Medicare’s Annual Enrollment Period (AEP) is here, so don’t worry if you missed your initial enrollment period, you’ve got time! You’ve probably seen all the ads urging anyone eligible to enroll or make changes, but what is the AEP, and how can you make sure you’re enrolling in the right plan? Well, you’re in the right place for those answers. This guide will show you how, when, and what changes you can make to your current Medicare health plan or prescription drug plan for 2024. You’ll get answers to all the important Medicare AEP questions so you can make the best choices.
What Is The Annual Enrollment Period?
For Medicare, this happens every year from October 15 to December 7. People might also call AEP “Open Enrollment” or “Fall Enrollment Period.” All people who are eligible for Medicare can sign up or make changes during this time, and your new coverage will start on January 1 of the next year.
What Can I Do During The Annual Enrollment Period?
You can use the AEP to initially enroll in Medicare. You can also use the AEP to sign up for a Medicare Supplement Plan or Advantage Plan if you already have Medicare Parts A and B. On the other hand, you can also drop your current Medicare Supplement Plan or drop your Medicare Advantage Plan and go back to Original Medicare if you choose.
Enrolling in Medicare
Medicare is a government program that helps pay for health care for people 65 and older or younger people with certain disabilities or health problems. The 4 Different parts of Medicare cover different kinds of medical treatments.
Medicare Part A – Medicare Part A pays for short-term inpatient care in a hospital, skilled nursing center, or nursing home, as well as hospice care and some home healthcare.
Medicare Part B – Medicare Part B pays for doctor visits and other outpatient services, as well as mental health care, ambulance transfers, durable medical equipment, lab tests, and preventive screenings. Parts A and B are sometimes called “original Medicare” to set them apart from Medicare Advantage plans that are run by private companies.
Medicare Advantage (Part C) – Medicare Advantage plans are an option to replace original Medicare. They are offered by private insurance companies in accordance with Medicare rules. Participants usually pay less out of pocket, but service is usually limited to providers in the network.
Medicare Part D – Coverage for prescription drugs. To sign up for Medicare Part D, you need to have either standard Medicare or a Medicare Advantage plan.
Medicare Supplement – Medicare Supplement Insurance is sold by private companies. It pays for some of the costs that original Medicare doesn’t cover, like deductibles, coinsurance, and copays.
Comparing
During the Annual Enrollment Period, one of your biggest decisions is whether it’s better to go with Original Medicare with a Medicare Supplement plan or a Medicare Advantage plan. Knowing the different types of coverage can help you decide which one makes the most sense for you. Here’s a look at how they compare.
Original Medicare
Allows you to use any doctor, hospital, or other health care provider who accepts Medicare and is taking on new patients.
Coverage for Parts A and B of Medicare.
There’s no need to pick a primary care doctor, and most of the time, you don’t need a referral to see a specialist.
Most of the time, you pay a deductible, co-pays or co-insurance, and Part B premiums.
Medicare Part D is not included.
Most people who have Medicare Part A benefits do not have to pay a premium. In 2024, the standard monthly premium for Medicare Part B is $179.80, but if you make more, your payment may be higher. The Part B deductible in 2023 was $226 and should be close to the same for 2024. There are deductibles and charges for both Parts A and B. The 2024 prices have not been announced yet but they should be close to the 2023 amounts. Part A charges in 2023:
Benefit period deductible was $1,600.
Hospital stay days 1-60 had no coinsurance per benefit period.
Days 61-90 has a $400 per day coinsurance per benefit period.
Days 91 and over had $800 coinsurance per lifetime reserve day used (up to 60)
Once you’ve used all of your lifetime reserve days the patient pays all costs
Medicare Supplement
Fills in the coverage gaps left by Original Medicare
Medicare is billed first for health care services, and the Supplement Plan is billed second.
Out-of-pocket costs will be based on what’s left after Medicare and the Supplement Plan pay their share.
Medicare Supplement plans vary based on the insurer and the plan you choose and where you live. To find out more about Medicare Supplement costs click here for our state-by-state Medicare Supplement Guide.
Medicare Advantage
Usually, you have to use doctors, hospitals, or other health care workers that are part of the plan’s network. There may be a fee if you go to a service that is not in your network.
Required to cover the same essential services Original Medicare does.
Depending on plan and provider, you may need a referral for specialists.
Plans have different out-of-pocket costs, but some may limit how much you have to pay each year.
Most plans cover medications through Medicare Part D.
How much you pay for a Medicare Advantage plan (Medicare Part C) depends on the plan you choose. Members of Medicare Advantage are still responsible for paying their Medicare Part B payments, but some plans may pay some or all of them on their behalf. This is called a “Medicare giveback benefit” in the insurance world. Some Medicare Advantage plans may have a monthly fee on top of what you already pay, but most don’t. Deductibles, copayments, and coinsurance costs can also be different.
AEP Tips
Your Medicare plan will automatically continue at the start of each year unless you change it, but you might not get the same benefits. Every year, insurance companies look at the perks of their Medicare plans and make changes. Instead of just letting your plan keep going, you should make sure it still meets your wants. During the Medicare Annual Enrollment Period (AEP), you can change your plan if you want. Here are some tips to help you make decisions about your Medicare coverage during AEP that are based on accurate information.
Check Your Current Plan Changes
Each year, your Medicare Advantage plan (Part C) or Medicare prescription drug plan (Part D) may change how much it covers or how much it costs. Changes go into action on January 1, so you need to be aware of them when making decisions during AEP. Changes to a plan may include adding new benefits, taking away benefits that were previously offered, updating the list of drugs that are covered, and lowering or raising prices. Plans will send you a letter called an Annual Notice of Change (ANOC) that explains any changes to your benefits or costs for the next year. Plan members usually get ANOC letters in September. Read it carefully and get in touch with your plan provider if you don’t get one.
Review Your Handbook
“Medicare & You” is the government’s official guide to Medicare. It covers coverage, costs, enrollment, and more. Every year, it’s changed. The guide shows what’s new with Medicare and what, if any, big changes are coming in the next year. Changes to Medicare rules or policies could affect your benefits, costs, or other parts of your health care, so it’s important to stay up to date.
Review Your Plan
Now that you’ve looked at plan changes and gone over what your plan covers it’s time to look at your present plan more closely. Start by figuring out how well your current Medicare plan will work for you in the coming year. If your plan still seems like the right choice, you don’t have to do anything during AEP to keep it. You’ll stay on the plan as long as you keep paying your fees and other costs.
Shop Around
If you think your plan won’t meet your requirements anymore, you should look for one that will. Even if you think your current plan will still meet your needs, you may want to look around to see if you can find one with better features or lower costs. Every year, on October 1, insurance companies release new information about their Medicare plans. They are competing for your business, so don’t be afraid to look at all of your choices.
What If I Miss The Annual Enrollment Period?
During the Medicare Annual Enrollment, you can change your Medicare Parts A or B coverage. From October 15 to December 7, anyone can sign up. People who have private Medicare Advantage plans have their own open enrollment time, which runs from January 1 to March 31. If you miss your open enrollment time, you usually have to wait until the next year to make changes. However, there are some cases where you can make changes before the next year. Special Enrollment Periods (SEPs) are times when you can make changes to your benefits. You might be able to get an SEP if you:
Move to a place that isn’t in the service area of your present plan.
Move to a new area that gives your current plan new coverage choices
Are let out of prison
Move into or out of a nursing home with skilled care
Move back to the United States after living abroad
Leave coverage through a company or COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage
Stop being covered by the Program of All-Inclusive Care for the Elderly.
Used to be able to get Medicaid, but now you’re not.
Are registered in a Medicare Advantage plan or Part D plan that hasn’t been renewed
Both Medicaid and Medicare are available to you.
These are just some of the times when you might be able to change your Medicare plan outside of the Annual Enrollment Period. On the Medicare page, you can find out more about these times.
Getting Medicare With EZ
EZ can assist you in enrolling in Medicare, purchasing a Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. They can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs and help you find a plan that meets your needs. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
If you have Medicare or will soon have it, you probably know what it covers on a basic level. But do you know about the less common perks that come with Medicare coverage? These perks aren’t technically free, since Medicare itself isn’t free. However, many Medicare recipients don’t have to pay anything out of their own pocket for these benefits.
There are a few exceptions. For example, there may be limits on how often you can see a doctor, and your doctor must agree to Medicare’s billing rules. Still, it’s good to know that you can get these benefits if you have Original Medicare or Medicare Advantage.Medicare advantage plans come with their own set of benefits in addition to the services that Original Medicare requires. Below are the “free” services that Medicare beneficiaries can access. They all help you save money and stay in good health.
Part A Premiums
Part A mainly covers hospital stays and inpatient care. While Part B mainly covers services in outpatient centers and doctor’s offices. Most people don’t have to pay a monthly fee for Part A coverage as long as they or their spouse paid Medicare taxes when they worked. Usually, you need to work and pay Medicare taxes for at least 10 years to avoid paying a premium for Part A.
Welcome to Medicare Visit
After you sign up for Medicare Part B, which pays for doctor visits and other outpatient services, you can get one free “Welcome to Medicare” checkup at any time during the first 12 months. This checkup is not a full physical test, but it gives your doctor a chance to look at your health and make a plan for your future care. You don’t have to get the “Welcome to Medicare” checkup, but if you do, it will help your doctor create a baseline to keep track of your health with your future annual wellness visits. However, Medicare will not pay for a wellness visit in your first year of Part B.
Annual Wellness Visits
Medicare beneficiaries are also able to get a free wellness visit once a year. This visit is meant to help you update your personalized health plan depending on how your health has changed year to year. It helps your doctor find new symptoms or possible health concerns early. The visit includes:
Reviewing your medical history as well as family medical history
Updating or changing your prescriptions
Recording your height, weight, and blood pressure
Checking your cognitive impairment
Creating a care plan based on any findings
It’s important to note that while the visit itself is free, if you get any additional testing or treatments that aren’t considered covered preventative care there may be a copay.
Vaccines
Medicare Part B covers a number of vaccines for free without any copayments. Starting in 2011 the Affordable Care Act got rid of cost sharing for many types of tests and vaccines that help people stay healthy. Here are the shots that Part B pays for. Depending on your age, risk, and when you get the vaccine or series of vaccines, you may have to meet certain requirements:
COVID-19 – Even though the public health emergency stopped on May 11, 2023, Medicare still pays for COVID-19 vaccines. Providers who are part of Medicare can’t charge Medicare recipients for the shot.
Flu – Most people of all ages get flu shots every year during flu season, which usually lasts from October to May, with most people getting sick from December to February. For extra protection, the Centers for Disease Control and Prevention (CDC) advises that people 65 and older get the high-dose version.
Hepatitis B – Part B covers the hepatitis B vaccine as a preventive benefit for people with diabetes, end-stage kidney disease, or hemophilia, who are at medium or high risk for getting the virus.
Pneumonia – Medicare pays for the pneumonia vaccine, which can help protect you from pneumococcal disease, which can lead to pneumonia, meningitis, and other illnesses. Medicare pays either a single dose of the vaccine or a two-dose series, with the second dose needed at least a year later for most people 65 and older. People who don’t have strong immune systems may get the second dose sooner.
Cancer Screenings
Medicare pays for several cancer screenings. Although some have requirements or are only covered in certain time frames.
Breast Cancer
Medicare Part B covers one mammogram test every 12 months for all women 40 and over. If you are between 35 and 39 years old and are eligible for Medicare, you get one free baseline mammogram. If your doctor accepts Medicare assignment the mammograms are free. Accepting assignment means that your doctor agrees to accept the Medicare-approved amount for the test as full payment rather than charging more.
Colorectal Cancer
Medicare will cover several screenings for colorectal cancer with specific guidelines for each;
Colonoscopy – If you have Medicare and are at high risk for colorectal cancer, you can get a screening colonoscopy every two years. If you don’t have a high chance of getting colon cancer, the test is covered once every 10 years, or 120 months. There is no minimum age, and if your doctor agrees, these tests won’t cost you anything.
Fecal occult blood tests – If you are 50 or older and have Medicare, you may be able to get one fecal occult blood test every 12 months to check for colon cancer. If your doctor agrees to do the tests, you won’t have to pay for them.
Stool DNA labs – Medicare will pay for a multi-target stool DNA lab test once every 3 years if you are 50 to 85 years old. You must meet certain requirements, such as having a normal chance of getting colorectal cancer and not having any signs of colorectal disease. If your doctor agrees to do the tests, you won’t have to pay for them.
Cervical Cancer
Part B of Medicare pays for a Pap test and pelvic exam every 24 months if you have Medicare. As part of the pelvic exam, the breasts are looked at to see if there are any signs of breast cancer. You might be able to get a screening test once a year if:
You have a high risk for vaginal or cervical cancer
You’re at childbearing age and had an abnormal pap in the last 36 months
If you are between the ages of 30 and 65, your Pap test every 5 years also includes an HPV test. If your doctor agrees to do the tests, you won’t have to pay for them.
Prostate Cancer
Medicare Part B pays for blood tests for prostate-specific antigen (PSA) and digital rectal exams (DRE) once a year for people 50 and older. The yearly PSA tests are free and won’t cost you anything if your doctor agrees to do them. The Part B deductible applies to the DRE, and Medicare will pay 80% of the allowed amount.
Medicare Part B will pay for a low-dose computed tomography (LDCT) lung cancer test once a year if you are between 55 and 77 years old. If your doctor accepts Medicare assignment, the tests will cost nothing. You do have to meet certain requirements such as:
You have no lung cancer symptoms
You smoke, or quit within the last 15 years
Your smoking history had an average of a pack a day
Medicare Part B pays for a yearly screening for depression. To be screened for depression, you don’t have to show any signs or symptoms, but the screening has to happen in a place where people get basic care, like a doctor’s office. This means that Medicare won’t pay for your screening if it happens in a hospital, skilled nursing facility (SNF), or emergency room. The annual depression check is done with the help of a questionnaire that you or your doctor fills out. This quiz is meant to show if you are at risk for depression or have signs of it. If your test results show that you might be at risk for depression, your provider will do a full evaluation and, if necessary, refer you for more mental health care.
Most of the time, you should get a depression test when you already have an appointment with your doctor. But your provider can choose to do the screening on a different visit. Original Medicare pays 100% of the Medicare-approved amount for depression screenings when they are done by a qualified provider. This means you don’t have to pay anything (no deductible or share). Medicare Advantage Plans are required to cover depression screenings without deductibles, copayments, or coinsurance if you see a provider in their network and meet Medicare’s standards for the service.
Diabetes Screenings
When diabetes is treated early, it can help people avoid problems. Depending on how likely you are to get diabetes, Medicare will pay for up to two diabetes tests per year. Medicare will also help you learn how to take care of your diabetes, but you’ll have to pay for it. Medicare also has a program to help people who are at risk of getting diabetes, but haven’t been officially diagnosed. This program is free of charge.
Working With EZ
Using the free services Medicare gives is a good way to stay as healthy as possible. If you’re new to Medicare, you should learn how it works so you can take advantage of all the services it offers. EZ can help you sign up for Medicare, buy a Medicare Supplement Plan, or just figure out what your best choices are. Our insurance brokers work with the best firms in the country. You can get a free review of all the plans in your area from them. We’ll talk about your physical and financial needs and help you choose a plan that fits them. To get started, just call 877-670-3602 and talk to one of our certified agents.
The Centers for Medicare and Medicaid Services, CMS, has announced that beginning in 2019, there will be a continuous Medicare Open Enrollment Period which will now be January 1- March 31st. During this time, Medicare beneficiaries will be able to to make a one time change of plans.
In 2011, the Affordable Care Act changed the Annual Election Period (AEP) to October 15 through December 7 every year and changed the Open Enrollment Period (OEP) into a Medicare Advantage Disenrollment Period (MADP) which was January 1-February 14. During the Disenrollment Period, you can drop your current Medicare Advantage plan and can return to Medicare and purchase Medicare Supplement. You can purchase Part D plan but only if you drop your Medicare Advantage Prescription Drug Plan, MAPD.
The 21st Century Cure Act that just passed and signed into law is bringing back the Open Enrollment Period dates. During the AEP, beneficiaries can change switch as much as they want but a final decision will be by December 7. The AEP will still during October 15- December 7 every year where beneficiaries can:
Switch from Original Medicare to Medicare Advantage Plan
Switch from Medicare Advantage Plan back to Original Medicare
Change Medicare Advantage Plans
Enroll in a Part D plan
Drop prescription drug coverage
Switch or purchase Medicare Supplement Plan
During the 2019 OEP, January 1-March 31st, beneficiaries can make a one time change to:
Medicare Advantage Prescription Drug Plan to another MAPD
Switch a MAPD to Original Medicare and a Part D
Switch Original Medicare and Part D to a MAPD.
Change Medicare Advantage Plans
Switch from Original Medicare to Medicare Advantage Plan
Switch Medicare Advantage Plan to Original Medicare
Purchase Medicare Supplement Plan when switching to Original Medicare*
*When purchasing a Medicare Supplement Plan during OEP, you will not have guaranteed issue and subject to underwriting.
The AEP can be a hectic time for many Medicare beneficiaries because it falls during the holidays. Some people will wait until the holidays are over to try and change plans and find out they cannot do it until the next AEP in a year. Now, with this new OEP, from January 1-March 31st, beneficiaries can help those that missed the deadline to have another chance to make changes.
There are specific times of the year when you can enroll, disenroll, or switch from a Medicare Advantage Plan, also called Part C or MA Plans. These plans are sold by private insurance companies that are approved by Medicare. If you miss these enrollment periods, it may be hard to make changes to your coverage, or enroll in a new plan.
Initial Coverage Election Period(ICEP)
The Initial Coverage Election Period is when you are first eligible to enroll in a Medicare Advantage Plan. For most people eligibility begins when they turn 65. You are allowed to enroll anytime over a 7 month period. This 7 month period starts 3 months before you turn 65 and ends 3 months after your birthday month. This means if your 65th birthday is in May you have the ability to sign up from February through August.
The initial enrollment period is when you are eligible for Part A and Part B. If you delay enrolling in Part B, then your ICEP for Medicare Advantage will not take place until you enroll.
To be eligible you must:
Have Medicare Part A and Part B
Permanently reside in the service area of the Medicare Advantage plan
Not have End-Stage Renal Disease (ESRD)
If you missed or did not utilize the ICEP, you can still join a Medicare Advantage plan during two other periods:
Annual Enrollment Period (AEP)
The Annual Enrollment Period occurs every year from October 15 through December 7, with coverage beginning January 1. This period is also referred to as the Fall Open Enrollment. During this period, people who are eligible can enroll in a Medicare Advantage plan. You can also switch plans and add, drop or change prescription drug coverage during the AEP.
Special Enrollment Period (SEP)
A Special Enrollment Period is a period when beneficiaries can enroll, or make changes to their Medicare Advantage plan outside of regular enrollment periods. If you qualify and get granted an SEP, your coverage will start the first of the month after you sign up. Certain situations are required to be eligible for a SEP, such as:
Moving out of your plan’s service area
Having full Medicaid coverage and Medicare
Qualifying for a low-income subsidy program
Tricked or misled into joining a plan
Living in a nursing home, rehab hospital, or skilled nursing facility
Enrolled in a State Pharmaceutical Assistance Program, or lose SPAP eligibility
Joining a Medicare Advantage plan during your initial enrollment period when you turned 65. The first year is considered a trial period, so you can change to Original Medicare at any time within the 12 months.
Receiving Extra Help to pay for your prescription drugs
In order to enroll in a Special Enrollment Period, you must apply and provide the necessary proof regarding the qualifying situation.
5-Star SEP
During the 5-star special election period, you can switch to a 5-star Medicare Advantage Plan from December 8 through November 30. The plan will go into effect beginning December 1. It is important to know that you can only use this SEP once per calendar year. After receiving your application, you will begin coverage the first day of the following month. To be eligible, you have to have Medicare Part A and B, and live in the service area.
What you can do during this period is:
Drop Original Medicare and enroll in a 5-star Medicare Advantage plan.
Switch from any Medicare Advantage plan to a 5-star Medicare Advantage plan.
Switch from a 5-star Medicare Advantage plan to a different 5-star Medicare Advantage plan.
Medicare star ratings are updated every fall on Medicare.gov.
Medicare Advantage Disenrollment Period (MADP)
Another different kind of enrollment period is the Medicare Advantage Disenrollment Period. This period occurs from January 1, to February 14 every year. This is when you can drop your current Medicare Advantage plan and switch to Original Medicare with or without adding a stand-alone Medicare drug plan (Part D). You cannot enroll in a Medicare Advantage plan, or switch to another Medicare Advantage Plan during this period, only drop a MA plan.
Shopping around will help you save money while finding a plan that best suits your needs. Research has shown that people with Medicare Advantage Plans could lower their costs just by shopping plans every year. EZ.Insure can help you shop around and compare different Medicare Advantage plans in your area. You can speak to one of our agent’s one on one without any hassle or obligation. To get started, just call 855-220-1144, email at [email protected], or simply put your zip code in the bar below to get quotes. The process of choosing a plan or signing up should not be difficult, make easy for you.
Medicare Supplement Insurance Does Not Have a Deadline
Many senior citizens think that the Medicare Open Enrollment period is the only time they can purchase a Medicare Supplement plan. But, there is no deadline to purchase Medicare Supplemental Insurance. During the Medicare Open Enrollment Period, everyone is busy picking a plan that is best for them. Some retirees rush into a new plan without focusing on the coverage, and some may miss the period. Missing the period does not mean you miss the opportunity to change or purchase a plan. You can change or buy it year round.
In order to actually sign up for a Medicare Supplement Insurance Plan, you must be 65 and have Original Medicare. You are most eligible to be guaranteed issue rights when purchasing a plan six months from when you turn 65. Guaranteed issue is the protected right that an insurer cannot deny you or raise rates due to pre-existing conditions.
While there is no deadline to buy or change a Medicare Supplement Plan and anyone eligible is able to buy a plan any time of the year, it comes with a catch. Medicare Supplement Insurers do have the right to ask you questions regarding your health. They can then determine if they want to insure you, deny you, or raise your rates due to pre-existing conditions. This is possible because you will not have guaranteed issue rights.
Picking a Medicare Supplement Plan can be a long and tough process. There can be questions you have about the coverage, costs, and the different types of plans. EZ.Insure offers you a trained one on one agent to assist in figuring out the process, coverage, and sign you up. We compare all plans for you, and find the best prices. Enter your zip code in the bar above to receive quotes, or contact your own advisor by calling 855-220-1144, or e-mailing [email protected]. We promise to provide the best service with no obligations, it’s that easy!
In 2011, the Affordable Care Act changed the Annual Election Period (AEP) to October 15 through December 7 every year and changed the Open Enrollment Period (OEP) into a Medicare Advantage Disenrollment Period (MADP) which was January 1-February 14. During the Disenrollment Period, you can drop your current Medicare Advantage plan and can return to Medicare and purchase Medicare Supplement. You can purchase Part D plan but only if you drop your Medicare Advantage Prescription Drug Plan, MAPD.