What is the 2021 Medicare Advantage Open Enrollment Period (MA OEP)
2021 Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1 – March 31. During this time, if you have an Advantage plan (Part C), you can make a one-time change to another Advantage plan or you can go back to Original Medicare.
What changes can I make during the Medicare Advantage Open Enrollment Period (MA OEP)?
- If you already have a Medicare Advantage plan, you can switch to a different Medicare Advantage plan.
- You can drop your Medicare Advantage and return to Original Medicare, and then sign up for a stand-alone Medicare Part D prescription drug plan.
- You generally can’t make other coverage changes during this period. For example, if you have traditional Medicare, Part A, and Part B, you typically can’t sign up for a Medicare prescription drug plan or a Medicare Advantage plan
Why would I want to change my plan?
There is a lot of reasons people switch plans or go back to Original Medicare during this time. Here is a few:
- You were misinformed by the salesperson on all the restrictions that come with an Advantage plan.
- You found out that your doctor or hospital is not in the network.
- You found another Advantage plan in your area with much richer benefits.
- You want to go back to Original Medicare so that you can go to any doctor or medical facility anywhere in the US that accepts Medicare.
These are just a few reasons but they are the most common ones I see. If you don’t like something about your plan, this is the time to change it. If you don’t change it before the end of March, you will be stuck with it until Jan 1st of next year. You might qualify for a Special Enrollment Period (SEP) but you have to have certain life events happen, you can’t use that just because you don’t like your plan.
What if I miss my MA-OEP?
If you don’t make a change before the end of March, you might still qualify for a Special Enrollment Period (SEP). Here are a few examples of reasons that would qualify you for a SEP:
You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.
You change where you live
- I moved to a new address that isn’t in my plan’s service area.
- I moved to a new address that’s still in my plan’s service area, but I have new plan options in my new location.
- I moved back to the U.S. after living outside the country.
- I just moved into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital).
- I’m released from jail.
You lose your current coverage
- I’m no longer eligible for Medicaid.
- I left coverage from my employer or union (including COBRA coverage).
- I involuntarily lose other drug coverage that’s as good as Medicare drug coverage (creditable coverage), or my other coverage changes and is no longer creditable.
- I had drug coverage through a Medicare Cost Plan and I left the plan.
- I dropped my coverage in a Program of All-inclusive Care for the Elderly (PACE) plan.
You have a chance to get other coverage
- I have a chance to enroll in other coverage offered by my employer or union.
- I have or am enrolling in other drug coverage as good as Medicare prescription drug coverage (like TRICARE or VA coverage).
- I enrolled in a Program of All-inclusive Care for the Elderly (PACE) plan.
Your plan changes its contract with Medicare
- Medicare takes an official action (called a “sanction”) because of a problem with the plan that affects me.
- Medicare ends (terminates) my plan’s contract.
- My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare isn’t renewed.
Other special situations
- I’m eligible for both Medicare and Medicaid.
- I qualify for Extra Help paying for Medicare prescription drug coverage.
- I’m enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility.
- I dropped a Medigap policy the first time I joined a Medicare Advantage Plan.
- I have a severe or disabling condition, and there’s a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with my condition.
- I’m enrolled in a Special Needs Plan (SNP) and no longer have a condition that qualifies as a special need that the plan serves.expandI joined a plan, or chose not to join a plan, due to an error by a federal employee.
- I wasn’t properly told that my other private drug coverage wasn’t as good as Medicare drug coverage (creditable coverage).expandI wasn’t properly told that I was losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).
What if I don't qualify for a SEP?
If you don’t qualify for a Special Enrollment Period (SEP) after the 2021 Medicare Advantage Open Enrollment Period (MA OEP) ends, your next time to make a change will be the Annual Enrollment Period (AEP) which will start on Oct 15 and ends Dec 7. Whatever you select during the Annual Enrolment Period will start the following Jan 1st.
Just a two more items to remember...
- If you switch plans, the new plan will start at the beginning of the next month.
Social Security will probably need a little time adjusting your deductions if you decide to use the MA-OEP. If you dropped or changed your Advantage plan during the MA-OEP and joined another MA plan or Part D plan, you may still see payments for your old MA plan deducted in February and maybe even March. Any over-payments will be reversed for your newly chosen MA or Part D plan.