Medicare Fall Open Enrollment

Medicare Fall Open Enrollment can be a very confusing time and you may feel a lot of pressure to do something about your current Medicare plan or even revisit your current Medicare options. Even if you are happy and feel like everything is working out well, all of the advertising and notices may still make you feel uncertain about whether or not you should make changes. Today, we are going to end all of the stress and confusion once and for all. We are going to answer all of your questions about Medicare Fall Open Enrollment. Get ready! 

When is Medicare Fall Open Enrollment?

Every fall, Medicare has an annual enrollment period. This time is between October 15 and December 7.

What is Medicare Fall Open Enrollment?

It is a period of time where you can make changes to your Medicare Advantage and Medicare Part D drug plans. 

Why is there a Medicare Fall Open Enrollment?

Every year there are changes in the Medicare Advantage and Medicare Plan D drug plans. This gives everyone with these plans the opportunity to change their plan if they do not like the changes in their coverage. 

Does the Medicare Fall Open Enrollment Apply to Medigap Plans?

No. Medigap works differently. You may change your Medigap plan at any time. However, you may have to deal with underwriting and your acceptance may not be guaranteed. 

Should I Change My Plan During Medicare Fall Open Enrollment?

If you are happy with any changes to your Medicare Advantage or Medicare Plan D drug plans, you do not have to make a change. 

If you are unsure if you should make a change, start with your Annual Notice of Change (ANoC). This is a document that you will receive in the mail in late September. This document will tell you about all of the changes that will affect your coverage through your Medicare Advantage or Medicare Plan D drug plan. 

You will see all of the changes listed in a clear side by side format so that you can compare the two during Medicare Fall Open Enrollment. 

What Are My Choices During Medicare Fall Open Enrollment?

You have several different choices to make during the open enrollment period. You should understand that if you simply do nothing, your Medicare coverage will renew and continue automatically into the New Year. By doing nothing, you are accepting your Medicare Advantage Plan and Plan D drug plan for another year with the announced changes outlined in your Annual Notice of Change. 

• If you have traditional Medicare coverage, you can change to Medicare Advantage, and if you have a Medicare Advantage Plan, you can change to traditional Medicare. 
• If you have Medicare Advantage, you may change from one Advantage plan to another Advantage plan. 
• If you do not have a Medicare Part D drug plan, you may enroll in one. You can also leave or change your Medicare Part D drug plan during the open enrollment period.

You should keep in mind that when you change your Plan D or Medicare Advantage Plan, there are no medical questions to answer. Your current health conditions should not be of any concern when deciding whether or not to switch plans. 

Reasons to Change Your Medicare Advantage Plan

When you are shopping for Medicare Advantage Plans during Medicare Fall Open Enrollment Period, there are some common reasons that people should and do make a change. Here are some reasons you should be looking for another Advantage plan: 

Your plan will no longer cover a needed medication. The Annual Notice of Change that you receive will tell you specifically any medications that will no longer be covered. If one of your medications is on the cutting block, you need to find a new plan or you will find yourself needing to pay for that specific medication out of pocket. 

Your doctor is being dropped from the network. If your doctor is no longer in your plan’s network, your visits won’t be covered. You will need to change to a network that your doctor participates in or you will need to change doctors.

You can no longer afford your copays. The copays on most plans may change each year, and if it is just a dollar or two, it probably is not enough of a reason to leave a plan during Fall Open Enrollment that meets your needs. However, if the increase is so much that you won’t be able to pay those costs, then you need to change plans. 

You shouldn’t feel like you have to change plans as long as your plans are working for you. If your plans make changes that leave you unhappy, you should contact your agent and they can help you shop for a plan that will better suit your needs.

What is Changing to Medicare Advantage in 2022?

Supplemental home health benefits, which include things like adult day care services, meal delivery, transportation and appointments, are not covered by Original Medicare. Some Medicare Advantage Plans do now include these benefits. If this is something important to you, make sure you are looking for these benefits in your new Medicare Advantage Plan during the Fall Open Enrollment.

What is Changing in Medicare Plan D Drug Plans in 2022?

Because of a new Medicare savings program, the co-pay, with participating plans, for insulin is capped at $35 dollars whether a patient has met their plan deductible or not. Note that not every company is required to put this cap on every type of insulin. Make sure you check whether or not your specific insulin is covered before you choose a plan. 

What is Changing in Medigap Coverage in 2022?

The great thing about Medigap plans is that your benefits never change because the plans are standardized. Rates may change, and each year when your plan renews, you will get a letter telling you about an increase. This has nothing to do with the Medicare Advantage open enrollment period. 

Should I Change My Medigap Plan During the Open Enrollment Period? 

There is no real advantage to shopping for your Medigap insurance at this time except that you are killing two birds with one stone by shopping both your Plan D and your Medigap at the same time. If that sounds or feels overwhelming, just call your broker and they will be able to simplify everything and help walk you through the process. 

Open Enrollment Does NOT Protect You from Underwriting

You should always keep in mind that the only time you are protected from underwriting and have guaranteed acceptance into a Medigap Plan is during your 6-month Medigap Open Enrollment Period. This has nothing to do with the Medicare Advantage Open Enrollment Period. The Medicare Open Enrollment Period for Medicare Advantage and Plan D drug plans does NOT protect you from medical underwriting or invasive medical questions that may disqualify you from coverage. 

Do You Need Help During Medicare Open Enrollment?

If you would like help finding the right plan for you or understanding how making changes could impact your coverage, schedule an appointment with your agent and they can show you all of your options.