Medicare Annual Enrollment Period

The Medicare Annual Enrollment Period is the time each fall when many Medicare beneficiaries can review and make changes to Medicare Advantage and Medicare Part D prescription drug coverage.  This period runs from October 15 through December 7 each year. Changes made during this period generally take effect on January 1 of the following year. Medicare.gov confirms that Open Enrollment happens from October 15 through December 7 and that changes are effective January 1 if the plan receives the enrollment request by December 7.  National Benefits Consultants helps Colorado Medicare beneficiaries review Medicare Advantage plans, Part D prescription drug plans, and plan changes during the Medicare Annual Enrollment Period.

What Can You Do During the Medicare Annual Enrollment Period?

During the Medicare Annual Enrollment Period, you may be able to:
  • Switch from Original Medicare to a Medicare Advantage plan
  • Switch from a Medicare Advantage plan back to Original Medicare
  • Switch from one Medicare Advantage plan to another
  • Join, drop, or switch a Medicare Part D prescription drug plan
  • Review whether your current Medicare Advantage or Part D plan still fits your needs
Medicare.gov explains that during the October 15 through December 7 Open Enrollment Period, people can join, drop, or switch Medicare Advantage plans, switch between Original Medicare and Medicare Advantage, and join, drop, or switch Medicare drug plans if they are in Original Medicare.

Why Annual Review Matters

Medicare Advantage and Part D plans can change each year. Premiums, copays, drug formularies, pharmacy networks, provider networks, prior authorization rules, and extra benefits may not stay the same.
CMS notes that Medicare health and drug plans can change each year, including cost, coverage, and what providers and pharmacies are in their networks.
Even if you like your current plan, it may be worth reviewing:
  • Are your doctors still in network?
  • Are your prescriptions still covered?
  • Did your medication costs change?
  • Is your pharmacy still preferred or in network?
  • Did the premium, deductible, copays, or maximum out-of-pocket limit change?
  • Are prior authorization rules affecting your care?
  • Are there new plan options that better fit your needs?
The goal is not to change plans every year. The goal is to confirm whether your current plan still makes sense.

Medicare Advantage Review

If you have a Medicare Advantage plan, the Annual Enrollment Period can be a good time to review your plan for the coming year.
Important items to check include:
  • Doctors and specialists
  • Hospitals
  • Prescription drug coverage
  • Copays and coinsurance
  • Maximum out-of-pocket limit
  • Dental, vision, hearing, and other extra benefits
  • Prior authorization rules
  • Travel needs
  • Whether staying with Medicare Advantage still fits your situation
Medicare Advantage plans can be useful for some people, but plan details matter. Provider networks and drug coverage should be reviewed carefully before making a decision.

Medicare Part D Prescription Drug Plan Review

If you have Original Medicare and a standalone Part D prescription drug plan, the Annual Enrollment Period is often the main time to review that coverage for the next year.
Your medication list, pharmacy, drug tiers, deductible, and copays can all affect whether your Part D plan is still a good fit.
A plan that worked well last year may not be the best fit next year if prescriptions, formularies, or pharmacy arrangements change.

What the Annual Enrollment Period Does Not Usually Do

The Annual Enrollment Period is mainly for Medicare Advantage and Medicare Part D changes. It is not the same as your first Medicare enrollment window, and it is not automatically a guaranteed time to buy any Medicare Supplement policy without health questions.  Medicare Supplement Insurance has different timing rules. If you are considering a move between Medicare Advantage, Original Medicare, and Medigap, it is important to review the details carefully before making changes.

Annual Enrollment vs. Medicare Advantage Open Enrollment

The Medicare Annual Enrollment Period runs from October 15 through December 7.
The Medicare Advantage Open Enrollment Period is different. Medicare.gov says the Medicare Advantage Open Enrollment Period runs from January 1 through March 31 and is only for people already in a Medicare Advantage plan. During that period, they can switch to another Medicare Advantage plan or drop Medicare Advantage and return to Original Medicare, with the option to join a separate drug plan.
These two periods are often confused, so it is important to know which one applies to your situation.

How National Benefits Consultants Helps

National Benefits Consultants helps Medicare beneficiaries review coverage during the Medicare Annual Enrollment Period.
We can help you review:
  • Current Medicare Advantage plan details
  • Current Part D prescription drug plan details
  • Doctor and hospital networks
  • Prescription drug formularies
  • Pharmacy networks
  • Premiums, deductibles, copays, and coinsurance
  • Maximum out-of-pocket limits
  • Plan changes for the coming year
  • Whether staying with your current plan makes sense
  • Whether another option may better fit your needs
Our goal is to help you make informed decisions before the Annual Enrollment Period closes.

Need Help During Medicare Annual Enrollment?

Need help reviewing Medicare Advantage or Part D prescription drug coverage during the Medicare Annual Enrollment Period? Call 720-488-9892 or contact National Benefits Consultants to review your Medicare coverage options.
Related topics: Medicare Insurance | Medicare Advantage Plans | Medicare Part D Prescription Drug Plans | Medicare Supplement Insurance | Medigap vs. Medicare Advantage: Which May Fit You Best? | Do I Need Medicare Part D?