During the MA OEP, beneficiaries can:
- Enroll in a new Medicare Advantage plan
- Change from one Medicare Advantage plan to another
- Disenroll from a Medicare Advantage plan and return to Original Medicare
- Enroll into a Medicare Supplement
- Join a Medicare Prescription Drug Plan (Part D)
It’s important to note that the MA OEP is separate from the Annual Enrollment Period (AEP), which is the time when all Medicare beneficiaries can make changes to their coverage for the following year.
Here are a few examples of scenarios where Medicare beneficiaries may have benefited from switching from Medicare Advantage to Original Medicare with a Medicare supplement:
- Joe was diagnosed with cancer. He needs to get a MRI. Joe must first go to his PCP to then get referred to a specialist who then orders the MRI. This process has taken 3 weeks. To add to it, he doesn’t like the facility, but it’s his only option based on his plan’s limitations.
Mary is enrolled in a Medicare Advantage plan with a zero premium, but she finds that the plan’s provider network is very limited, and she is unable to find a provider who accepts her plan in her area. She decides to switch to Original Medicare with a Medicare supplement so that she can see any provider that accepts Medicare.
- John is enrolled in a Medicare Advantage plan with a zero premium, but he has high medical expenses due to a chronic condition. He finds that the out-of-pocket costs for his plan are still too high, even with the plan’s maximum out-of-pocket limit. He decides to switch to Original Medicare with a Medicare supplement so that he can take advantage of the plan’s lower out-of-pocket costs.
- Sue is enrolled in a Medicare Advantage plan with a zero premium, but she frequently travels internationally for extended periods of time. She finds that the coverage for international travel offered by her Medicare Advantage plan is very limited and does not provide the level of protection that she needs. She decides to switch to Original Medicare with a Medicare supplement so that she can have more comprehensive coverage for emergency medical care while traveling.
The Medicare Advantage Open Enrollment Period is an annual event that allows Medicare beneficiaries to review their current coverage and make changes to their Medicare Advantage plans or switch back to Original Medicare. There are a few reasons why Medicare beneficiaries may decide to switch away from a Medicare Advantage plan that has a zero-dollar premium at the time and switch to Original Medicare with a Medicare supplement, such as a limited provider network, high out-of-pocket costs, lack of coverage for certain services, or better coverage for international travel. By carefully considering their needs and comparing their options, Medicare beneficiaries can choose a coverage option that meets their needs and provides the best value.
To download a copy of “Understanding Medicare Advantage and Medicare Drug Plan Enrollment Periods” packet click here.
If you’d like to chat about your options, give us a call at 1-888-559-0103