Unhappy with Your Medicare Advantage Plan? This Open Enrollment Period Is for You

Sometimes an enrollee finds themselves in a Medicare Advantage plan that they don't feel is right for them.

​It's easy to miss details about rules and doctor networks in a plan's Summary of Benefits during the year-end Annual Enrollment Period and opt for a plan that's not best suited to you.

Luckily, there's the Open Enrollment Period - a sort of second chance to make a one-time change and sign up for a different Medicare Advantage plan that better suits you.
 
Some background
The Medicare Advantage Open Enrollment Period used to be a fixture, but the Affordable Care Act abolished it and replaced it with the Medicare Advantage Disenrollment Period, which only allowed Medicare Advantage enrollees to go back to traditional Medicare between Jan. 1 and Feb. 14 every year.

After new legislation took effect in 2019, the Open Enrollment Period is back, allowing beneficiaries with Medicare Advantage to:

• Switch from one Medicare Advantage plan to another Advantage plan, or
• Disenroll from a Medicare Advantage plan and return to traditional Medicare, with or without a Part D drug plan.

 
The rules were changed for a number of reasons:

• An enrollee may be confused about which Medicare Advantage plan is right for them during the Annual Enrollment Period.
• They may not understand how the plans work.
• They may not know a plan has a doctor network or they failed to research if their doctor is in their plan's network.
• They were focused only on the plan's low premium and didn't know it also has copays.
• Their plan's formulary may not cover the medications they need.

 
Confusion about the period
Many Medicare beneficiaries are confused by what constitutes the Open Enrollment Period because the words are used interchangeably during different enrollment periods. Here's a breakdown of the different enrollment periods for Medicare.

Initial Enrollment Period - When someone turns 65, they get an Initial Enrollment Period of seven months to enroll in Medicare during the three months before they turn 65, the month they turn 65 and the three months after that.

Sometimes people mistakenly call the this an open enrollment period.

Annual Enrollment Period - During Oct. 15 and Dec, 7 every year, you can sign up for a Medicare Advantage plan if you are on traditional Medicare or you can change from one Advantage plan to another. You can also make changes to your Part D drug plan.

This period is also known as the Annual Election Period. It is often mistakenly called the Open Enrollment Period, probably because it takes place at the same time as open enrollment for group health plans and plans on the ACA marketplaces.

Medicare Supplement Open Enrollment - This is a one-time only six-month period during which a Medicare beneficiary can enroll in a Medicare supplement policy, without being asked any medical questions. Medicare supplement insurers cannot turn beneficiaries down during this special period, which is sometimes also called the Open Enrollment Period.
 
The next step
If you are enrolled in a Medicare Advantage plan that you are less than thrilled about, you have a golden opportunity to make a change from Jan. 1 to March 30.
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Call us with any questions and we can help you sort through your plan options and find one that is right for you.