Fall Open Enrollment is the time of year when you can change your Medicare coverage. You can:
- Join a new Medicare Advantage Plan or stand-alone prescription drug plan (Part D) plan
- Switch between Original Medicare with or without a Part D plan and Medicare Advantage
Listed below are six things to keep in mind while you are choosing your Medicare coverage.
1. Fall Open Enrollment occurs each year from October 15 through December 7.
- Any change you make during Fall Open Enrollment will take effect January 1.
- In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Part D plan.
- If you have Medicare Advantage, you can also switch to Original Medicare. To get drug coverage, you should also join a Part D plan.
- Depending on where you live, you may be able to buy a Medigap policy, which helps pay Original Medicare costs. Limitations apply as to who can buy a Medigap and when.
2. Review your current Medicare health and drug coverage. If you are dissatisfied with your coverage for next year, make changes during Fall Open Enrollment.
- If you have Original Medicare, take a look at next year’s Medicare & You handbook to know your Medicare costs and benefits for the upcoming year.
- If you have a Medicare Advantage Plan or a Part D plan, you should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits, and/or rules for the upcoming year.
- Even if you are satisfied with your current Medicare coverage, look at other Medicare options in your area that may better suit your individual needs in the upcoming year. For example, check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Part D could lower their costs by shopping among plans each year. There could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices.
3. Help is out there.
- Use Medicare’s Plan Finder tool if you need help finding Part D plans. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you visit, and your drug costs.
- If you want to join a Medicare Advantage Plan, call 1-800-MEDICARE to find out which plans are in your area. When you receive the list of plans, check the plans’ websites or call them to see which best fits your needs.
- If you research a plan online, also call the plan itself to confirm what you have learned. Make sure the plan includes your doctors and hospitals in its network. Confirm that the plan covers all your drugs, and that your pharmacies are in the preferred network. Write down everything about your conversation, including the date, the representative you spoke to, and any outcomes or next steps. This information may help protect you in case a plan representative gives you misinformation.
- Call or visit the website of your State Health Insurance Assistance Program (SHIP). Your local SHIP can help you understand your Medicare coverage options and navigate any changes.
4. The best way to enroll in a new plan is to call 1-800-MEDICARE.
- Enrolling in a new plan directly through Medicare is the best way to protect yourself if there are problems with enrollment. Write down everything about the conversation when you enroll through Medicare, including the date, the representative you spoke to, and any outcomes or next steps.
- Before you enroll in a new plan, remember to confirm all the details about your new plan with the plan itself.
5. If you are dissatisfied with a Medicare Advantage Plan you choose during Fall Open Enrollment, you can change your plan during the Medicare Advantage Open Enrollment Period (MA OEP).
- The MA OEP occurs each year from January 1 through March 31, with changes taking effect on the first of the month following the month you enroll. During this time, you can switch from one Medicare Advantage Plan to another, or switch from a Medicare Advantage Plan to Original Medicare with or without a Part D prescription drug plan.
6. Understand the difference between Fall Open Enrollment and Open Enrollment for the state or federal Marketplaces.
- The federal Marketplaces (also known as Exchanges) offer annual open enrollment periods for uninsured and underinsured Americans. This enrollment period may overlap with Fall Open Enrollment. The Marketplaces are typically not meant for people with or eligible for Medicare.
- If you have or are eligible for Medicare, you should only use the Fall Open Enrollment Period (October 15 through December 7) to make changes to your Medicare coverage.