Medicare Providers Blog and Resources

Guest Post by Lindsay Malzone Medicare’s Fall Open Enrollment Period, also known as the Annual Enrollment Period (AEP), starts October 15 and ends December 7 each year. This is a chance for beneficiaries to make changes to their current coverage for the following year. If you or a loved one is a Medicare beneficiary, it helps to know a few things before this window begins.  Changes you can make during the open enrollment period Simply put, AEP allows you to enroll, switch, or disenroll from Medicare Part C (Medicare Advantage) and Part D prescription drug plans. Benefits on both types of plan are subject to change annually. As a result, you could pay higher premiums, your doctor may leave your Advantage plan’s network, or your medication could be removed from the drug formulary on either a Part C or Part D plan. These are just a few reasons people switch or drop these plans.  It’s important to understand that this enrollment window does not apply to Original Medicare (Parts A and B) or Medigap. Learn more about the parts of Medicare How to know what changes you want to make Each September, before the start of AEP, beneficiaries get an Annual Notice of Change (ANoC) letter in the mail from their insurance carrier. This letter outlines changes to your current policy for the following year. It explains in full detail changes to your benefits, premiums, and other costs, or to the plan’s service area. Once you get your letter, it’s helpful to contact a licensed agent to go over your policy. Beneficiaries enrolled in an Advantage plan should review their ANoC to ensure that their medications and dosages are still on the drug formulary and their practitioners are still in-network. Members of Advantage plans should also take note of maximum out-of-pocket costs and monthly premiums to make sure they’re still within their price range. View Medicare Advantage Plan Checklist Like Advantage plans, Part D plans inform beneficiaries of changes to their costs and formularies. View Prescription Drug Plan (Part D) Plan Checklist While reviewing your ANoC letter, it’s a good idea to consider any future doctor visits and procedures. This gives you a guesstimate about your potential out-of-pocket costs under your current plan. Keep an eye out for this letter and make sure your coverage will still be sufficient and affordable for the next year. If you don’t receive your ANoC letter by the end of September, contact your provider. Important things to remember The effective date for your new plan will be January 1 of the following year. No matter when you make your changes during AEP, your new coverage will be effective on January 1 of the following year. Your next opportunity to make all the same changes will be this same enrollment period, the following fall.  The last change you make is the one that goes into effect. AEP gives you multiple chances to make changes to your Advantage or Part D coverage; however, the last change you make is the one that will become effective on January 1. You have until the last day of AEP to make your final decision. If you’re unhappy with your advantage plan, you have another chance to change it. It’s important to understand how each enrollment window works. If you’re not pleased with your Advantage plan, you have a three-month window to make changes.    The Medicare Advantage Open Enrollment Period runs from January 1 through March 31. This enrollment period allows you to switch or disenroll from the Medicare Advantage plan you picked up during AEP. Unlike AEP, you can only make changes one time, so it’s important to weigh all your options before this window kicks off. Further, if you’re unhappy with the changes you made during the Medicare Advantage Open Enrollment Period, you’ll need to wait until AEP next year, unless you qualify for a Special Enrollment Period. Keep in mind that if you don’t already have a Medicare Advantage plan, you cannot enroll in a new one during the Medicare Advantage Open Enrollment Period. Stay alert next fall Regardless of whether you make changes to your coverage this year, you should check on your plan and ANoC every year to see if you’ll want to make changes during AEP. To recap, here’s a few things to take into consideration:  Has my doctor been removed from my Advantage plan’s network of providers? Have my plan’s ratings changed?  Do I plan on traveling next year? Are my annual medical costs expected to rise? Will my monthly premiums increase?  Are my prescriptions still listed on my plan’s drug formulary? Before AEP begins, it’s best to understand your health needs, the changes you can make, and how this enrollment window works. If you have more questions about AEP, contact a licensed agent who can walk you through the entire process. Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in Medicare since 2017. She is featured in many publications and has become the expert in the Medicare industry. Her passion is providing Medicare beneficiaries with the resources they need to make an educated decision on their healthcare needs and provide them the opportunity to learn about Medicare in a non-sales environment. You can also find her over on YouTube where she publishes Medicare-related video content regularly.

One of the two Medicare enrollment periods that start the new year is Medicare Advantage Open Enrollment. (The other is the General Enrollment Period.) We've gathered the information you need to know about this enrollment period to help you determine whether or not you can participate and what action you want to take. Key Facts Eligibility: Currently enrolled in a Medicare Advantage planEnrollment Dates: January 1 through March 31 annuallyCoverage Start Date: New coverage starts the first of the month after new plan receives notificationAction to Take: Choose a different Medicare Advantage plan or switch to Original Medicare with the option to enroll in a prescription drug plan. What to expect This enrollment period allows you to make changes if your current Medicare Advantage plan no longer meets your needs. Medicare Advantage plans are subject to change, and you may have switched to a new Medicare Advantage plan during the Annual Election Period without realizing the full implications. Fortunately, you have from January 1 through March 31 to make one change. You can either enroll in a new Medicare Advantage plan or switch to Original Medicare. As you decide whether or not to make a change, HMS director of quality programs and Medicare strategy Anne Davis suggests considering the following questions: "How has your experience been with your plan to date? Often the first few experiences will have been with your medications and prescription drug plan (if you enrolled in one) – are all of your medications covered? Are you having any trouble with accessing the care you need? Have you interacted with customer service or care management? How were those experiences? Did you experience a positive care transition? (Think about your relationships with your providers, medication transitions, any provider network changes). Have you reviewed your plan materials and had any questions answered?" How to make changes If you're switching to a new Medicare Advantage plan, you'll need to communicate with the private insurer sponsoring your plan. You can also work with a trusted insurance agent to help you with this process. If you're switching to Original Medicare, you can work with your current Medicare Advantage plan to drop coverage or call Medicare. When you make this change, you're also able to enroll in a prescription drug plan. Original Medicare does not offer prescription drug coverage, so purchasing a prescription drug plan can be a good idea. (Medicare Advantage plans offer qualifying drug coverage.) Prescription drug plans are offered by private insurers. You can work directly with the insurance company offering the plan or with a trusted insurance agent to enroll. Coverage offered Medicare Advantage plans cover the same services Original Medicare does. These plans also offer qualifying prescription drug coverage, so you don't have to buy another plan. If you're planning to switch to a new Medicare Advantage plan, use our checklist to help you find a plan that meets your needs. Original Medicare consists of two parts: Part A and Part B. Part A is hospital insurance. Part B is medical insurance. When you switch to Original Medicare, you'll want to look at Medicare prescription drug plans offered by private insurance companies to ensure coverage for medications. Check out our guide to evaluating a prescription drug plan. Unlike Medicare Advantage plans, Original Medicare does not have annual out-of-pocket limits. Out-of-pocket limits help you control your spending on health care. Instead, you can purchase a Medigap plan from a private insurer to help with out-of-pocket costs for Original Medicare. Since you're applying for Medigap coverage outside of its unique open enrollment period, your policy will go through underwriting to determine insurability.  Best Medicare Companies Learn more about top Medicare companies by reading customer reviews. Learn More

Medicare's many enrollment periods can be confusing, which makes it easy to miss an enrollment opportunity. Missing a timely enrollment can lead to higher premiums and leave you without needed coverage. The beginning of each year brings two simultaneous Medicare enrollment periods: General Enrollment and Medicare Advantage Open Enrollment. We'll cover everything you need to know about the General Enrollment Period here. For more information on Medicare Advantage Open Enrollment, read our other article. Key facts Eligibility: Missed your Initial Enrollment Period and are not eligible for a Special Enrollment PeriodEnrollment Dates: January 1 through March 31 annuallyCoverage Start Date: July 1Actions to Take: Enroll in Medicare Part A and Part B Note: The 2020 BENES Act made changes to the General Enrollment Period. These changes will start January 1, 2023. The new General Enrollment Period dates will be October 1 through December 31. Your coverage will start at the beginning of the month after the month you enroll. Learn more about these changes from BoomerBenefits. What to expect If you're enrolling in Medicare during the General Enrollment period, be prepared to see higher prices for premiums. These higher prices result from financial penalties for not enrolling in Medicare during your Initial Enrollment Period to prevent people from only buying coverage when they need it. With Part A, your premium may increase 10 percent for late enrollment. Fortunately, you won't have to pay the higher premium for as long as you keep Part A. You'll only pay the higher premium for the number of years you didn't have Part A times two. So, one year without Part A means two years of paying a higher premium for Part A once you enroll.  Part B premiums can increase 10 percent for each year you didn't have Part B. In this case, years are 12-month periods, not necessarily calendar years. Unlike the Part A penalty, the Part B penalty is permanent. How to enroll You'll need to work with Social Security to enroll in Part A and Part B. You can apply online, over the phone, or in-person.  If you just need to add Part B enrollment, you'll need to complete form CMS-40B, the Application for Enrollment in Part B. Coverage offered If you're enrolling in Original Medicare, keep in mind that there aren't annual out-of-pocket maximums. Out-of-pocket maximums help control your medical costs because once this limit is reached, the insurer will take responsibility for costs of covered care. Since Original Medicare doesn't have these out-of-pocket limits, you'll want to consider enrolling in a Medigap plan. Medigap plans also don't have out-of-pocket limits. However, these plans offer additional cost-sharing beyond what Medicare Part A and Part B do. As you apply for a Medigap plan, keep in mind that you will likely have to go through underwriting before being issued a policy. Depending on your circumstance, you may not pass underwriting. Original Medicare also doesn't cover prescriptions. You'll need to buy a prescription drug plan from a private insurer for this coverage. You can buy a prescription drug plan April 1 through June 30th after your Part A and Part B sign-up during General Enrollment. As you consider prescription drug plans, use this checklist to ensure that your needs are met and don't forget to read customer reviews. Some Medicare beneficiaries opt for a Medicare Advantage plan instead of signing up for Original Medicare. While you can only sign up for Original Medicare during General Enrollment, you can switch from Original Medicare to a Medicare Advantage plan April 1st through June 30th following your enrollment in Part A and Part B. Best Medicare Companies Learn more about top Medicare companies by reading customer reviews. Learn More

If you opted for Medicare Part A and Part B, you don't have coverage for prescriptions. Fortunately, you can purchase a separate plan from a private insurer to cover your medications.  If you delay enrollment in a prescription drug plan or lapse in coverage, you'll be charged higher premiums for the delay. If you anticipate needing medications in the future, it can be smart to buy and maintain a plan sooner rather than later. As you look for the best fit, here are five things to evaluate before choosing a prescription drug plan: Pharmacy Network Drug Formulary Cost Medicare Star Ratings Customer Reviews 1. Pharmacy Network Prescription drug plans have pharmacy networks. Be sure that there's an in-network pharmacy in your area before you buy a plan. If you fill prescriptions out-of-network, you may not have coverage for your medications. Generally, prescription drug plans also cover mail delivery. Opting into this service makes getting your medications convenient and saves you a trip to the pharmacy. "Coverage for mail delivery of prescription drugs has become an important plan feature in 2020 with the elevated risks of going inside a pharmacy due to potential COVID-19 exposure," says Christian Worstell, licensed health insurance agent. 2. Drug Formulary Checking the drug formulary is perhaps the most important part of evaluating a prescription drug plan. The drug formulary is the list of medications that your plan covers, so you need to check to see if your medications are covered by the plan. "To make this process easier, write down a list of your drugs that you use regularly or ones that you may need if you have a medical episode. Also, consider any potential changes in your health this year that may require medication next year. Drug Name Dosage (750 mg, 1 mcg, etc.) Frequency (2 times per day for 30 days = 60 pills per month) Optional — Why do you take this medication? Optional — Which doctor prescribed this medication? Keep this list in a safe place and try to remember to update it when your meds change. This is also useful for a family member should you need help picking up or managing your medications," says Bethanie Nonami of Real Talk Medicare. Multiple medications treat the same illness or symptom. Medicare categorizes medications based on what they treat. Plans are not required to cover every drug that treats a diagnosis, but must cover at least two of those medications. "Every year, Medicare defines a list of covered drugs. But every plan doesn’t offer every drug that is available to us or approved by Medicare. Every year the list of formularies change.  You should do your due diligence to verify with your plan or proposed plan for 2021, if your drugs are covered," says Nonami. If you have prescriptions that are working for you, you'll want to be sure that your prescription drug plan covers these specific medications.  Even if you plan to keep your current prescription drug plan during an Annual Election Period, double-check the formulary because the drug list can change. "You can search online to verify the Formularies that your Medicare Insurance plan covers. The Formulary List is a list of what drugs are covered. This comprehensive list that often breaks the drugs out by Tiers, Drug Dosages, Requirements, and Limits. Your insurance company has their own version of a Formulary List, which may also be called a Prescription Drug List (PDL). In fact, many insurance companies have multiple Formulary Lists. Before you look for your drugs triple check the Formulary List for two critical components: First, make sure you are looking at the PDL for the next plan year of 2021, not the current year.   Second, please make sure that you are viewing PDL for your plan for your state. Plans, coverages, and limitations may vary by state," says Nonami. If there are prescriptions that are not covered by your plan that you'd like to have covered, you can look for another plan or work through your plan's prior authorization for step therapy.  You may have to start with a less expensive, generic medication to see if it's effective first. Your doctor can also work with your insurer for an exception to allow you to start directly with the more expensive medication with coverage if the generic one would cause adverse health effects or if it's medically necessary to start with the more expensive drug. 3. Cost Aside from evaluating the monthly premiums, you also need to consider the out-of-pocket costs. Medications are categorized in tiers, and each tier has different cost-sharing rules. Look for how your prescriptions are categorized under your plan and project your out-of-pocket costs for your medications. "Do you prefer a higher monthly premium in exchange for a lower deductible or cost-sharing? Or would you rather pay less upfront per month but pay a little more for each prescription? There's no universal right or wrong and each plan shopper should ask themselves how they would most prefer to spend their money," says Worstell. You'll also need to consider the coverage gap. Your plan has limits on the amount it contributes to your prescriptions. When the insurer has reached its limit, you'll be charged higher copays for your medications until the gap is closed. 4. Medicare Star Ratings The Centers for Medicare & Medicaid Services rate Medicare prescription drug plans each year. These ratings score the quality of prescription drug plans by considering clinical recommendations and plan member feedback. Five is the highest rating. New plans are not rated. "Plan quality should not be ignored either. Each year, plans are rated on a scale of one to five stars for quality and customer experience. Shoppers should pay attention to a plan's rating before buying," says Worstell. 5. Customer Reviews Customer reviews also offer insight into the customer experience with Medicare prescription drug plans. While reviews are sorted by company, reading reviews can help you understand how an insurer treats its Medicare plan members.  Pay attention to what plan reviewers mention. Private insurers offer Medicare Advantage, prescription drug, and Medicare supplement (Medigap) insurance plans. Weigh what reviewers writing about prescription drug plans say over what Medicare Advantage or Medigap members say.  Note what year the reviews are from. Prescription drug plans can change, so the most recent reviews are the most helpful, even though the plans may change each year. You can trust the reviews on Best Company because we do not repress reviews. All reviews that pass our verification process are published — positive or negative. Our verification process helps prevent the publication of fake reviews. Medicare Customer Reviews Learn more about Medicare companies by looking at the customer ratings and reviews. Learn More

When you become eligible for Medicare, you have lots of decisions to make. You can opt for Original Medicare, which is managed by the Centers for Medicare & Medicaid Services, or a Medicare Advantage plan offered by a private insurer. If you're looking for a Medicare Advantage plan — whether it's your first time enrolling in Medicare or you're participating in Medicare's Annual Election Period — here are six things you need to consider before buying in a Medicare Advantage plan: Provider Network Drug Formulary Cost Additional Coverage Medicare Star Rating Customer Reviews 1. Provider Network Unlike Original Medicare, Medicare Advantage plans have set provider networks. These networks can be specific to your plan and to your area.  "The first and most important factor are networks.  You want to make sure your regular doctors accept your plan and your preferred healthcare facilities nearby are also in their network. You should compare PPO and HMO plans to see where you have the best access to care," says Adam Hyers, Hyers and Associates, Inc. If your Medicare Advantage plan has an Health Maintenance Organization (HMO) network structure, you'll only have insurance coverage when you visit in-network providers. If you have a Preferred Provider Organization (PPO) network structure, you'll have the flexibility to visit out-of-network providers with higher out-of-pocket costs. If you're considering a Medicare Advantage plan, be sure to check your provider network to make sure there are doctors in your area who can give you the care you need. Most insurers offer an online "Find a Provider" tool that allows you to search for doctors in your area that accept your plan. Since networks can change, it's worth reaching out directly to doctor's offices to double-check that they'll continue to accept your plan in 2021 before you enroll in it again. 2. Drug Formulary Most Medicare Advantage plans include qualifying prescription drug coverage. If your Medicare Advantage plan offers this coverage, you don't need to purchase a separate plan to cover prescriptions. As you evaluate Medicare Advantage plans, check the drug formulary to make sure that the medications you need are covered. Even if they're covered on your current plan, they may not be covered for 2021. If there's a medication that you think may work better than your current medication, you should also look for that drug to be listed on the formulary and how cost-sharing works. "Some Medicare Advantage plans will give you better pricing on your prescriptions than others.  All other things being nearly equal, prescription costs can be a differentiating factor," says Hyers. In addition to checking that your medications are listed on your plan's formulary, you should also pay attention to what tier they fall under. Each tier has different cost-sharing rules. Some tiers have higher out-of-pocket costs. Understanding how your drugs are categorized will help you anticipate costs. The insurance company should provide you with the drug formulary before you enroll in a plan. You may be able to find it online as you learn about plans online. 3. Cost As you look at Medicare Advantage plans, you'll want to consider the out-of-pocket costs and any monthly premium amounts you'll have. "Many Medicare Advantage plans these days are offering a $0 premium, so the deductible and copayments or coinsurance requirements are deserving of a closer look," says Christian Worstell, licensed insurance agent. Low monthly premiums are especially friendly when you're on a fixed income dealing with a rising cost of living. "Before you enroll in an Advantage plan, it’s important to understand why these plans have low to zero dollar premiums. They come with many additional out of pocket costs in the form of copays, deductibles, and coinsurance. Medicare pays the Advantage carrier around $1,000 per month to take on your risk. Then they collect cost-sharing from the beneficiary as they use the benefits," says Lindsay Engle, Medicare expert. Knowing that you'll likely be taking more responsibility out-of-pocket for your care, project your prescription and medical services costs based on what you predict you'll need. Consider the copays or coinsurance, the annual deductible, and out-of-pocket maximum. Understanding these costs will help you find a plan that will protect your budget and meet your needs in the long-run. 4. Additional Features Medicare Advantage plans are required to cover the same services that Medicare does. With prescriptions, Medicare groups similar medications and plans have to cover at least one drug per group. Medicare Advantage plans often include additional coverage. Some plans offer some dental, vision, and hearing coverage. Medicare Advantage programs may also include fitness programs, access to telemedicine, and other features. Keep in mind that the additional coverage offered by Medicare Advantage may not be as robust as choosing a separate dental or vision plan. However, the additional coverage and features can be nice perks of choosing a Medicare Advantage plan. Some Medicare Advantage plans are Special Needs plans. These plans are tailored to meet the specific needs like dual eligibility for Medicare and Medicaid or chronic illness. If you have specific needs, looking into a Special Needs plan may be beneficial. 5. Medicare Star Rating The Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage plans annually for the quality of their services. These ratings consider clinical recommendations and plan member feedback. These quality ratings can help you understand the care quality offered through Medicare Advantage plans.  New Medicare Advantage plans are not rated. 6. Customer Reviews Customer reviews can also help you evaluate how well insurers treat their members. Each member's experience will vary based on their personal needs, location, and plan; however, reviews can also help you gauge the quality offered by an insurance company. You can trust reviews posted on Best Company because we have a verification process to ensure that reviews are left by real people. We also don't suppress reviews, so you can get an unfiltered understanding of the customer experience with insurers. As you read customer reviews, pay attention to what reviewers say about their plan. Private insurers offer Medicare Advantage, prescription drug, and Medigap plans. Give more weight to reviewers that have a similar plan to the one you're looking for. This will help you get a better sense of how good the plans you need are from the insurer. Medicare Customer Reviews Learn more about Medicare companies by looking at the customer ratings and reviews. Learn More

Guest Post by Lindsay Engle COVID-19 has made an impact on the world over the last couple of months, especially here in the United States.  As if choosing a Medicare plan before wasn't complicated enough, we now have a new monkey wrench — a global pandemic. It's time to pay attention when choosing Medicare coverage to ensure you’re making the decision that’s best for you long-term.  2020 Medicare Annual Election Period Guide We worked with MedicareFAQ to create this guide to help you be confident when you go through this year's Annual Election Period for Medicare. Download Guide Choosing coverage Understanding your Medicare coverage can be cumbersome. Like all major life decisions, there are a plethora of considerations to take, especially now with the pandemic looming overhead.  While it’s easy to impulsively choose the plan that seems to provide the best coverage at the lowest cost, you'll want to remember these seven things when beginning your Medicare journey and weigh all options thoroughly: Cost   Quality of care Coverages Prescription coverage Extra coverage Travel Doctor and hospital choices Costs Like most people, you’ll need to budget your finances accordingly. Health insurance is generally known to be costly, and many people who enroll in Medicare are on fixed incomes due to retirement. Cost becomes an even larger factor now, considering the drastic changes we’ve seen with our economy over the last several weeks and millions of Americans have lost their income as a result.  But with the continued spread of the coronavirus, health insurance costs are incredibly crucial right now. You'll want to consider how much you'll be paying in copays, deductibles, and premiums, and if you’ll have an annual limit. To help reduce some of your expenses, you can opt into buying a Medicare Supplement plan. Another option is looking into a Medicare Advantage policy — once you reach a specific limit each year, you won't be responsible for extra charges for the rest of the year.  However, there is a drawback to buying into an Advantage policy. Medicare Advantage plans have their own networks of doctors and hospitals, and if you end up seeing a doctor out of network, you could be on the hook for all costs.  Considering all possible costs before making a decision can help save you hundreds of dollars. Quality of care Another important thing to consider in times like these is the level of care you'll be receiving. You'll want to work with an insurance company that is taking the initiative to help its members. Many insurance companies are waiving fees for COVID-19 telehealth appointments right now, and doctors and hospitals are also taking many steps to help protect their patients. The quality of the care you receive can make all the difference in a stressful situation.  Coverages How comprehensive is your Medicare coverage? With many different plan options, this will be one of your biggest considerations.  COVID-19 can have a detrimental effect on people of all ages, but particularly those who are over 65. Should you wind up getting seriously ill, will your coverage be able to cover days or weeks in the hospital?  By choosing a plan with comprehensive coverage, you'll likely save yourself money. If you need a two-week stay in your local hospital, you could quickly rack up tens of thousands in bills. Part A and B don't generally cover everything you may need coverage-wise, so it’s usually a smart investment to buy a supplemental plan. Prescription coverage While there may not be any medications available for COVID-19 right now, that could change. Plus, you may already be on certain medications that need coverage. Medicare won’t cover your prescription costs, so there are a couple of different routes you can take.  You may choose to buy a Part D prescription drug plan, or you may decide to buy a Medicare Advantage plan with drug coverage. Perhaps you decide to forego a prescription plan. But if you end up skipping the drug coverage, you may regret that decision. Prescription drug costs can be abundant — some of the medications in today's market end up costing thousands every single month. If you're not in the position to pay enormous amounts in drug costs, a drug plan is the best way to go.  Extra coverage Not everyone who joins Medicare only has Medicare health coverage. Many people have prescription or health coverage through their employers.  If you are still working, there is the option to remain on your employer’s group health insurance plan, and how your Medicare benefits coordinate with this coverage depends on the size of the company. If you work for an employer with over 20 employees, your group plan will be primary, meaning they pay first, then Medicare, and if you work for a company with less than 20 employees, your Medicare plan will be primary. Regardless, it’s advised to enroll in Part A once eligible as the premium is free if you’ve paid enough Medicare taxes and it can help keep costs lower if a hospital stay becomes necessary. If you have small group insurance (fewer than 20 employees), you’ll also want to enroll in Part B to cover any outpatient costs. You’ll always want to compare the cost of your group insurance to the cost of Medicare + Medigap + Part D to see what makes the most sense in terms of coverage and price, and keep in mind that it’s illegal for employers to contribute to Medicare premiums. For additional information on choosing between Medicare and group insurance, visit this resource. Travel Traveling right now isn't what it used to be with the requirement of face masks, sanitizers, and temperature checks. While many have halted their travel plans for the foreseeable future, it’s a matter of time before we’re able to travel comfortably again.  When that time comes, it’s important to ask yourself if your health coverage will help to cover you if you were to get sick overseas. Medicare doesn't cover health care out of the United States, but that's not to say that supplemental coverage won't help ease some of those costs.  Doctor and hospital choices Finding a doctor that accepts your health coverage is paramount. In addition to doctors who take your insurance, health facilities need to accept it as well.  When you have a Medicare Supplement plan, you can go to any doctor that takes Medicare. If you have a Medicare Advantage plan, you'll have to stay within the network.  Despite being in the middle of a health crisis, doctors are continuing to see their patients. But it may not be in a traditional appointment setting. Many doctor's offices are implementing telehealth appointments, and although you may not be physically going to see the doctor, you'll still need to be sure they take your insurance. Preparing for the future For most of us, 2020 is unlike anything we've ever imagined, much less seen before. You may take some comfort knowing that many insurance companies are waiving fees.  Companies are going the extra mile to ensure all Americans have access to medical care, but hospitalizations can quickly deplete any health savings you may have. By considering a few things, you can prepare yourself for any turns this pandemic may bring.  COVID-19 is proving its strength every day. Arming yourself with excellent health coverage can make all the difference to the future of your health. Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare space since 2017. She is featured in many publications and writes regularly for other expert columns. She has a passion for sharing her expertise on Medicare to beneficiaries so they can be better prepared for healthcare costs after retirement. You can find her on YouTube where she has a featured channel for Medicare beneficiaries to become educated on all their options.

Updated September 10, 2021. Just when you started to think health insurance made sense, you became eligible for Medicare! Medicare has its own processes, rules, and enrollment periods that can be tricky to understand at first. “Medicare has several different enrollment periods, so it can be confusing to keep track of everything and remember which enrollment period is for what,” says Lindsay Engle, Elite Insurance Partners, LLC Marketing Manager. The Medicare Open Enrollment is one of those periods. Here are five things you should know about the Medicare Open Enrollment: What is the Medicare Open Enrollment Period? Who does it apply to? What are the dates? What’s with the advertising? What do I need to do? What is the Medicare Open Enrollment Period? Over the years, you may have gotten used to the Open Enrollment Period for enrolling in health insurance every November. The Medicare Open Enrollment Period overlaps with those dates, so it may seem like it’s the same thing but for Medicare. The short answer: It’s not. If the Medicare Open Enrollment Period isn’t for enrolling in a plan, what is it for? The Medicare Open Enrollment Period gives you an opportunity to review and make changes to your current Medicare coverage: Switch between Original Medicare (Parts A and B) and a Medicare Advantage Plan (Part C). Change to a new Medicare Advantage Plan. Change your prescription drug coverage by switching to a new plan, dropping coverage, or enrolling in a plan for the first time. If you have a Medicare Advantage plan that offers qualifying prescription drug coverage, you do not need to enroll in Part D. If you do, you’ll be automatically disenrolled from your Medicare Advantage plan and enrolled in Original Medicare. As you evaluate your prescription drug coverage, check the formulary (drug list) to make sure the medications you need are covered. This will help you decide if you need to enroll in a new plan or keep your old one. Before opting out of prescription drug coverage, be aware that there is a late enrollment penalty if you are without creditable prescription drug coverage and enroll in a Part D plan later. Back to Questions Who does it apply to? While you can switch from Original Medicare to a Medicare Advantage plan during the Annual Election Period (AEP), the Annual Election Period primarily affects people with Part C (Medicare Advantage Plans) or Part D (Prescription Drug Plans). The Medicare Open Enrollment Period does not apply to Medicare Supplement Plans (Medigap). “While it is critical that they examine their Part D (drug) plan at this time every year, it is important that they understand that the Medigap, otherwise called Medicare Supplement plans, do not change and do not need to be changed during this time period. Each Medicare Supplement plan automatically renews on the policy anniversary and nothing can change with those policies,” says Christopher L. Westfall, Sr., from Senior Savings Network. Back to Questions What are the dates? The Medicare Open Enrollment Period runs each year October 15th through December 7th. Keep these dates in mind, especially because they are different from health insurance Open Enrollment dates, even though the periods overlap. Back to Questions What’s with the advertising? Health insurance companies do a lot of advertising during the Medicare Open Enrollment Period and during health insurance Open Enrollment. Because the dates overlap, you may feel like you’re being bombarded with health insurance ads. The Medicare Open Enrollment Period is a money-making opportunity for Medicare providers. During this time, Medicare beneficiaries can enroll in a new plan and switch health insurance companies. “I think the Open Enrollment Period (OEP) can be very confusing sometimes. There is so much advertising EVERYWHERE. It makes clients think that they have to change their plan or sign up for it again,” says Katherine Adams, founder of Creative Legacy Group. Don’t be confused by the ads. Make sure you understand your Medicare plans and how the Open Enrollment Period works. Review your current coverage to make sure that it will continue to meet your needs next year. Back to Questions What do I need to do? Now that you have a better understanding of what the Open Enrollment Period is, the next thing to figure out is what to do. Melissa Negrin-Wiener, Genser Cona Elder Law Partner, suggests taking these steps: “Read your Annual Notice of Change mailed to you every September informing you of any changes to your plan, such as changes in premiums, co-pays, pharmacies and prescription drug coverage. Review your coverage, costs, and doctors to determine if you should switch from traditional Medicare to a Medicare Advantage Plan. Review your medications and change your Part D plan if your prescriptions are no longer covered or your costs have increased.” Following these steps if you have a Medicare Advantage or Prescription Drug Plan will help you ensure that your Medicare coverage will be sufficient for next year. Doing nothing during the Open Enrollment Period does not mean that you won’t have coverage next year. In most cases, you'll be automatically re-enrolled in your current plans. However, if you want to be on the safe side, it doesn’t hurt to contact your health insurer to double-check your enrollment. Back to Questions Want more insight into the Medicare Open Enrollment Period? Check out these articles and our downloadable guide: "Ways to Prepare for Medicare Open Enrollment" "Pitfalls to Avoid During Medicare Open Enrollment"