2020 Medicare Advantage Open Enrollment
What to Know About 2020 Medicare Advantage Open Enrollment
By Lindsay Engle, Medicare Expert, MedicareFAQ
If you have a Medicare Advantage plan, you now have a one-time chance to change your coverage. During the Medicare Advantage Open Enrollment Period, you can sign up for a different Medicare Advantage plan. Or, you can enroll in traditional Medicare Parts A and B, as well as a Medicare Part D prescription drug plan.
Open enrollment only applies to people who are currently in a Medicare Advantage plan. Medicare Advantage is also known as Medicare Part C. If you have traditional Medicare, you can’t change coverage during this time.
To get the most out of Open Enrollment, it helps to understand the differences between Original Medicare and Medicare Advantage and to be aware of other Medicare dates.
Original Medicare vs. Medicare Advantage
Original Medicare consists of Part A, which covers hospitalization, and Part B, which applies to other medical expenses. Medicare Part D provides prescription drug coverage to people with Original Medicare. There are also supplemental Medicare policies, known as “Medigap,” that cover out-of-pocket costs that aren’t paid by Medicare.
Medicare Advantage plans are a private insurance alternative to Original Medicare. By law, Medicare Advantage plans must cover the same services as Original Medicare. However, the insurance companies that sell Medicare Advantage plans can establish their own premiums, out of pocket costs, and provider networks.
Medicare Advantage plans often offer “one-stop shopping,” with prescription, vision, dental, and hearing coverage included. You can still obtain this coverage if you enroll in Original Medicare, but you must buy it separately.
Reasons to Switch during Open Enrollment
During the Medicare Annual Election Period from October 15th to December 7th, insurance companies heavily promote their Medicare Advantage plans on TV and in newspaper ads. But Medicare coverage is much more complicated than it sounds. It’s easy to get lured in by low premiums and then feel overwhelmed by the details. Many people discover after signing up that the plan they chose doesn’t work for them. There can be several reasons for this.
First, Medicare Advantage plans have provider networks, and the doctors you’ve seen for years may not be part of your plan’s network. To keep seeing those providers, you’ll have to pay more out of pocket. Some providers may not be covered at all. In contrast, Original Medicare lets you see any doctor who accepts Medicare.
Second, the out of pocket costs may be higher than you thought they would be. While Original Medicare and Medigap plans have standardized deductibles, copays, and coinsurance, Medicare Advantage plans do not. Individual insurance companies establish these amounts for each plan, and some people discover they can’t afford the deductibles or copays.
Third, it’s easy to gloss over prescription coverage when choosing a plan. Every prescription plan has a schedule of drugs that it covers. If your essential medications are too expensive, you may be better off with different coverage.
And finally, problems have been reported with Medicare’s online Plan Finder this year, especially when it comes to drug pricing. The government believes these issues may have led people to purchase plans that aren’t right for them.
Medicare Advantage plans lock you in for a year. Lawmakers established the Medicare Advantage open enrollment period to prevent people from being stuck in a Medicare plan they don’t want.
Changes You Can—And Can’t—Make During Open Enrollment
During Medicare Advantage Open Enrollment Period, there are only two types of changes you can make to your Medicare coverage.
- You can switch from your current Medicare Advantage plan to a different one. You can enroll in a new plan with or without prescription coverage, regardless of whether you have a prescription benefit now.
- You can also opt-out of Medicare Advantage altogether and enroll in traditional Medicare. If you do this, you can add a Medicare Part D prescription drug plan. You can also join a Medigap plan, but your costs and eligibility may depend on your health.
During the open enrollment period, you are allowed to change plans only once. You cannot, for example, switch to a new Medicare Advantage plan and then decide to change to Original Medicare.
Open enrollment is only for people who currently have Medicare Advantage plans. If you have Original Medicare, you cannot make changes during open enrollment. For example, you cannot switch to Medicare Advantage, change prescription plans, or sign up for prescription coverage for the first time. You will need to wait until the next fall annual election period.
Other Opportunities to Change Your Medicare Advantage Coverage
You can also change your Medicare coverage during the Medicare Annual Election Period, which runs from October 15 to December 7 each year. The fall Annual Election Period allows more changes than the Medicare Advantage Open Enrollment period. You can switch from Original Medicare to Medicare Advantage, or vice versa, change prescription plans, add a prescription plan, change Medicare Advantage plans.
If you are new to Medicare and sign up for Medicare Advantage during your initial enrollment period (usually around the time you turn 65), you have another chance to change your mind. During your first three months on Medicare, you can switch to a different Medicare Advantage plan or go back to Original Medicare.
Changing Plans—Things to Think About
If you are thinking of changing your Medicare Advantage coverage, it pays to do your homework. Remember, any changes made during the open enrollment period are locked in for the rest of the year.
When comparing plans, it pays to talk to a knowledgeable agent who works with many insurance companies, rather than an agent who only sells one company’s policies. At MedicareFAQ, for example, our agents are trained to evaluate our clients’ needs and help them find plans with the best coverage at the lowest overall cost.
If you’re looking at Medicare Advantage plans, consider whether your doctors and preferred hospital are in the plan’s network. Find out what you will pay if you use someone out of the network. Find out whether your prescriptions are covered and how much you will pay for them out-of-pocket. Make sure you can afford the deductible, copays, and coinsurance.
Unfortunately, Medicare is confusing, and it’s easy to end up in a plan with unintended results. If you’re in that situation with a Medicare Advantage plan, open enrollment is a chance to set things right.
Lindsay Engle is a Medicare expert at MedicareFAQ. She loves sharing her expertise and knowledge with those who are looking to learn more about Medicare. Her goal is to make sure Medicare beneficiaries are given the right resources to become educated on all their Medicare options.
