Most individuals have a feeling they should be doing something during the Medicare Open Enrollment (MA-OEP), but they are not quite sure what. The constant bombardment of television, internet, and radio ads can cause anxiety and confusion because they make people wonder if they should be changing something. We get many phone calls with people saying, “AEP just ended. What is the difference between AEP and MA-OEP?”

The Annual Enrollment Period (AEP) is the time of year when you, as a beneficiary, can change your current coverage. AEP runs from October 15th to December 7th. Before AEP starts in October, the plans wait to update pending new Medicare guidelines, allowing you to check around and make sure you choose the plan that best meets your needs.
Given the changes with Medicare Advantage and Part D plan benefits, prescription drug formularies can change, and premiums increase. Each September, you will receive an Annual Notice of Change (ANoC) letter explaining all of the upcoming year changes that affect your plan. Then you have a chance to choose another plan if you are unhappy with the future adjustments to your plan.

So no, Medicare Open Enrollment did not end in December! That was the Medicare Annual Enrollment Period.

So what’s the difference?

Medicare Advantage Open Enrollment Period or what many people call “Medicare Open Enrollment” happens at the beginning of every year from January 1 to March 31. But, it is only for those who already have a Medicare Advantage plan!

The Medicare Advantage Open Enrollment Period (MA-OEP) is another enrollment period where individuals currently enrolled in a Medicare Advantage plan (MAPD or MA) have an opportunity to change or drop Medicare Advantage plans, return to original Medicare Part A and Part B coverage, or join a stand-alone Medicare Part D prescription drug plan (PDP).

MA-OEP Provides one additional chance to change your Medicare Advantage plan enrollment outside of the Annual Enrollment Period (which ended December 7).

During MA OEP, you can only make a single change.

Changes You Can Make During the Medicare Open Enrollment Period (MA-OEP):

  1. During the Medicare Advantage Open Enrollment Period, you can only make changes if you are already enrolled in a Medicare Advantage plan.

Changes you cannot make during MA-OEP

  1. Switch from Original Medicare to a Medicare Advantage plan.
  2. Join Medicare Part D (prescription drug) if you are in Original Medicare.
  3. Switch from one Medicare Part D (prescription drug) plan to another if you’re in Original Medicare.
Important: You do, however, have a choice to change the manner with which you receive your Medicare coverage if you are unsatisfied with it. The coverage you decide on should consider your immediate health needs and affordability. If, for some reason, you want to change how you receive your Medicare coverage, MA-OEP lets you change the way your coverage is delivered to you.
Since the enrollment windows can be confusing and the many choices you have with Medicare, you should always speak to a licensed Medicare insurance agent. Senior Healthcare Advisors specialists will provide you with the expertise you need to understand your choices and help you with the entire enrollment process. We can inform you about the comparisons of all Medicare plans now available in your area.

If you want to use the MA-OEP, please call Senior Healthcare Advisors at 855-824-6618| TTY 711 and ask a specialist to help you find another Medicare Advantage plan in your area or ask to return to Original Medicare and add a stand-alone Medicare Part D plan that most economically covers your medications.

Why would I use the MA-OEP to change my Medicare Advantage plan enrollment?

  1. You may wish to use the MA-OEP to change Medicare Advantage plan coverage if you chose the wrong Medicare Advantage plan during the Annual Enrollment Period (AEP) and now want to make a change to another plan with more benefits.
  2. You mistakenly enrolled in a Medicare Advantage plan that does not have drug coverage (MA) and you wanted to enroll in an MA with prescription drug coverage (MAPD).
  3. You find that another Medicare Advantage plan in your area provides more affordable overall coverage – and maybe has a lower maximum out-of-pocket limit (MOOP).
  4. A Special Needs Medicare Advantage Plan (SNP) is available in your area and provides benefits designed specifically to your health needs, financial status, chronic condition, or Long Term Care (LTC) residence.
  5. Your healthcare providers (e.g., doctor or specialist) have moved to another healthcare network and they are out of network or no longer available through your chosen Medicare Advantage plan.
  6. Your MA or MAPD no longer provides SilverSneakers (TM) or other fitness program coverage and you wish to change to a plan that includes this benefit.
  7. You found another Medicare Advantage plan in your area with better supplemental benefits such as vision, hearing, dental, transportation coverage, or meal delivery.
  8. Your Medicare Advantage (MAPD) plan no longer includes your neighborhood pharmacy within the plan’s pharmacy network, or your chosen pharmacy is no longer a preferred network pharmacy and you are paying a higher cost for your formulary medications because your pharmacy is a standard network pharmacy.
  9. Your Medicare Advantage (MAPD) plan’s drug formulary no longer covers all of your medications.

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