Medicare Annual Election Period

Each fall, the Medicare Annual Election Period runs from October 15 to December 7 and offers beneficiaries the chance to make changes to their Medicare Advantage or Part D plans. When you make changes during the Annual Election Period, your new plan becomes effective on January 1st of the new year.
 
To prepare, beneficiaries should review their Annual Notice of Change letter and get with their independent agent  to see if their prescription drug plan is still the most cost-effective for their current list of medications.
 
Hopefully you’ve heard by now that there are unprecedented changes coming to Medicare Part D in 2025 that will affect both standalone drug plans and Medicare Advantage plans that include Prescription Drug plan coverage.  This is not the year to let your plan automatically renew without a review.
 
Some of the common reasons why people may want to change their plans are:
       

• Your monthly plan premium is going up
• You have learned that one of your doctors will no longer be in the network
• The plan is dropping one of your important medications or it has changed tiers
• You want to drop Medicare Advantage and go to the more comprehensive coverage provided by a Medicare supplement plan

 
Medicare Advantage
If you are enrolled in a Medicare Advantage plan, find out if your doctors are still in-network. Ask them if they are satisfied with the plan, or if there is any chance they’ll be leaving the network. Doctors can change networks at any time of the year.
 
Have a current list of your medications.  Use the medication name that’s listed on the pill bottle so your agent will know if you’re taking the brand name or generic version, include the dosage, whether it’s a tablet or a capsule, and frequency that you take these medications.
 
Prescription Drug
If you have never been in a Drug Plan before (also known as Part D) you can use the Annual Election Period to sign up for the first time. Be aware that you may be subject to a late penalty if you didn’t have other creditable drug coverage after you turned 65. The Medicare Part D late enrollment penalty is a monthly fee added to a person's Part D premium for each month they went without creditable prescription drug coverage after their initial enrollment period and will be assessed to both stand alone drug plans and Medicare Advantage plans with prescription drug coverage.
The penalty is calculated by multiplying 1% of the national base beneficiary premium by the number of months without coverage. The result is rounded to the nearest 10 cents.
 
How to Switch from Medicare Advantage to Medigap
If you enrolled in a Medicare Advantage plan and you want to switch from Medicare Advantage to Medigap, you can use the Annual Election Period to return to Original Medicare. You can choose a new Part D drug plan as well. However, for the Medigap plan, you will need to apply and, in most cases, will need to answer health questions. There is no guarantee that you will be accepted.
For this reason, you would want to apply for the Medigap plan first with a January 1st effective date. Once you are certain that this new Medigap application is approved, then you can apply for a Part D drug plan which will automatically disenroll you from your Medicare Advantage plan.
If you are not able to qualify for a Medigap plan due to health conditions, you can consider switching to a different Medicare Advantage plan during Fall Open Enrollment.
 
Medicare Supplement/Medigap
Your Medigap plan does not change benefits from year to year like Part D plans and Medicare Advantage plans do. However, you may still want to see if you can change your Medigap plan if there has been a premium increase, or simply see if you can get a better rate.

It’s important to know that you can shop for better pricing for your Medigap plan any time of year but in most states, this will require health questions. Never disenroll from your Medicare Advantage plan until you have first applied for and been approved by the new Medigap carrier. Once they notify you of acceptance, then you can disenroll from your Medicare Advantage plan and return to Original Medicare as well as add a standalone Part D drug plan.

In summary, the Medicare Annual Election Period gives you the option to change plans if it benefits you. If you do nothing, your current plan will automatically renew.
 
Mary Hiatt is President of Mary the Medicare Lady (A non-government entity.) She is a member
of a pharmacist-led organization that helps her clients source savings for medications. She
offers Educational Workshops on Medicare, Drug Savings, How to Stop Phone Calls, and more
at no charge. Not connected with or endorsed by the U.S. government or the federal Medicare
program. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. See www.hiattagency.com or contact licensed independent agent mary@hiattagency.com or call or text 402 672 9449 for more information.