Medicare’s fall open enrollment period occurs from October 15 through December 7 each year. That means 2015 Medicare open enrollment is just a few weeks away. At that time, anyone with Medicare can make changes to their Medicare health plan and prescription drug coverage (part D).
During the fall open enrollment period, those already enrolled in Medicare can do the following:
- Change from Original Medicare to a Medicare Advantage Plan
- Change from a Medicare Advantage Plan back to Original Medicare
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan
- Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage
- Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage
- Join a Medicare Prescription Drug Plan
Be aware that changes to your coverage will take effect January 1 of the next year.
Plan information for 2015 will become available in October. At some point before open enrollment, your current Medicare plan will send your Evidence of Coverage and as well as your Annual Notice of Change. These documents will detail your current plan costs and benefits and provide information about changes to costs, benefits and service areas effective in the new year, respectively. When you receive these documents and open enrollment begins, review your current coverage and weigh your options for 2015.
Satisfied with your Medicare coverage or not, consider your options
It is important to ensure you are getting the best rates and benefits for your personal needs. You may find you prefer to keep Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance) and is provided by Medicare, or you may find you wish to switch to a Medicare Advantage Plan, which is called Part C and includes both Part A and Part B and is provided by a private insurance company.
Questions you should ask yourself during Medicare open enrollment include the following:
- Does your current Medicare plan meet your healthcare needs?
- What does your current coverage cost? Look at premiums, deductibles and other out-of-pocket costs.
- Will your plan change in 2015, and will it alter benefits or access to providers in a way that still works for you?
- Do your preferred healthcare providers take Medicare?
- Are you satisfied with the quality of care you receive from your current providers?
- Look at networks. Are the doctors, hospitals and pharmacies you have access to conveniently located and open during hours that work for you?
- Do you need prescription drug coverage?
If you do not want to make changes, you do not need to take any action. But, again, it can be helpful to take some time to be sure keeping your current coverage is the right decision.
Medicare open enrollment is different than open enrollment for major medical health insurance. You will not use the state-based and federally facilitated health insurance exchanges to enroll in Medicare.
You are initially eligible to enroll in Medicare three months before you turn 65 and up until three months after. If you fail to sign up when you first become eligible and are not eligible for a special enrollment period, you can enroll during the general enrollment period that is held January 1 through March 1 each year. Coverage begins in July, and you may pay a higher premium than if you had enrolled when first eligible.
Enrolling in Medicare supplement insurance plans
If you have Medicare Advantage, also known as Medicare Part C, you cannot enroll in a Medicare supplement plan. You have to be enrolled in Medicare Part A and B. That means if you wish to purchase Medicare supplement insurance, you should switch to Original Medicare during fall open enrollment.
Note that if your Medicare Advantage plan ends at the end of 2014, you will be notified by Oct. 2. At that point, if you enroll in Original Medicare, you will be subject to a special enrollment period that allows you to enroll in a Medigap plan without a pre-existing waiting period from Nov. 2, 2014, through March 4, 2015. Coverage will begin on Jan. 1, 2015, if you enroll before Dec. 31, 2014.
Medicare supplement insurance, also known as Medigap, helps reduce out-of-pocket medical expenses not covered by Medicare. This may include copayments, coinsurance, deductibles and even emergency medical care when traveling outside of the United States, depending on the Medicare supplement plan you choose.
Medicare supplement insurance plans are guaranteed issue during your Medigap Open Enrollment Period—regardless of your health history or current medical conditions. This enrollment period occurs only once and begins on the first day of the month you both turn 65 years old and enroll in Medicare Part B; it lasts six months.
Outside of your one-time Medigap Open Enrollment Period you may enroll in a Medicare supplement plan at any time of the year, but you will be subject to underwriting. That means you could be denied Medicare supplement coverage or charged more based on your health history or current medical conditions, unless specific circumstances apply.
Visit HealthCare.com for more information on Medicare supplement insurance plans, and contact a licensed insurance agent for assistance.
 U.S. Department of Health & Human Services. “Understanding Medicare Part C & D Enrollment Periods.” Revised August 2014. Retrieved from http://www.medicare.gov/Pubs/pdf/11219.pdf.
 Centers for Medicare & Medicaid Services. “8 Things to Consider When Choosing or Changing Your Coverage.” Medicare.gov. N.D. Retrieved from http://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/things-to-consider/8-things-to-consider.html.
 Centers for Medicare & Medicaid Services. “When Can I Sign Up for Part A & Part B?” Medicare.gov. N.D. Retrieved from http://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html.
 Medicare Interactive. “What are My Options if My Medicare Advantage Plan is Ending at the End of the Year?” N.D. Retrieved from http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1753.
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