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Medicare Advantage vs. Medicare Supplement Open Enrollment Period

Medicare Advantage vs. Medicare Supplement Open Enrollment Period

January 01, 2024

Medicare Advantage Open Enrollment has started! It began January 1 and runs through March 31. What does this mean? Let’s look at the options you have:

Medicare Advantage

During this open enrollment period, if you are on a Medicare Advantage plan, you can:

  • Switch to another Medicare Advantage plan (Part C).
  • Move to original Medicare (Parts A and B).
  • If they switch to original Medicare, enroll in a prescription drug plan (Part D).

This open enrollment period applies only if you are enrolled in a Medicare Advantage plan as of Jan. 1. If you’re enrolled in original Medicare, you cannot use this period to move to an Advantage plan; you must wait until the next Medicare open enrollment period that begins  Oct. 15. This period also cannot be used to make changes in your drug plan coverage or a Medigap supplement for those enrolled in original Medicare.

Any changes made during this Medicare Advantage open enrollment period will be in effect for the remainder of 2024. The changes made during this period will be effective as of the first day of the next month. For example, a change made in February will become effective March 1.

Aside from any special situation that may apply during the year, you will need to wait for the Medicare open enrollment period in October to make any changes in your existing Medicare coverage.

Reasons to Consider Changing Medicare Coverage

There may be a number of reasons for you to consider changing your coverage from your current Medicare Advantage plan. These generally revolve around changes in coverage or changes in your personal situation, including:

  • Are your doctors or other providers still in the plan’s network?
  • Has your health situation changed, requiring new or additional doctors and other providers who are not in your current plan’s network?
  • Have your prescription drug needs changed and some of the drugs you need are not covered by your existing plan?
  • Have you moved or plan to spend more time in other parts of the country and your current plan’s coverage in these locations is limited?
  • Has your current plans costs increased, including premiums, deductibles, copays, coinsurance and other costs?
  • Does a new plan offer additional benefits such as fitness programs, online pharmacy options, wellness programs and others? Would you be happy with these options if offered? If not offered, do you want a plan that offers these types of additional benefits?

Switching to Another Medicare Advantage Plan

It’s important for you to review your Medicare Advantage plans every new year. What, if anything, will be changing for 2024? This might include an increase in premiums or any number of changes in providers or coverage.

Or, you might have enrolled in a Medicare Advantage plan during the annual Medicare open enrollment period that ended in December and have realized that you made a mistake. 

Medicare Supplement (Medigap)

This one-time-only, six-month period is when federal law allows you to buy a Medicare supplement policy sold in your state. To be eligible for this Open Enrollment option, you must:

  • Be at least 64½ years of age (in most states)
  • Be within six months of your enrollment in Medicare Part B.
  • If covered under Medicare Part B prior to age 65, you are eligible for a six-month Open Enrollment period prior to reaching age 65.

Coverage will be effective between the age of 64 ½ and 65 – the first of the month you turn age 65.

Switching to Medicare and a Medicare Supplement Plan

Switching to Medicare and a Medicare Supplement (Medigap) plan could be a great option if you are on an Advantage plan. Original Medicare does not have any network or geographical restrictions. While not every doctor or provider will take only what Medicare pays, many do. And, if your provider accepts Medicare, they will also accept your Medicare Supplement plan.

Unlike an Advantage plan, original Medicare does not offer coverage beyond Parts A and B; and these can be very costly. This is where your Medicare Supplement comes in – picking up what Medicare doesn’t cover.

If you do switch to original Medicare and add a Supplement, you will need to add prescription drug coverage plan, called Part D. Failure to do so in a timely fashion could result in penalties that could be permanent.

One issue with securing Medigap coverage could arise if you have health issues. New Medicare enrollees cannot be denied this coverage during Medigap open enrollment, which is a period starting the first month you have Medicare Part B coverage and are age 65 or older and extends for six months. After this initial period, Medigap issuers can deny coverage or charge higher rates based on your health situation.

Original Medicare and Medicare Supplement plans do not offer coverage in a number of areas including vision, dental and hearing services. If you move to original Medicare and a Supplement, from an Advantage plan, you will need to consider obtaining coverage for routine dental vision and other non-covered services. Original Medicare may cover some services in these areas, but only if they are deemed to be medically necessary.

And don’t forget – you can pay these premiums through your health savings account, if you have one, from your pre-Medicare days.

Medical costs can comprise a significant expense in retirement, and Medicare is an important benefit for this reason. Failure to enroll at the proper time can result in costly penalties. In some cases, these penalties are a permanent additional cost. 

For more information on the enrollment periods for Medicare Advantage and Medicare Supplements, be contact me or schedule a complimentary meeting for us to discuss and review your options.

 

*Note that Medicare supplement Plans C and F (including High Deductible F) are not available to Medicare beneficiaries who became Medicare-eligible on and after January 1, 2020.