Understanding Medicare Advantage and When You Can Change Your Enrollment

Medicare benefits are an excellent resource for addressing the healthcare needs of Americans aged 65 and older. While Original Medicare benefits may vary from state to state, Part A generally covers certain inpatient services such as hospital stays. Additionally, Part B covers some outpatient medical needs, such as ambulance services or medical equipment. To obtain further health coverage, many Americans also purchase additional coverage under Medicare Advantage plans. Changes in 2019 have added a new opportunity for those enrolled in Medicare Advantage to make changes to their healthcare coverage.

6. Medicare Advantage

Medicare Advantage plans fill in some of the gaps in healthcare coverage left by Original Medicare. There are limited enrollment periods in which one is able to sign up for new coverage or switch from one Medicare Advantage plan to another. In 2019, a new Medicare Advantage Open Enrollment Period (MA OEP) has launched. This new enrollment period replaces the former Medicare Advantage Disenrollment Period. There are now three enrollment periods eligible Americans can use to enroll or make changes to their coverage.

5. Initial Enrollment Period

According to the U.S. Medicare website, the initial enrollment period for Medicare and Medicare Advantage Plans opens when you reach the age of 65. This seven-month period begins three months before the month you turn 65, includes that month, and continues for the three months following your birth month. In addition to turning 65, individuals may become eligible for Medicare and Medicare Advantage if they are disabled. Some individuals may become eligible for Medicare Advantage if they have been eligible for Medicare due to a disability and are now approaching their 65th birthday.

4. Fall Open Enrollment Period

The fall enrollment period runs from October 15 through December 7 of each year. During the fall enrollment period, those on Medicare can make changes and additions to their coverage. Such changes include switching from Medicare Advantage back to Original Medicare or vice-versa. Members may also switch from one Advantage plan to another, join a Medicare Prescription Drug Plan, switch Medicare drug plans, or drop prescription drug coverage altogether. Changes made in Medicare coverage will then go into effect on January 1.

3. Special Enrollment Period

In addition to the typical enrollment dates, the U.S. government provides a Special Enrollment Period (SEP) for individuals who experience major life changes at other times of the year. Events that may qualify for an SEP include losing health insurance, moving out of the covered area, getting married, having a baby, or adopting a child. Typically, an individual has 60 days following the life event to enroll in a plan. Once the 60 days have passed, it is necessary to wait for the next Open Enrollment Period to apply for coverage.

2. New Medicare Advantage Open Enrollment Period

The new MA OEP allows individuals to make certain changes to their existing Medicare Advantage Plans. January 1 through March 31 are the dates in which members can make these changes to their plans. Changes that can be made during the MA OEP include switching from one Medicare Advantage Plan to another or dropping the Medicare Advantage Plan to return to Original Medicare. During this time period, members are not able to switch from Original Medicare to a Medicare Advantage Plan or either join or change a Medicare Prescription Drug Plan if they are enrolled only in Original Medicare.

1. Reasons to Enroll in Medicare Advantage Plans

Original Medicare provides for some basic health needs such as inpatient hospital or skilled nursing facility stays. However, there are many medical needs that Original Medicare does not provide for. Examples of these include dental visits, eye exams for glasses, acupuncture, and clinic visits for hearing aids. Individuals wishing for greater healthcare coverage can seek out Medicare Advantage Plans that provide many of these services. Prescription drug coverage, fitness programs, and maximum out-of-pocket limits are other possible advantages of investing in a supplemental Medicare Advantage Plan. Check out Top Medicare Plans Here:

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