What’s New in Medicare Advantage for AEP This Year

News
October 12, 2023
Eric Kent

Introduction

Medicare Advantage, plans often referred to as Medicare Part C, are private health insurance plans that provide an alternative way to receive Medicare benefits. Some key advantages of Medicare Advantage plans:

Comprehensive Coverage: Most Medicare Advantage plans offer coverage for hospitalization (Medicare Part A), medical services (Medicare Part B), and often prescription drugs (Medicare Part D) all in one plan. This can simplify your healthcare coverage.
Additional Benefits: Many Medicare Advantage plans include extra benefits not covered by Original Medicare, such as dental, vision, hearing, wellness programs, and fitness memberships.
Cost Predictability:These plans often have out-of-pocket cost limits, providing a level of financial predictability for your healthcare expenses.
Provider Networks: Medicare Advantage plans typically have networks of doctors and hospitals. Staying within the network can help you save on healthcare costs, but you may have less flexibility in choosing healthcare providers.
Coordination of Care: Some plans offer care coordination services to help manage your healthcare and ensure you receive appropriate care.
Premium Options: While some Medicare Advantage plans have low or no additional premium beyond the standard Medicare Part B premium, others may have higher premiums for added benefits.
Annual Changes: It’s important to review your plan each year during the Medicare Annual Enrollment Period (October 15 to December 7) as plan benefits, costs, and provider networks can change.
Choice: You have the freedom to choose from various Medicare Advantage plans offered by different insurance companies, allowing you to find one that fits your needs.

Keep in mind that Medicare Advantage plans vary by location, so the availability of specific plans and their benefits may differ depending on where you live. It’s crucial to research and compare plans in your area to select the one that best aligns with your healthcare needs and preferences.

The AEP, or Annual Enrollment Period, for Medicare is a critical time for Medicare beneficiaries to make changes to their Medicare coverage. Here are some key points about the AEP:

Dates: The Annual Enrollment Period typically runs from October 15th to December 7th each year.

Purpose:During the AEP, Medicare beneficiaries can make various changes to their Medicare coverage, including:

- Switch from Original Medicare to a Medicare Advantage Plan.
- Switch from a Medicare Advantage Plan back to Original Medicare.
- Change from one Medicare Advantage Plan to another.
- Enroll in or change your Medicare Part D prescription drug plan.

Coverage Changes: Changes made during the AEP go into effect on January 1st of the following year. It’s an opportunity for beneficiaries to review their current coverage, assess any changes in their healthcare needs, and make adjustments accordingly.

How to Make Changes:You can make changes to your Medicare coverage during the AEP by using the Medicare Plan Finder tool on the Medicare website, working with an insurance agent or broker, or contacting the insurance companies directly.

Late Enrollment Penalties: It’s important to note that missing the AEP deadline can result in late enrollment penalties for certain parts of Medicare, particularly for Part D prescription drug coverage. So, it’s essential to make changes or enrol in new plans during the AEP to avoid potential penalties.

Special Enrollment Periods: Outside of the AEP, there are specific circumstances that may qualify you for a Special Enrollment Period (SEP), allowing you to make changes to your Medicare coverage. These include life events such as moving, losing employer coverage, or qualifying for Medicaid.

Changes In Annual Enrolment Period

The AEP is a crucial period for Medicare beneficiaries to ensure that their healthcare coverage aligns with their current needs. It’s advisable to review your options and make any necessary changes during this timeframe to ensure you have the right coverage for the upcoming year.

During the Annual Enrollment Period (AEP) for Medicare, which runs from October 15th to December 7th each year, Medicare beneficiaries can make various changes to their coverage. Here are some of the key changes you can make during the AEP:

Switch from Original Medicare to Medicare Advantage (MA):f you currently have Original Medicare (Part A and Part B) and want to switch to a Medicare Advantage plan (Part C), you can do so during the AEP.
Switch from Medicare Advantage to Original Medicare:If you’re enrolled in a Medicare Advantage plan and want to return to Original Medicare, you can make that change during the AEP.
Change Medicare Advantage Plans:If you’re already on a Medicare Advantage plan but want to switch to a different one, you can do so during this period.
Enroll in or Change Medicare Part D Prescription Drug Plans:If you have Original Medicare and want to in a Medicare Part D prescription drug plan or switch to a different one, the AEP is the time to do it.
Make Changes to Supplemental (Medigap) Insurance: While the AEP primarily focuses on Part C and Part D changes, in some cases, you may be able to make changes to your Medigap (Medicare Supplement) plan, depending on your state’s rules and the insurance company’s policies.
Review and Adjust Coverage: Even if you’re not making significant changes, it’s a good practice to review your current Medicare coverage annually during the AEP to ensure it still meets your healthcare needs. You can make adjustments as necessary.

Conclusion

As a result of changes made during the AEP take effect on January 1st of the following year. Additionally, missing the AEP deadline could limit your options and may result in late enrollment penalties for Medicare Part D if you don’t have creditable prescription drug coverage.

During the AEP, you can use the Medicare Plan Finder tool on the official Medicare website, consult with an insurance agent or broker, or contact the insurance companies directly to explore your options and make changes to your Medicare coverage as needed.