Medicare Advantage vs Medigap

Medicare Advantage Open Enrollment Period: Everything You Need to Know About Medicare Annual Enrollment

For those 65 years old or with a qualified disability, the Medicare Open Enrollment Period will quickly come upon us! Has your health care provider changed? You may need to change to another plan.

This is the time of year when you can change plans and update your Medicare coverage for the upcoming year. Here is everything you need to know about the Medicare Open Enrollment Period.

Table of Contents

Medicare Advantage Open Enrollment Period

What is the Medicare Advantage Annual Enrollment Period?

The Annual Enrollment Period (AEP) for Medicare Advantage plans is the time each year when you can sign up for a plan, make changes to your current plan, or switch back to Original Medicare. 
AEP runs from October 15 to December 7 each year. If you’re happy with your current plan and don’t want to make any changes, you don’t need to do anything during AEP. Your coverage will automatically renew.
If you’re considering making changes to your Medicare Advantage plan, it’s essential to understand how the process works. First, you’ll want to research the available plans in your area to find one that best meets your needs. 
Once you’ve found a plan you’re interested in, you can enroll in it during the AEP period. If you’re switching from one Medicare Advantage plan to another or from a Medicare Advantage plan back to Original Medicare, you can do so during AEP. 
If you have questions about AEP or the Medicare Advantage enrollment process, you can contact your State Health Insurance Assistance Program (SHIP). SHIP provides free, unbiased counseling and assistance to people with Medicare and their families.

What Can I do During the Medicare Advantage Open Enrollment Period?

The Medicare Annual Enrollment Period (AEP) is October 15 through December 7. This is the time of year when you are eligible to switch to a new Medicare Advantage Plan, new Medicare standalone Part D prescription drug plan, or return to Original Medicare. 
If you’re happy with your current coverage, you don’t need to do anything during the AEP. But it’s a good idea to review your coverage and ensure your plan will still meet your needs for the upcoming year. 
If you’re not satisfied with your current plan, now is the time to make a change. During the AEP, you can:
  • Switch to a new Medicare prescription drug plan
  • Return to Original Medicare
  • Join a Medicare Advantage Plan
  • Switch from a Medicare Advantage Plan to another
  • Drop your Medicare Advantage Plan and return to Original Medicare
Be sure to talk with one of our Medicare insurance agents and compare your options before you make a decision. Making a change to your plan can have additional repercussions.
If you have questions about the AEP or your Medicare coverage options, please call us at 562-606-1030 x1 or complete our online quote request form. We’re here to help.

My Part D Prescription Drug Plan Changed Can I Change Plans During The Medicare Annual Enrollment Period?

Yes, if you’re unhappy with your Medicare prescription drug plan, you can make a change during Medicare’s Annual Enrollment Period.
Here’s what you need to know about changing your Medicare prescription drug plan:
Suppose you’re enrolled in a Medicare Advantage plan with prescription drug coverage. In that case, you can switch to a new Medicare Advantage plan or return to Original Medicare during the annual enrollment period.
If you switch to a new Medicare plan, your new plan will begin on January 1.
Here are some things to consider when deciding whether to switch Medicare prescription drug plans:
  1. What are my prescription drugs and dosages?
  2. Do I need coverage for all my prescription drugs?
  3. What type of plan do I want?
  4. What is my budget?
  5. What is the quality of the plan’s network of pharmacists and doctors?
  6. If I Enrolled in a Medicare Advantage Plan, will my Doctors be covered under the new plan?
If you have questions about changing your Medicare prescription drug plan, contact our Medicare insurance agency, and we will provide the needed assistance to ensure you don’t make the wrong decision.
Medicare Advantage vs Medigap

What is the difference between Medicare Advantage and Original Medicare with a Medigap Plan?

There are two types of Medicare plans: Medicare Advantage and Original Medicare with a Medigap plan.

Private insurance companies offer Medicare Advantage plans and must follow the rules set by Medicare. These plans typically have lower premiums than Medigap plans but may also have higher out-of-pocket costs.

The federal government runs original Medicare and does not have annual limits on out-of-pocket costs. You can add a Medigap plan to help pay for some or all of these costs.

Private insurance companies offer Medigap plans, which can help pay for the out-of-pocket costs that Original Medicare does not cover, such as deductibles, coinsurance, and copayments.

Unlike Medicare Advantage plans, Medigap plans work alongside Original Medicare and do not replace Original Medicare. This means you keep your Medicare benefits intact and enhance your coverage by closing the gap in coverage with a Medicare supplement plan.

With a Medicare Advantage plan, you leave Original Medicare and turn over your medical decision to the insurance company. You will need to continue to pay your Medicare Part B premiums.

What are my Prescription Drug Coverage options with Medicare?

There are two main ways to get Medicare prescription drug coverage:

  • Enroll in a Medicare Advantage plan that includes prescription drug coverage, or
  • Enroll in a Medicare Part D standalone prescription drug plan (PDP)

If you are enrolled in a Medicare Advantage plan, you cannot enroll in a standalone Part D plan. You can only enroll in a standalone prescription drug plan if enrolled in Original Medicare with a Medigap plan.

Medicare beneficiaries enrolled in a Medicare Advantage plan are given a single Part D prescription drug option when Part D coverage is included.

How do I Compare Medicare Plans?

When you first signed up for Medicare, you were eligible for Medicare under your Initial Enrollment Period. Many people have little knowledge of what to do or how to compare Medicare plans.

If you are currently enrolled in a Medicare plan, you can compare Medicare plans side-by-side by speaking with a licensed insurance agent who can help you understand your coverage options.

You can also compare plans online. The Centers for Medicare and Medicaid Services (CMS) has a plan Finder tool that allows you to compare different Medicare plans side-by-side.

Finally, state resource websites can provide information about Medicare coverage and benefits.

Once you have reviewed all options, our Agents can help you enroll in a new plan any time during the annual enrollment period.

We do not recommend signing up for a Medicare plan without the assistance of a Medicare agent, as there are many moving parts to Medicare. We will review the new plan’s benefits to ensure the coverage for the following year will meet your needs.

What if I have questions about my Medicare Advantage Plan (Part C)?

Contact your plan’s customer service number if you have questions about your Medicare Advantage Plan. They will need to know which plan you are enrolled in, so ensure you have a Medicare Advantage ID card available for the call.

You can also reach out to one of our licensed insurance agents, and we can help review your plan. If calling during an enrollment period for Medicare, we can also assist you in finding another Medicare Advantage plan.

I want to Switch my Medicare plan, what do I need to do?

If you want to switch your Medicare plan, you can do so during the annual open enrollment period. You can make changes to your plan by calling one of our Medicare agents. 

You may also qualify for a special enrollment period in specific circumstances. 

During a special enrollment period, you can enroll in a new Medicare health and drug plan outside of the annual enrollment period and general enrollment period.

When switching Medicare plans, coverage begins on the 1st of the following month or on January 1, depending on the qualifying event.

I am happy with my current Medicare plan, do I need to do anything during the Open Enrollment Period?

If you are happy with your current Medicare plan, you do not need to do anything during the Open Enrollment Period. You will automatically be re-enrolled in your current plan for the following year.

Please verify your pharmacy coverage has not changed by reviewing your new formulary. Once your plan renews, you have limited Medicare options in the future.

Suppose you discover your prescription drug coverage changed after open enrollment ends. In that case, you may qualify to make changes during the General Enrollment Period that runs from January 1 through March 31 each year.

Happy Older couple

What are some things I should keep in mind when choosing a Medicare plan?

There are a few things you should keep in mind when choosing a Medicare plan:

  1. You can join, switch, or drop a plan during the Medicare Open Enrollment Period.
  2. You can learn more about plans and enroll during the Medicare Open Enrollment Period.
  3. Most Medicare services are covered through a Medicare Advantage Plan.
  4. Before you go back to Original Medicare, ensure you qualify to buy a Medicare Supplement plan.
  5. If you switch back to Original Medicare, obtain Part D coverage.

At no cost, some plans offer additional coverage, such as essential dental, vision, or hearing coverage. You may need to purchase additional coverage for more comprehensive dental and hearing aid coverage. You will need to weigh the costs and benefits of each plan to find the best one for you.

Where can I get more help with Enrolling in a Medicare Plan?

The Medicare Open Enrollment Period is the time each year when you can sign up for a new Medicare plan or make changes to your existing coverage. It is essential to stay up-to-date on all Medicare changes so you can change your plan if needed.

Integrity Now Insurance Brokers is an independent insurance agent to help protect your health care coverage. You can also call 562-606-1030 to speak with one of our partners, who can help you find a plan in your area.

Bonus Questions:

Do I need to be enrolled in Medicare Part A and Part B?

If you want to join a Medicare Advantage plan or sign up for a Medigap Plan G, you must sign up for both Part A and Part B o Medicare.

Does Medicare cover long-term care?

Long-term care is not covered by Medicare and must be obtained through other means.

Can I Disenroll from a Medicare Advantage plan?

Yes, you can initiate a disenrollment from a Medicare Advantage plan during specific times of the year. Please ensure you qualify for a Medigap plan before attempting to disenroll from an Advantage plan.