The Medicare open enrollment period, which occurs annually from October 15 to December 7, allows individuals already enrolled in Medicare to modify their coverage. Having a good grasp of Medicare open enrollment can significantly enhance the benefits you receive from your Medicare or Medicare Advantage coverage in 2024.

Here are some key points to note:

• Medicare open enrollment takes place from October 15 to December 7.
• During this period, you have the option to switch between Original Medicare and a Medicare Advantage plan, or vice versa.
• Additionally, you can compare your Part D prescription drug plan coverage with other available options.

When does Medicare open enrollment take place?

Medicare open enrollment occurs annually during the fall, specifically from October 15 to December 7.

What are your options during Medicare open enrollment? 

During the Medicare open enrollment period, you have the flexibility to:

• Switch from Original Medicare to a Medicare Advantage plan, or vice versa.
• Change from one Medicare Advantage plan to another Medicare Advantage plan.
• Transition from a Medicare Advantage plan without drug coverage to one with drug coverage, or vice versa.
• Enroll in a Medicare prescription drug plan.
• Switch from one Medicare drug plan to a different Medicare drug plan.
• Discontinue your Medicare prescription drug coverage.

It’s important to note that if you revert to Original Medicare during this annual enrollment period and wish to purchase Medicare Supplement Insurance (Medigap), you might encounter unexpected costs for the supplement policy or even be denied coverage.

(Within the first six months of obtaining Medicare Part B, you have the opportunity to purchase any available Medigap policy in your area without regard to your health condition. After this period, except for four states, Medigap companies might require a medical examination and may charge you more or decline coverage based on your health status.)

What are the limitations of Medicare open enrollment?

Medicare open enrollment is exclusively designed for individuals who are already enrolled in Medicare. If you’re not currently enrolled, you cannot sign up for it during this period. Eligible individuals must enroll in Medicare during their initial enrollment period, the general enrollment period, or a special enrollment period if they qualify.

What options are available during Medicare open enrollment?

During the annual enrollment period, several types of Medicare coverage are accessible:

• Original Medicare: This comprises Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Enrollees must first sign up for these two parts and pay the Part B premium before exploring additional coverage options. If you’re presently enrolled in a Medicare Advantage plan, you have the choice to switch back to Original Medicare during this period.
• Medicare Advantage (Medicare Part C) Plans: Offered by private insurers, these plans serve as a comprehensive alternative to Original Medicare. Medicare Advantage plans may provide extra benefits, including limited coverage for dental and vision care. Typically, these policies also include Part D prescription drug coverage.
• Medicare Part D Prescription Drug Coverage (Stand-alone Policies): Administered by private insurers, Part D is an optional program that assists in covering the costs of prescription drugs. It’s essential to maintain continuous Medicare drug coverage to avoid penalties, especially if you go without coverage for 63 or more consecutive days.
• Medicare Supplement Insurance Plans (Medigap Plans): Also known as Medigap plans, these policies help cover out-of-pocket healthcare expenses associated with Original Medicare Parts A and B. While you can apply for Medigap at any time if you have Original Medicare, you’re generally guaranteed a policy during your six-month Medigap open enrollment period, starting the first month you turn 65 and have Medicare Part B.

Please note: If you’ve claimed Social Security or Railroad Retirement Board benefits before turning 65, you will automatically receive Original Medicare (Parts A and B) in the month you reach 65. While you can opt out of Part B if you have other qualifying health insurance, Part A is automatically associated with Social Security benefits.

FAQS

Can I switch from Original Medicare to a Medicare Advantage Plan during Open Enrollment?

Yes, you can switch from Original Medicare to a Medicare Advantage Plan during Open Enrollment. Evaluate your healthcare needs and compare the benefits of both plans before making a decision. It’s advisable to consult with a Medicare advisor if you’re unsure about the best choice for you.

Will my existing medications be covered under a new plan?

Different plans cover varying medications. During Open Enrollment, carefully review the formulary of each plan to ensure your current medications are covered. If you have specific drugs that you need, choose a plan that includes them in its coverage to avoid unexpected expenses.

How can I find out if my preferred healthcare providers are in-network under a new plan?

Most insurance providers have online tools or helplines where you can verify if your preferred doctors and healthcare facilities are in-network. It’s essential to choose a plan that allows you to continue seeing your current healthcare providers to maintain continuity of care.

Conclusion

Medicare Open Enrollment 2024 is a vital opportunity to assess your healthcare needs and optimize your coverage. By understanding the changes, benefits, and options available, you can make well-informed decisions that positively impact your health and finances. Stay proactive, gather necessary documents, compare plans diligently, and seek assistance from Medicare advisors if needed. Remember, your healthcare coverage is a crucial aspect of your overall well-being, so make the most of this open enrollment period.

Need help? Call Health Plans in Oregon: 503-928-6918. Our assistance is at no cost to you.