Find the right Medicare plan!
Learning Center / Medicare / Medicare Advantage Open Enrollment Period
Medicare
·
Enrollment

Medicare Advantage Open Enrollment Period

November 21, 2023

Medicare Advantage Open Enrollment Period

For anyone over 65, the Medicare Advantage program offers complete healthcare coverage. The Advantage Plan is a private insurance company-managed health insurance option to traditional Medicare plans. Medicare Advantage (Medicare Part C) beneficiaries are covered for medical services such as doctor visits, hospital stays, and prescription medications. Every year, during the Medicare Advantage Open Enrollment Period (MA-OEP), Medicare Advantage participants can modify their health insurance coverage.


 

What is the Medicare Advantage Open Enrollment Period?


 

The MA-OEP allows individuals enrolled in Medicare Advantage plans to do the following:

  1. Change Medicare Advantage Plans: If both Medicare Advantage plans are offered in a person's location, they can change from one to the other.
  2. Return to Original Medicare After Dropping a Medicare Advantage Plan: Individuals have the option of dropping their Medicare Advantage plan and switching back to Original Medicare, Parts A, and B, with or without a Part D prescription drug plan. Additionally, a Medicare Supplement (Medigap) policy may be added.


 

When does the Medicare Advantage Open Enrollment Period take place?

The MA-OEP occurs from January 1 to March 31 every year. You can change plans during the MA-OEP if you're a current member of a Medicare Advantage plan and choose to do so. This may include switching between different insurance companies or plans within the same insurance company in your area.


 

If you miss the deadline for the MA-OEP, you might not have another chance to modify your Medicare Advantage plan until the next enrollment season. Eligible enrollees should keep track of the open enrollment windows and closing dates to ensure they don't lose the chance to modify their coverage.


 

Can I change Medicare Advantage plans anytime during the year?

The Medicare Advantage Open Enrollment Period and the Annual Election Period (AEP) are when most Medicare beneficiaries can make changes to their Medicare Advantage plans. However, some exceptions allow changes to be made outside of these enrollment periods.


 

Here are the circumstances that may allow you to change Medicare Advantage plans outside of the MA-OEP and AEP:

  1. Special Enrollment Period (SEP): Certain life events, such as moving to a new location, losing other healthcare coverage, or qualifying for Extra Help with prescription drug costs, may trigger a Special Enrollment Period. During an SEP, you may have the option to switch Advantage plans.
  2. 5-Star Special Enrollment Period: Allows you to switch to a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star rating if one is available in your area. The 5 Star Special Enrollment Period is only available to you once between December 8 and November 30 the following year.

 

It's important to note that these exceptions to the Medicare Advantage Open Enrollment Period may have specific eligibility criteria and time limitations. Furthermore, not all circumstances may apply to everyone.


 

How do I enroll in Medicare Advantage coverage?
 

If you want to enroll in Medicare Advantage, you can follow these steps:

Determine your eligibility: You're eligible for Medicare Advantage if you meet the following criteria:

  • You're enrolled in Medicare Part A, hospital insurance, and Part B, medical insurance.
  • You live in the service area of the Medicare Advantage plan you want.
  • You do not have End-Stage Renal Disease (ESRD) with some exceptions.

 

Understand the available plans: Research and compare the Medicare Advantage plans available in your area. Consider coverage, premiums, deductibles, copayments, a network of healthcare providers, prescription drug coverage, and additional benefits like vision or dental care.

Enroll during the appropriate enrollment period:

  • Initial Enrollment Period (IEP): This is the seven-month period around your 65th birthday month. It includes the three months before your birthday, your birthday, and the three months after.
  • Annual Enrollment Period (AEP): This enrollment period occurs from October 15 to December 7 each year. You can switch Medicare Advantage plans or switch between Original Medicare and Medicare Advantage.
  • Special Enrollment Period (SEP): Qualifying life events, as we mentioned above, may grant you an SEP outside of the regular enrollment periods.


What is the difference between open enrollment and annual enrollment?

Here we've listed the key differences between the Medicare Advantage Open Enrollment Period and the Annual Enrollment Period:


Open Enrollment Period:

  • Applies to Medicare Advantage plans.
  • Occurs every year from January 1 to March 31.
  • Allows individuals who are already enrolled in an Advantage plan to make changes to their coverage.
  • During the OEP, you can switch from one Medicare Advantage plan to another or return to Original Medicare (Part A and Part B) with or without a standalone Part D prescription drug plan.
  • You may also have the option to add a Medigap policy.


 

Annual Enrollment Period:

  • Applies to Medicare Part D prescription drug plans and Advantage plans.
  • Occurs every year from October 15 to December 7.
  • Allows individuals to make changes to their Medicare Part D or Medicare Advantage coverage.
  • During the AEP, you can switch from one Medicare Part D or Medicare Advantage plan to another.
  • You can also join a Medicare Part D prescription drug plan if you didn't have one before or switch from Original Medicare to a Medicare Advantage plan, or vice versa.

 

What are the restrictions during MA-OEP?

You cannot enroll in Medicare Advantage for the first time during the MA-OEP if currently enrolled in Original Medicare (Part A and Part B) without a Medicare Advantage plan. The MA-OEP does not allow for switching from Original Medicare to Advantage.


 

Do I need to renew my Medicare Advantage plan during the MA-OEP?

No, you do not need to renew your Advantage plan during the Medicare Advantage Open Enrollment Period. But, during this time it's a good idea to review your current plan and make changes if you need to.


 

Can you be turned down by a Medicare Advantage plan?

img


 

Yes, it's possible to be turned down by a Medicare Advantage plan. Because Advantage plans are offered by private insurance companies, unlike Original Medicare that's available to all eligible individuals, Advantage plans have specific enrollment criteria and can deny coverage in certain situations. You may be turned down by a Medicare Advantage plan due to:

  1. Geographic Location: Advantage plans are offered by private insurance companies, so they only have specific service areas where they offer coverage. If you live outside the plan's service area, you may not be eligible to enroll in that plan.
  2. Enrollment Period: If you attempt to enroll outside of the specific enrollment periods, the plan may deny your application.
  3. Medical Underwriting: Some Medicare Advantage plans, may require you to undergo medical underwriting. This means the insurance company can evaluate your health status and pre-existing conditions before accepting or denying your application. However, most Medicare Advantage plans, including Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans, do not require medical underwriting.
  4. Non-Payment of Premiums: Medicare Advantage plans usually require the payment of monthly premiums. The plan may terminate your coverage if you fail to pay the premiums.

If an Advantage plan provider rejects you, you still have the choice to sign up for Original Medicare and receive the necessary healthcare coverage. You can also explore other Advantage plan options and find a plan that meets your needs.

 

Understanding the Medicare Advantage Open Enrollment Period is essential in making the best decisions for your health care coverage. Through our user-friendly web platform, discover the convenience of comparing Medicare plans straight from the comfort of your own home. Visit our website today to access a comprehensive selection of Medicare plans and easily compare their attributes, advantages, and prices. Empower yourself with the knowledge needed to feel confident about your healthcare coverage.

 

Don't hesitate to call us to speak with a licensed insurance agent at 1-800-620-4519 (TTY 711), available weekdays from 8 a.m. to 8 p.m EST. We'll assist you in taking the time to make the choice that's best for you because your health coverage shouldn't be taken lightly.



 

© 2021-2024 HealthInsurance.com, LLC

Privacy Policy  |  Terms and Conditions

GENERAL DISCLAIMERS

Healthinsurance.com is a commercial site designed for the solicitation of insurance from selected health insurance carriers and HealthInsurance.com, LLC is a licensed insurance agency. It is not a government agency. It is also not an insurer, or a medical provider. HealthInsurance.com, LLC is a licensed representative of Medicare Advantage (HMO, PPO, PFFS, and PDP) organizations that have a Medicare contract. Enrollment depends on the plan’s contract renewal.

We do not offer every plan available in your area. Currently we represent nine carrier plan organizations nationally. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Alternatively, you may be referred, via a link, to a selected partner website, which is independently owned and operated and may have different privacy and terms of use policies from us.

If you provide your contact information to us, an insurance agent/producer or insurance company may contact you. If you do not speak English, language assistance service, free of charge, is available to you; contact the toll-free number listed above. This site is not maintained by or affiliated with the federal government's Health Insurance Marketplace website or any state government health insurance marketplace.

The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. To learn more about a plan's nondiscrimination policy, please click here.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.