What to Expect During Medicare Annual Enrollment Period (AEP)

More than 63 million Americans are eligible for the federal government’s health insurance program, Medicare. These include:

• People who are age 65 or older
• Certain younger people who have permanent disabilities
• People who have End-Stage Renal Disease

While you can initially enroll in Medicare within 3 months before or after the month of your 65th birthday, the fall Medicare Annual Enrollment Period (AEP) may enable you to make changes to your current Medicare plan. Medicare’s fall enrollment period began October 15 and lasts through December 7, 2021.

During this time, you may be contemplating your current Medicare healthcare coverage and whether or not you should adjust it. Here’s what to consider during the Medicare AEP.

What Is Medicare AEP?

AEP is a 7-week time frame where Medicare plan holders can make changes to their existing plan without a penalty. First, it helps to understand Medicare basics so you know what’s available with Medicare.

Medicare Basics

There are two main ways to get Medicare coverage: through Original Medicare or through Medicare Advantage. Original Medicare includes both Medicare Part A and Medicare Part B, explained further below.

Medicare coverage falls into several different categories. These include:

• Medicare Part A: Part A is hospital insurance. You typically aren’t billed a monthly premium for your Part A coverage if you or your spouse contributed Medicare taxes while employed for a specific amount of time. If you aren’t eligible for premium-free Part A coverage, you can purchase it. Part A covers:

o Inpatient hospital stays

o Care in a skilled nursing facility

o Hospice care

o Some home healthcare

• Medicare Part B: Part B is medical insurance. Most people pay a monthly premium for Part B, which covers:

o Certain doctors’ services

o Outpatient care

o Medical supplies

o Preventive services

• Medicare Part D: Part D is prescription drug coverage offered by private insurers, sometimes called a prescription drug plan (PDP). You can also get a Part D plan as part of a Medicare bundle through a Medicare Advantage Plan (called a MAPD), or purchase it as a separate plan with Original Medicare coverage with Part A and Part B. Part D helps cover the cost of:

o Prescription drugs

o Various recommended shots

o Various recommended vaccines

Finally, a Medicare Part C plan is also known as a Medicare Advantage Plan. Medicare Advantage Plans function similarly to a health maintenance organization (HMO) or preferred provider organization (PPO). It’s a Medicare health plan choice that’s offered by private companies Medicare has approved.

Medicare Advantage Plans include all Part A and Part B coverage and typically include Part D coverage, too. These plans may also provide extra coverage for healthcare needs like:

• Vision
• Hearing
• Dental
• Health and wellness

While Medicare will pay a fixed amount for care to the company you get a Medicare Advantage Plan from, you typically will need to pay certain out-of-pocket costs for the extra coverage. There may also be different rules regarding the services you can get and which providers you can get them from.

What Medicare Changes Can You Make During AEP?

During AEP, you can add or change coverage related to your Medicare Advantage Plan or your Medicare Part D plan. You can add, drop or switch those parts of your coverage. Comparing your options could help you save money or help you get better preventive coverage that helps protect your health.

It’s helpful to do research on plan changes, since you may be using a new prescription drug or you may be interested in changing medications. Typically, formulary and drug tiers may change with carriers every AEP.

During the AEP, you can make as many of the following changes to your plan as you’d like before the December 7 deadline, as many times as you want. Whatever changes you end up with will go into effect on January 1, 2022. The changes you’re able to make during the AEP include:

• Change your Medicare Advantage Plan to a different one
• Drop a Medicare Advantage Plan and return to Original Medicare
• Change your Original Medicare plan to a Medicare Advantage Plan
• Change a Medicare Part D plan to a different one
• Cancel a Medicare Part D plan
• Add a Medicare Part D plan if you don’t currently have one

If you’re new to Medicare altogether, and your eligibility period comes up during the AEP period, don’t feel rushed by the December 7 deadline. You’re eligible to apply for Medicare 3 months before the month of your 65th birthday, during the month of your 65th birthday and within 3 months after the month you turn age 65.

Also, if you never signed up for Medicare when you were eligible or during a special enrollment period, there’s a general enrollment period for Medicare from January 1 through March 31. Your Medicare Part B benefits will not begin until July 1.

With the various deadlines to keep track of, it may help to talk with an Arizona Medicare insurance agent so you know what you’re eligible for and when your deadlines are. If you’re perfectly happy with your current plan, you don’t have to do anything to keep it into 2022 and beyond.

What Should You Expect from Your Current Carrier?

If you’re currently enrolled in a Medicare Advantage Plan or a Part D plan, your carrier should send you a packet, called an annual notice of change (ANOC), explaining Medicare changes in costs and coverage for the upcoming year. You should have received this information by September 30.

If you didn’t, contact your carrier to obtain this information. It should include:

• Adjustments to monthly premiums
• Changes to copays and deductibles
• Information on coinsurance or maximum out-of-pocket limit changes
• Adjustments to drug coverage

If you do decide to change your coverage, add Part D coverage, etc., you may also have changes to your Medicare card. You may get a new type of plan card if you add Part D coverage or supplemental coverage, which you’ll want to carry with you or keep in a safe place.

Reasons to Change a Medicare Plan

If you currently have Medicare, use the AEP to consider your options. You may benefit from making a change to your plan if:

• Your prescriptions are no longer on your plan’s formulary or they’ve become more expensive.
• Your preferred doctors are no longer in-network.
• You could save money on a different plan, based on your health needs.
• You may be able to get extra benefits you need, like dental, hearing or vision coverage.

You have the AEP to research your options and make changes penalty-free. Talk with your carrier or other Medicare brokers to compare your options and find the best Medicare plan.

Helpful Medicare Resources

Whether you’re new to Medicare or you’re thinking about making a change to your plan during the AEP, there are resources that can help.

Every year, the U.S. government publishes a Medicare handbook. You can download the Medicare & You 2022 handbook here. You can also access it by logging into your Medicare account.

The handbook has lots of helpful information that explains which type of Medicare plan may work best for you. You can also preview 2022 health and prescription drug plans online. This tool enables you to create or access a list of your drugs if you have a Medicare account.

It’s also valuable to get a free Medicare consultation with an Arizona health insurance broker. On the phone, it’s easy to explain your unique health needs and get recommendations for the most cost-effective Medicare plan that protects your health.

Contact AZ Health Insurance Brokers online or at 602.617.4107 for a free Medicare consultation. You can learn about your Medicare Advantage Plan and Part D plan options.