The Annual Enrollment Period
It is almost impossible to avoid the topic of the Annual Enrollment Period, with the never ending phone calls, commercials, and booths at every pharmacy. Even so, there is still confusion surrounding some aspects and rules of the Annual Enrollment Period. When is it? Is this the only time of year I can make changes? This article will provide clarity on what you need to know for the next Annual Enrollment Period.
When is it?
The Annual Enrollment Period, or AEP, is a set time each year to review and execute any changes necessary to your Medicare plan and benefits for the upcoming year. AEP takes place every year from October 15th to December 7th. These dates can be extended for crisis or unfavorable circumstances, like we saw in the year 2020. New plans and plan benefits for the upcoming year are released on the 1st of October, but any enrollments must wait until the 15th. Medicare Advantage and Prescription Drug plans have annual contracts. Also in the first weeks of October all members enrolled in a Medicare Advantage or Prescription Drug plan should receive a document titled ANOC or Annual Notice Of Change. This document should arrive before enrollment begins, and it informs the plans members of the changes their plan will impose on January 1st. If your benefit amounts are going down or your copays are going up, it could be beneficial to review the other plans available in your area to see how they compare to these new changes,
If you are enrolling for AEP it is important to know your plan selection will not start until January 1st. If you are turning 65 and enrolling into Medicare for the first time, your plan will start the first day of your birth month or the first day of the following month, depending on the time of enrollment. If you are enrolling because of a recent move or other special circumstance your plan will start the first day of the following month.
Do I have to make any changes?
No, you don’t. If you do nothing during the Annual Enrollment Period your plan will continue with you into the new year with it’s updated costs and benefits beginning on January 1st. This is, as long as your plan is still available. The ANOC document is very important for this reason. There are times when a company decides to take away a plan completely from a certain market. The company may pull out of the market completely or they could end several plans and continue with others. If a plan has received consistently low star ratings CMS may require the plan be terminated. There are many reasons this may happen, but the important part for the member, is to make sure they choose a new plan. If nothing is done, on January 1st the plan will no longer exist and the members will go without until they enroll into a new plan. This is true for both Part C and Part D.
If you have a Medicare Supplement plan you can ignore the Annual Enrollment Period completely. You are able to apply for a Medicare Supplement plan at any time. You may have to pass medical underwriting if you are outside of the guaranteed issue window. Because of all the changes being made by MAPD and Part D members, we recommend waiting to price shop Medicare Supplement plans until after AEP. If you are turning 65 or enrolling into Medicare for the first time please do not delay, but for those already enrolled and interested in shopping around for a different plan or lower price we recommend waiting.
How can I keep up with all of the changes?
Sometimes it can seems like managing your healthcare benefits is a full time job. It shouldn’t be that way. This is where working with a reliable independent broker offers many benefits. First being, this is our full time job. It is our responsibility to keep up with all the changes Medicare releases and communicate those to our clients when it will pertain to their situation. Many members receive so many post cards about benefits and plan changes sometimes the important documents get lost in the sea of advertisements. As agents and brokers we also receive notices of plan changes and terminations. We contact all of our current clients to review these updates and verify if the plan they are on will continue to be their best option in the new year. It is hard to know who to trust when dealing with strangers on the phone making great promises about amazing benefits that you may qualify for. This is why we recommend working with someone you can know and trust, someone who will be with you year after year.
We helped a beneficiary who did not review her ANOC document during AEP. She was not sure who her agent was and did not remember receiving any type of documentation about her plan. Her Part C plan was pulled from the market and on January 1st she had Part A and B only. She would have been alerted to the lack of Part D coverage first when visiting her pharmacist. Unfortunately, while traveling to see family for the holidays she tripped and fell and broke a couple bones. This led to a stay at an inpatient nursing facility. When she was released, she went to pick up her medications from the local pharmacy and was told she had no drug coverage and she needed to pay over $4,000. This is when she started calling around to see who could help her. We were able to look back and let her know why she had lost coverage and provide her with some resources to save on medications until her new plan could start the following month. Now that she has become our client we make sure to review her plan every year, so that she never has to go through something like that again.