Ready for the Annual Enrollment Period (AEP)? Tips to Prep for AEP
Key Takeaways
- The Annual Enrollment Period (AEP) is also known as Medicare Open Enrollment Period.
- AEP runs each year from October 15 to December 7.
- During this period you can change or drop your Medicare coverage.
- There are several factors you should evaluate, including your Annual Notice of Change and your current medical and prescription needs.
The leaves are starting to change. The summer heat is starting to break. You know what that means.
Medicare’s Annual Enrollment Period (AEP) is almost here.
If you’re looking to change your existing coverage, AEP is the time to do so. Also known as Medicare Open Enrollment, this Medicare enrollment period is your chance to evaluate your needs and whether your plan still works for you. It doesn’t matter whether you’re looking into Medicare Part D enrollment, Medicare Part A enrollment — or any other portion of Medicare; If you need a change, you can shop for a plan that may work better.
Let’s find your ideal Medicare Advantage plan.
How to Plan for the Annual Enrollment Period
When does Open Enrollment start?
- October 15
When does Medicare Open Enrollment end?
- December 7
If you’re looking to take advantage of the Annual Enrollment Period, here are some things you can do to prepare.
How to Prep Before Medicare’s Annual Enrollment Period
Whether you’re looking to make a change during the AEP or not, it pays to review how your current plan performed in the last year. That way, you can determine if you’d like to re-enroll in the same or a similar plan, or if you’d like to shop for something else. Here are some tips on how to do so:
- Read your Annual Notice of Change (ANOC). This is typically mailed in the fall prior to AEP. Your ANOC will highlight all the changes in cost and coverage that are coming to your plan. This may be your first indication that you’ll need to find a new plan during AEP.
- Review your Medicare Summary Notice (MSN) or your Explanation of Benefits (EOB). If you’re enrolled in Original Medicare, you’ll receive a Medicare Summary Notice a few months after you receive any benefits. Medicare Advantage enrollees receive an Explanation of Benefits. Both forms detail the benefits you received, and how much your plan pays for them. These can be great tools to use when comparing prospective plans to your current one.
- Write down any changes to your health you’ve experienced in the last year. Even minor conditions should be considered when looking at which plan to choose for the upcoming year.
- Make a list of all your healthcare providers. Don’t take this part for granted. While your doctors were covered this year, there are no guarantees that they’ll be included on your plan next year. To help avoid any issues, have this list handy during AEP.
Of course, your pre-enrollment checklist could be much longer depending on your needs.
Original Medicare vs. Medicare Advantage
One popular way for enrollees to use their AEP is to switch from Original Medicare to a Medicare Advantage plan, and vice versa. And while you may think you understand what that means, when was the last time you really examined Original Medicare and Medicare Advantage? Do you know the differences between the two, or what’s changed since last AEP?
Now’s the time to learn.
Depending on your needs, you’ll want to evaluate the pros and cons of each option. Here’s an example:
PROS
- You’re allowed to visit any doctor or hospital that accepts Medicare
- Coverage is often nationwide
- No referrals needed for specialists
- Medicare Part D and Medicare Supplement (Medigap) plans can add coverage and offset out-of-pocket costs
CONS
- Dental, vision, hearing, and overseas care not covered
- No out-of-pocket maximums
- Must buy additional plans and pay premiums for prescription drugs
PROS
- Covers all the services that Original Medicare covers, but may include extra benefits such as dental, vision, hearing, and prescriptions
- Cost effective: $0 premium plans available. Medicare Advantage premiums also may be lower than Medigap and Part D premiums
- Out-of-pocket maximums help protect enrollees
- Out-of-pocket costs may be lower than original Medicare
- Available for end-stage renal disease (ESRD) patients
CONS
- Members are responsible for copayments and deductibles
- Specialist visits may require a referral
- The provider network limits the choice of doctors/hospitals and doctors may not accept certain Medicare Advantage plans
- If you see a provider out of your network, you may be required to pay full price for services received
- Inconsistency: Plans may change annually
Find the Medicare Advantage plan that meets your needs.
Don’t Forget Your Prescription Drugs!
During AEP you can also enroll in or change your Prescription Drug Plan (Part D). Just like you should with your healthcare providers, it’s a good idea to verify that any prescription drugs you need are still going to be covered by a Part D plan you enroll in during your AEP. If your medications were covered this year, they may not be covered at the same levels if you re-enroll in the same Part D plan.
To find a plan that will work for you during Medicare Part D enrollment:
- Write down all the medications you’re currently taking or may need in the coming year.
- If you’re on Original Medicare, review your Medicare Summary Notice to verify how much your medications cost in the last year. Medicare Advantage enrollees can read their Explanation of Benefits for the same information.
- Consult your prospective plan’s drug formulary to see how your medications are covered.
Know How To Talk to Your Insurance Company
This is something people rarely think about before AEP, but it’s a biggie; learn how to talk to your insurance carrier. It’s so important, we’ve dedicated an entire page to it. Basically, you need to know where to start. Here are some examples:
- What are the different health insurance costs, such as premiums, deductibles and coinsurance?
- What are the differences between a PPO (Preferred Provider Network, as in Medicare Advantage) and a Health Maintenance Organization (HMO) like Original Medicare.
- What do you do if your doctor denies a claim?
FAQ
When do you have to sign up for Medicare?
For example, if you turn 65 in June, your IEP begins March 1 and ends September 30.
Are there other enrollment periods?
- General Enrollment Period: If you miss your IEP and don’t qualify for a Special Enrollment Period (see below), you can enroll between January 1 and March 31. Your coverage will begin July 1.
- Medicare Special Enrollment Period (SEP): If you delayed your enrollment in Parts A and B because you had employer-based group coverage, you’ll have an eight-month SEP to sign up for a new plan once your job-based policy ends. Learn more about how Special Enrollment Periods work.
Can I sign up for social security but not Medicare?
How do I know if I am signed up for Medicare? If you’re drawing social security before age 65, you should receive a Medicare card from the SSA in the mail shortly before your 65th birthday. The welcome packet will include instructions on how to decline enrollment into Medicare.
Still have questions? GoHealth has the answers you need.
Sources
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.