Medicare A & B Part D Prescription Drug

What to know about the Medicare Annual Enrollment Period (AEP)

Mark your calendar. October 15th to December 7th is the Medicare Annual Enrollment Period (AEP.) During this time Medicare beneficiaries can change Medicare Advantage ( Part C) or Medicare Prescription Drug (Part D) plans with ease. Plan or coverage changes go into effect January 1.

If you are enrolled in a Medicare Plan C or Plan D it is important to be aware of any changes to your plan and to take advantage of this period to be sure you have the most appropriate coverage at the lowest possible cost. It’s best to be proactive during the October 15 – December 7 period to minimize surprises when you visit a doctor or pharmacy in January.

If you are enrolled in a Medicare Supplement (Medigap) Plan

If you are currently enrolled in a Medicare Supplement (Medigap) plan with a separate Part D drug coverage here is what you need to know about Medicare’s Annual Enrollment Period for that drug plan:

  • The Annual Enrollment Period applies to Part D drug plans, not your MediGap plan. Since most drug plans change their formularies every year it is very important to check your plan’s 2018 formulary. Make sure your prescription medications are still covered at the same or similar tier levels.  If not, it may make sense to look at other Part D drug plans that cover your prescriptions with lower out of pocket costs.
  • You can leave your Medicare Supplement (Medigap) plan and join a Medicare Advantage plan. There is no underwriting to move to a Medicare Advantage plan.  You will be automatically accepted as long as you are in the coverage area.
  • New York State residents can change their Medicare Supplement plan at any time of the year and without medical underwriting. (Click here for details) If you reside outside of New York State, and if this is after your Initial Enrollment Period you most likely will be subject to underwriting and can be denied coverage.

If you are enrolled in a Medicare Advantage (Part C) Plan

  • You can leave your Medicare Advantage plan and enroll in another Medicare Advantage plan in your coverage area. There is no underwriting and you are guaranteed to be accepted.
  • Since many Medicare Advantage plans change their networks every year, be sure your doctors and hospitals are in the 2018 network.  Even if you decide to stay with the same Medicare Advantage plan make sure your doctors and hospitals are still in your network, especially if your plan is a HMO. Check and confirm if your plan is a PPO; you can visit doctors outside of the PPO network yet usually with a higher co-pay.
  • You can leave Medicare Advantage and return to original Medicare and purchase a Medigap policy.  For New York State residents acceptance is guaranteed and the continuous coverage transfer means no pre-existing condition limitations apply. (Click here for details)

The Annual Enrollment Period is built into the Medicare system to give recipients the right to change plans. Even though in most cases it can benefit the recipient to compare plans, most people do not because navigating their options can seem complicated, even intimidating.

Take advantage of my no-obligation complimentary service to help you compare Medicare plans in your coverage area.

Call (518) 346-2115 or use the online schedule tool to choose a convenient date and time for a consultation!


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