Medicare Advantage Open Enrollment Period: What you need to know

If you have a Medicare Advantage (MA) plan and want to make a change, the MA Open Enrollment Period (OEP) provides you with a window of opportunity to do so. Here’s what you need to know:

OEP: The basics

MA OEP runs from Jan. 1 to March 31 each year and gives MA members a chance to switch from their current coverage to another MA plan or to return to Original Medicare coverage.

Reasons to change

The most common reason to switch plans is for the provider network. MA plans usually require members to use a doctor in their network. If a physician leaves a plan’s network, members may decide to change plans to keep seeing their doctor.

Can I change my Part D prescription drug plan during OEP, too?

If you decide to switch from a MA plan back to Original Medicare during OEP and lose your drug coverage as a result, you can switch to a different Part D prescription coverage plan at the same time.

Otherwise, all other changes to your Part D plan will have to wait until the annual enrollment period in the fall, unless other events trigger a special enrollment period.

What is a special enrollment period?

A special enrollment period occurs if you lose creditable coverage, which is coverage that meets a minimum set of qualifications set by the Centers for Medicare & Medicaid Services.

Examples of a loss in creditable coverage include:
• Moving outside of your plan’s coverage area
• Losing your current coverage involuntarily
• And other special situations, according to Medicare.gov.

How to avoid a disruption in your coverage

It’s important to remember that any change in coverage made during OEP will start the month following your change request. For example, if you change plans in February, your new coverage will begin March 1.

Make sure you keep your old plan for the remainder of the month in which you make the change. This will prevent a disruption in coverage.

Talk to the experts

If you decide to make a change during OEP, it’s smart to work with a Medicare-certified insurance broker who can provide all of the relevant information you need to consider.

Additionally, a broker can help you determine if you are eligible for other coverage. They can also help you decide which plan best meets your current and expected needs.

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