Plan, but there are some exemptions. Call your health insurance provider for Medicare Advantage Plan if you are unsure.
Opt out of a stand-alone Prescription Drug Cover.

Why change to another form of Medicare Advantage policy?

Without a doubt, the Medicare Advantage plans have some benefits that are very useful. They give you hospital insurance (Medicare Part A) and medical insurance (Medicare part B) benefits, apart from hospice care. In addition to that, some of them include cover beyond Original Medicare, which covers just Part A and Part B. However, those extra benefits may change from one year to another. Therefore it is always important to review your policy every year.

Would you wish to get assistance on the different Medicare enrollment periods? If you are uncertain about the plan you have, would wish to know other choices, or just prefer to know you have the most suitable plan, you can contact Aines Carter & Associates. We offer a wide range of products for Medicare and life insurance. Our Medicare agents are available to assist you in comparing plans, so that you can make a knowledgeable decision in choosing a Medicare plan.

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