Medicare Open Enrollment Explained
The Medicare Open Enrollment Period (also known as the Annual Enrollment Period, or AEP) is the yearly opportunity for current Medicare beneficiaries to review their health and prescription drug coverage and make changes for the following year.
Key Details about Medicare Open Enrollment in New York
- When: The period runs annually from October 15 to December 7.
- Who: This period is for people who are already enrolled in Medicare Part A and/or Part B. It is distinct from the Initial Enrollment Period when individuals first become eligible for Medicare (usually around their 65th birthday).
- When Changes Take Effect: Any changes made during this period become effective on January 1 of the following year.
- Why It’s Important: Medicare plans (especially Medicare Advantage and Part D plans) can change their costs, benefits, provider networks, and covered drugs from year to year. Reviewing options helps ensure coverage continues to meet your medical needs and budget.
Actions You Can Take
During the Medicare Open Enrollment Period, you can make a wide range of changes to your coverage:
- Switch from Original Medicare to a Medicare Advantage Plan (Part C).
- Switch from a Medicare Advantage Plan back to Original Medicare (Parts A & B).
- Switch from one Medicare Advantage Plan to a different one. Like other states, Medicare Advantage Plans in New York can change every year and require annual reviews.
- Switch from one Medicare Part D prescription drug plan to another.
- Switch from one Medicare Supplement Plan to another
Common Changes New York Residents Make Include:
- Switching plan types: Moving between Original Medicare (Parts A & B) and a private Medicare Advantage Plan (Part C), or vice versa.
- Changing Medicare Advantage plans: Switching from your current Medicare Advantage plan to a different one that might offer a lower premium, better benefits (like dental, vision, or fitness programs), or a more suitable provider network.
- Adjusting prescription drug coverage (Part D):
- Enrolling in a Part D plan if you have Original Medicare.
- Switching from one Part D plan to another (either a stand-alone plan or one integrated into a Medicare Advantage plan).
- Dropping your Part D coverage entirely.
- Ensuring coverage for current needs: Verifying that your doctors, hospitals, pharmacies, and all your current medications are still in-network and on the plan’s formulary (list of covered drugs) for the next year.
- Comparing costs: Reviewing changes to premiums, deductibles, copayments, and the annual out-of-pocket maximum to find a more cost-effective option.
It is important to note that plans can change their costs, benefits, and networks from year to year, so even if you are satisfied with your current plan, it is recommended to review your options annually.
How to Make Medicare Plan Changes:
If you are considering changing your Medicare Supplement or Medicare Advantage Plan, or want a review of your current insurance, reach out to an agent at Plan Medicare to assist you.
We have local agents in both Manhattan and Long Island and have served the residents of New York for more than 15 years.
