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Time To Change Medicare Advantage Plans

Time To Change Medicare Advantage Plans
09/30/2022
  • Medicare with Melissa

The most common time to change Medicare Advantage Plans is during the Medicare Annual Enrollment Period. This enrollment period takes place one time every year and allows for all Medicare beneficiaries to make changes to their current plan or enroll in a new Medicare Advantage plan.

New Medicare Advantage Plans and benefits are announced to the public on October 1st. You can submit your application for coverage beginning October 15th and no later than December 7th.

Medicare Enrollment Periods

There are many different Medicare Enrollment Periods to join, change or enroll in a Medicare Advantage Plan.

  1. Initial Coverage Election Period (ICEP). This enrollment period takes place 3 months prior to you turning 65 and last 3 months after you turn 65.
  2. Annual Enrollment Period (AEP). Dates for the AEP run from October 15th – December 7th.
  3. Medicare Advantage Open Enrollment Period (MAOEP). Medicare allows for certain, eligible beneficiaries to make additional changes between January 1 and March 31. Not all beneficiaries are eligible for this enrollment period and you should contact a licensed agent to see if you are eligible.
  4. Special Enrollment Period (SEP). This enrollment period is applicable to eligible beneficiaries that qualify for a plan change outside of other designated enrollment periods. For example, the most common reasons for a plan change in the middle of the year are:
    • You moved out of the plan service area and had a change of address.
    • Lost or are losing creditable insurance.
    • You became eligible for Medicaid and/or had a Medicaid status change.

I like my Medicare plan, do I have to make changes?

Unless you’ve received a notice that your plan is no longer being offered, you are not required to change your Medicare Advantage plan.

However, Medicare Advantage plans can change every year. Those plan changes could impact the plan performance and your out-of-pocket cost.

Some of the common benefits/features that can impact what you pay versus the year prior:

  1. Network of doctors and preferred pharmacies
  2. Drugs covered on the plan
  3. Deductible, Co-Pays and Maximum Out of Pocket (MOOP). The MOOP is the most you would pay in a calendar year if something catastrophic happens.

Taking no action is the worst thing you can do to protect yourself, even if you like the plan.

It’s recommended to review your Medicare plan with a licensed agent every year. By properly reviewing your plan with a licensed agent, you can move forward with confidence and feel comfortable that you’ve invested the time wisely with your health insurance.

Why do I need a licensed agent to help me change Medicare plans?

Licensed Medicare agents can be a great resource to compare several plans in a short time. The alternative is calling each carrier separately, getting stuck in phone trees and only being advised of that specific carrier offering.

The team at Senior HealthCare Solutions has assisted thousands of Medicare beneficiaries and have access to over 25 top-rated insurance companies.

According to CMS, Medicare agents are not allowed to charge service fees, so you don’t have to pay anything extra by using your agent as a resource.

In fact, there is no downside to working with a licensed agent. Find a good one and be sure to keep him/her in your back pocket. You can call 866-633-4427 and speak with one of our friendly, knowledgeable agents today!

Click here to read more about “Why Work With Us”

Can I still change my Medicare Advantage Plan if I miss the Annual Enrollment Period?

That depends on your current plan and what time of the year it is. (We know, Medicare is confusing).

Hang with me here. If you have a Medicare Advantage Plan and it’s between January 1 and March 31, you can submit an application to change Medicare Advantage Plans. You can also drop your Medicare Advantage plan, go back to Original Medicare and enroll in a Medicare Supplement Plan.

However, if you have a Medicare Supplement Plan and want to change to a Medicare Advantage plan, you must generally wait until the next Annual Enrollment Period.

What is the difference between a HMO and PPO?

Medicare HMO and Medicare PPO plans are not created equal. Below are a few key differences to help you better understand which type of Medicare plan might be a good fit for you.

  1. Network. Both plan types have a network of preferred providers that provide the best cost when receiving care. However, most HMO plans will require referrals, whereas no PPO plan will require a referral to see a specialist. Also, HMO plans tend to have smaller networks than PPO plans.
  2. Benefits. Whether you choose a Medicare HMO or PPO, plans are designed to cover what Original Medicare offers and in most cases more. Generally, we find that HMO plans will have richer benefits and higher coverage amounts than PPO plans. For example, HMO plans tend to have higher Part B reimbursement and offer additional benefits like a Flex Card. You wont commonly find those benefits on a PPO plan.
  3. Cost. It’s not uncommon for both plans to have $0 premium options. However, HMO plans generally have a much lower maximum-out-0f-pocket (MOOP) cost than PPO plans. For example, the average MOOP for a HMO is $3,500 per calendar year. On the other hand, the average MOOP for a PPO is $6,700 per calendar year.

We generally find that PPO’s provide the flexibility and coverage our clients need. When we looked at our client enrollment, 40% have chosen an HMO and the other 60% a PPO.

It’s important to remember that with a HMO plan, you can be responsible for 100% of services received outside of the plan network (except in the case of an emergency).

On the other hand, a PPO allows for services outside of the plan network. You will pay a higher cost, but not 100% (it provides a safety net).

Can I have a Medicare Advantage and Medicare Supplement plan?

No. You should not be enrolled in a Medicare Advantage and Medicare Supplement plan at the same time. You are essentially paying for benefits you cannot fully utilize.

Unfortunately, we’ve spoken with beneficiaries through the years that have ended up with both, and have been paying for the Supplement plan, only to find out that claims won’t be paid through the Supplement plan.

Remember, Medicare Supplement plans work together with Original Medicare and is considered secondary payor behind Medicare.

However, when you have a Medicare Advantage plan, Original Medicare takes a back seat and the Medicare Advantage plan is the primary payor, not Original Medicare.

You can read more here about Medicare Supplement vs. Medicare Advantage. We also created a short video, click here to watch the video.

Need help comparing and changing Medicare Plans?

Our agency has been assisting beneficiaries since 2014 and are well equipped with most carriers and plans in your area.

We are woman-owned and family operated. The agent you speak with will be sure to take their time to understand what your needs and wants are, to ensure we find the most suitable plan to fit your budget.

You can call 866-633-4427 today and one of our team members can begin assisting you immediately.

If you prefer to compare plans on your own, click here to compare Medicare Advantage plans in your area.

You can also click here to schedule an appointment at a time more convenient for you.

Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.

-Melissa

Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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