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  • Medicare Experience

Changes You Can Make During Medicare Open Enrollment

Knowing which options are available can help to ensure you always have the best coverage.

The Medicare Open Enrollment Period runs each year from October 15 – December 7, providing all Medicare enrollees an opportunity to reevaluate their health coverage.


Whether you’re just reviewing your coverage to ensure that you are covered for the upcoming year, or you’re actively shopping for a new health or drug plan, it can be helpful to know exactly what options are available to you during this period.


Here, we’ll outline your available open enrollment options and why it’s important to prepare for the Medicare Open Enrollment Period every year.



What Options Do I Have During the Open Enrollment Period?


While there's never any shortage of Medicare-related commercials when Open Enrollment rolls around each year, the barrage of information can often overwhelm rather than clarify.


So, here we'll clearly lay out the choices at your disposal during this period. These are five options available during the Medicare Open Enrollment Period:


1. If you currently have Original Medicare coverage, you can switch to a Medicare Advantage plan.

2. If you currently have a Medicare Advantage plan, you can switch to Original Medicare.

3. Or, if you currently have a Medicare Advantage plan, you can switch to a different Medicare Advantage plan.

4. If you currently have a Medicare Part D plan, you can switch to a different Medicare Part D plan.

5. For those that did not enroll in a Medicare Part D plan when first eligible during their Initial Enrollment Period, you can enroll in a Medicare Part D plan.





Preparing for Medicare Open Enrollment


Even if you’re happy with your current plan, it’s a smart idea to review your coverage every year.


Not only can there be financial implications of letting your coverage go unchecked but you may also find yourself lacking in benefit coverage or plan quality compared to other available options.


Here are three reasons why it’s important that you prepare for Medicare Open Enrollment.


1. Benefits Vary By Plan. Comparing the available plans in your area is the only way to get a good sense of which is best for you.


Not only do benefits vary from plan to plan but it’s also possible for your current plan’s benefits and costs to change annually. Keep a look out for notices from your plan that detail any changes for the upcoming year.


2. Healthcare Needs Evolve. Just as health and drug plans can make changes from year to year, it’s also possible that you may require changes in your coverage.


Whether this is a new prescription or change in prescription, an increase in doctor visits, or any other potential change, the Open Enrollment Period is a great time to review your coverage and anticipate what your needs might be for the upcoming year.


3. New Options Become Available. This is an important point to keep in mind. Even if you like your current plan, it’s possible that a newly available plan is more affordable or better addresses your healthcare needs (or both!).


By reasoning that your current plan is good enough, you can miss out on new and improved plan options that have evolved to better meet the current needs and interests of Medicare beneficiaries.



Reviewing Your Prescription Drug Coverage


Even if your current plan covered all the medications that you needed in the previous year, it’s possible that your plan’s list of covered medications is set to change in the upcoming year.


So, even if you’re happy with your current plan, it’s important that you review it during Open Enrollment to ensure that you still have the plan that’s best fit for you.


Each plan has its own drug formulary, which is the list of medications covered by that plan. Drug formularies rank their medications into tiers: lower-tier drugs are less expensive and higher-tier drugs are the more expensive options.


These formularies vary by plan and can also change from year to year. It’s not uncommon for a plan to switch their preferred choices or drop medications from their formularies all together.


For this reason, what may be your best plan option one year can switch in the next year. Reviewing your coverage to prepare for the Open Enrollment Period is a great way to ensure you have the plan that’s right for you in terms of both coverage and cost.



Do I Need to Act If I Already Have Medicare?


The Medicare Open Enrollment Period is an opportunity for any Medicare beneficiary, long-standing or brand new, to reassess their Medicare coverage and make certain changes should they choose.


If you have traditional Medicare, also known as Original Medicare (Part A and Part B), there’s no need to make a change if you’re content with your current coverage.


However, if you’re interested in taking a look at your options, you have the five listed above at your disposal. And if you do decide to make a change, your new coverage will begin on the 1st of the new year.




Up Next: Medicare Open Enrollment 2021

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