The Medicare Open Enrollment Period is one of several Medicare enrollment periods. Because there are other enrollment periods with similar names and purposes, many people are confused about exactly what this period is for and when it occurs. Most people refer to the Annual Election Period as the Medicare Open Enrollment Period. However, this isn’t quite accurate.
The Annual Election Period occurs in the fall from October 15th through December 7th. During this annual enrollment period, Medicare beneficiaries can enroll in, change, or drop both Medicare Advantage and/or Part D plans. While the Medicare Open Enrollment Period is similar, it is separate from the Annual Election Period.
When is the Medicare Open Enrollment Period, and what is it for?
The Medicare Open Enrollment Period occurs during the first part of the year from January 1st through March 31st. During this period, Medicare beneficiaries who are enrolled in a Medicare Advantage plan have the option to change Medicare Advantage plans or drop their plan and enroll in a stand-alone Part D plan and Original Medicare.
As you can see, the Medicare Open Enrollment Period is slightly different than the Annual Election Period. Anyone with Medicare can make changes during the Annual Election Period. However, during the Medicare Open Enrollment Period, you must already have a Medicare Advantage plan to do anything during that time.
Who should use the Medicare Open Enrollment Period?
As stated above, a beneficiary must already be enrolled in a Medicare Advantage plan to do anything during the Medicare Open Enrollment Period, but why might someone need this special period? The Annual Election Period happens right before the Open Enrollment Period, so the Open Enrollment Period is sort of like a chance to undo what you did last fall.
For instance, if someone enrolled in a new Medicare Advantage plan during the Annual Election Period, and then in January, he goes to his first doctor appointment of the year and finds out they coverage isn’t what he expected, then he can change back to his old Medicare Advantage plan or find a new one during the Medicare Open Enrollment Period.
Another example of someone who might need the Open Enrollment period is someone who missed the Annual Election Period and needs to change plans or wants to switch to Original Medicare. They now have a second chance to make these changes.
Who shouldn’t use the Medicare Open Enrollment Period?
An example of someone who can’t use the Open Enrollment Period is someone who is enrolling in Medicare for the first time later in the year. If you become eligible for Medicare in August 2021, the Medicare Open Enrollment Period in 2021 has nothing to do with you. You will use your own special enrollment period to enroll in your Medicare parts and plans.
Other people who won’t find much use out of the Open Enrollment Period are people who want a free pass into a Medigap plan. While you can drop your Medicare Advantage plan and switch to Original Medicare during this time, it doesn’t give you the right to a guaranteed issue Medigap plan.
You can apply for a Medigap plan anytime throughout the year as long as you can drop your Medicare Advantage plan (if you have one). However, you will likely have to answer health questions if you aren’t within your six-month open enrollment window for Medigap.
So, while the Medicare Open Enrollment Period is helpful to many, it isn’t needed for everyone. If you fail to make changes to your plans before March 31st, you will have to wait until the Annual Election Period for another chance. So, don’t miss your chance.