This article “Medicare Advantage Open Enrollment 2020” will explain to you what it is and what you can do during it if you are a Medicare beneficiary.
First, let’s get a few things straight! Don’t confuse the Medicare Advantage Open Enrolment 2020 (MA-OEP) with the Annual Open Enrollment Period (AEP). I know that sounds confusing and I have no idea why they named them like this but a lot of people are confused by this.
The Annual Open Enrollment Period (AEP) is every year from Oct 15 to Dec 7. During this time you can do basically anything regarding plan selection or changes if you have Medicare. Some restrictions apply and you can read all about the AEP by clicking here after you finish this article.
Who can use the MA-OEP
MA-OEP applies to people who are enrolled in a Medicare Advantage Plan or also know as Part C. This would be for example an HMO or PPO plan, which are the most common Advantage Plans.
What can you do during MA-OEP?
If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage) from Jan 1 to March 31 during the Medicare Advantage Open Enrollment Period. Your new coverage will start on the following month on the 1st.
You can also drop your Medicare Advantage Plan and return to Original Medicare. You’ll be able to join a stand-alone Prescription Drug Plan (Part D).
What can you NOT do during MA-OEP?
If you use Original Medicare and not an Advantage plan you can NOT make any changes during this period. This is only for people who are on an Advantage plan.
You can NOT switch from Original Medicare to a Medicare Advantage Plan. You can NOT join a Prescription plan (Part D) if you have Original Medicare. You can NOT switch between Prescription drug plans if you don’t like yours.
Why would I use the MA-OEP to change my plan?
Here are several examples of why someone would use the MA-OEP to switch plans.
You wrongly enrolled in a plan that does not have drug coverage but you wanted one with drug coverage.
Another MA plan in your area provides more affordable overall coverage with a lower maximum out-of-pocket limit (MOOP).
A Special Needs Medicare Advantage Plan (SNP) is available in your area and provides benefits tailored specifically to your health needs, chronic condition, Long Term Care (LTC) residence, or financial status.
Your doctor or specialists have moved to another healthcare network and they are no longer available in your plan.
You found another Medicare Advantage plan in your area with better supplemental benefits such as vision and dental coverage.
Your Medicare Advantage plan’s drug formulary no longer covers all of your medications.
Those are some of the most common reasons why someone who has a Medicare Advantage plan would use the Medicare Advantage Open Enrollment 2020 to make changes.
What do you need to consider?
Can I change my Medicare Advantage plan enrollment to any plan?
Not necessarily. Each Medicare Advantage plan has the option of closing enrollment during the Medicare Advantage Open Enrollment 2020 and is not required to allow new plan members to enroll in the plan during the MA OEP.
As noted by the Centers for Medicare and Medicaid Services (CMS), “Unlike the mandatory election periods, any MA organization has the option to voluntarily close one or more of its MA plans to enrollment requests during the Medicare Advantage Open Enrollment Period. If an MA plan is closed for enrollments, then it is closed to all individuals.
Reminder about the timing
When you disenroll from your Medicare Advantage plan, the dis-enrollment begins the first day of the next month after dis-enrollment.
For example, if you disenroll from your Medicare Advantage plan on February 10th, your Original Medicare Part A and Part B coverage begin on March 1st. At the same time, you can also join a stand-alone Medicare Part D prescription drug plan and your new Medicare prescription drug plan will also start on March 1st.
Automatic SSA premium deductions
If you dropped or changed your plan during the Medicare Advantage Open Enrollment 2020 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.