Most of you are probably familiar with Medicare Part A (hospitalization coverage) and Medicare Part B (doctor visit coverage). But how much do you know about Medicare Part C? Are you familiar with the Medicare Open Enrollment Period? (Also referred to as the Medicare OEP or OEP Medicare)
Medicare Part C, also called Medicare Advantage (MA), these are coverage plans maintained by private insurers, but required to meet Medicare standards. Those incorporating prescription drug coverage (Medicare Part D) are known as MAPD plans and are the most common Medicare Part C plans.
Unlike Original Medicare, which has an annual enrollment period (AEP) of Oct. 15 to Dec. 7, the Medicare OEP begins January 1 and ends March 31. This Medicare enrollment period is designed for beneficiaries that have a MAPD (Medicare Part C Plan) and wish to make changes to their coverage. So, what are your plan options and when do your changes take effect?
- Change your current MA or MAPD plan to another MA or MAPD plan.
- Drop your current MA or MAPD plan and go back Original Medicare with a Medicare Supplement Plan (Medigap Plan) and add a Part D (Medicare Drug Plan).
- Drop your current MA or MAPD plan and go back to Original Medicare only.
The OEP Medicare offers to beneficiaries provides additional opportunity to secure the coverage he/she desires before potentially being locked in for the remainder of the year. In general, Medicare Advantage Plans Have Grown in Popularity Over the last 10 years, Medicare-eligible Americans have increasingly chosen MA plans.
In 2021, over 26 million beneficiaries enrolled in an MA plan, according to the Kaiser Family Foundation. In 2022, most Medicare beneficiaries can access 39 MA plans. By comparison, there were 33 available MA plans in 2021, and 28 available plans in 2020. Of the 39 MA plans available in 2022, 31 offer prescription drug coverage.
Advantages of MAPD Plans
An MAPD plan bundles the coverages of Medicare Parts A, B and D into a single package.
Close to 70% of MAPD plans will have a four-star rating in 2022, according to Policy & Medicine, a publication focusing on legal, regulatory and compliance issues facing the pharmaceutical and device industry.
Other advantages of MAPD plans are that most offer additional benefits beyond what Original Medicare covers. Some of the most popular MAPD plan benefits are: Part B Giveback (This provides money back to your Social Security check), Flex Spending card (Provides money with no restrictions on where to spend), Additional Monthly benefits for Over-The-Counter items, dental, vision and hearing coverage and gym membership discounts, to name a few.
Medicare Advantage PPO plans are a great choice for someone looking to have a flexible network, additional benefits and no referrals for a specialist. Medicare Advantage HMO plans have increased in popularity because of the Part B giveback benefit and low out of pocket cost.
Switching a Medicare Advantage Plan
If you currently have a Medicare Advantage Plan, you should be aware that there certain enrollment period that allow you to make changes. The most common dates to make changes to your Medicare Advantage plan are:
- Medicare Annual Enrollment Period (AEP), which runs from October 15-December 7, and your new plan begins January 1.
- Medicare Open Enrollment Period (Medicare OEP), which runs from January 1–March 31, and your new plan begins the first of the following month.
You may have other opportunities throughout the year to change your MA or MAPD plan, which is referred to as a Special Enrollment Period (Medicare SEP). There are many types of SEP’s, the most common example of a SEP is someone moving out of the plan service area. In this example, the Medicare beneficiary has 63 days to enroll into another plan from the last date of coverage with the current insurance carrier.
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