I’m going to tell you a little secret. As a Medicare insurance advisor and agency owner, I hate the Medicare Annual Enrollment period (AEP). Yes I know, a very strong statement, but hear me out. The insurance industry and the federal government combined forces to create this monster where they stir 60 million people into a frenzy each year by telling them they have seven weeks to review their insurance plans and make changes. It’s flat-out ridiculous! In my opinion, the AEP causes a lot of unnecessary stress. Even worse, many Medicare beneficiaries make poor choices under the duress of a ticking timer that sounds the alarm on December 7th.
Let me tell you another secret. For many Medicare beneficiaries, this stress is unnecessary and avoidable because there are other enrollment windows throughout the year. Not every change is relegated to the AEP in the fall. I also believe Medicare understands the monster that has been created and over the past several years has made some changes designed to alleviate some of the pressure and allow Medicare beneficiaries more flexibility so they can make better decisions or get out of bad decisions they made in the heat of the moment.
For example, there is a lesser-known enrollment period called the Medicare Advantage Open Enrollment that runs from January 1st through March 31st. Medicare beneficiaries can switch from Original Medicare to Medicare Advantage or switch from one Medicare Advantage plan to another. This provides people who have original Medicare the option to take a long hard look at Medicare Advantage plans without the pressure of making a quick decision. It also allows people who switched Medicare Advantage plans time to switch again if they feel they made a bad choice—for instance, if they discover one of their providers is not in network or one of their medications is not on the formulary.
Another “special enrollment period” available to those considering Medicare Advantage is the Five Star Special Enrollment. This allows people in original Medicare to go on a Five Star-rated Medicare Advantage plan any time of year if one is offered in their area. This can be a change from original Medicare or from a different Medicare Advantage plan. For readers in the Lehigh Valley, there are several plan options available in our area.
Another option is the Medicare Advantage 12-month trial period. This rule states that if it’s your first time in a Medicare Advantage plan, you have 12 months to switch back to original Medicare and pick up your supplement with no medical underwriting and no questions asked.
Finally, if you are on original Medicare with a supplement, you can review your supplement rate any time during the year and switch to another plan with a lower rate. Of course, this change is subject to passing a medical questionnaire, and in our agency, we do this successfully with many clients each month. In fact, we advise our clients and others shopping their rates to do so outside of Medicare AEP to avoid the chaos that takes place in those seven weeks.
The one change you cannot make outside of the Medicare Annual Enrollment Period is switching from one prescription plan to another. If you wish to change your stand-alone Part D prescription plan to another stand-alone plan, this change can only be made during the Medicare Annual Enrollment Period.
In summary, I encourage all Medicare beneficiaries to be aware that there are several other opportunities to review and change coverage outside of the Medicare Annual Enrollment Period.
For more information about Silver Crest Insurance, visit silvercrestins.com or call 610-868-5801.