Medicare Open Enrollment with Mike Novelli

This edition of Health Matters with the Medicine Center Pharmacy features special guest Mike Novelli from Aultcare and Primetime Health Plan. Mike will be helping us learn more about Medicare’s Annual Enrollment Peroid for 2024.

Your Guide to Medicare’s Annual Enrollment Period (AEP) 2024: FAQs Answered

Medicare’s Annual Enrollment Period (AEP) is a critical time for millions of Medicare beneficiaries. It runs from October 15, 2024, to December 7, 2024. During this window, individuals can make changes to their Medicare plans for the upcoming year. Whether you’re new to Medicare or a long-time participant, it’s essential to understand how AEP works and what your options are. Below, we answer some of the most frequently asked questions to help guide you through this period.

1. What is the Medicare Annual Enrollment Period (AEP)?

The Medicare Annual Enrollment Period (AEP) is a set time each year when beneficiaries can make changes to their Medicare coverage. This includes Medicare Advantage (Part C) and Prescription Drug Plans (Part D). AEP is also referred to as the Medicare Fall Open Enrollment period.

2. Who can make changes during the Annual Enrollment Period?

Anyone who is already enrolled in Medicare Part A and Part B can make changes during AEP. This includes:

                  •               People looking to switch from Original Medicare to a Medicare Advantage plan.

                  •               Those already enrolled in Medicare Advantage who want to switch to a different plan or return to Original Medicare.

                  •               Anyone who wants to change, add, or drop their Part D Prescription Drug Plan.

3. What changes can I make during AEP?

During the AEP, you have several options:

                  •               Switch from Original Medicare (Part A and Part B) to a Medicare Advantage Plan (Part C).

                  •               Switch from one Medicare Advantage Plan to another (with or without drug coverage).

                  •               Drop a Medicare Advantage Plan and go back to Original Medicare.

                  •               Change your Medicare Part D Prescription Drug Plan.

                  •               Enroll in or drop a standalone Part D plan if you’re on Original Medicare.

These changes will take effect on January 1, 2025.

4. Can I change my Medigap (Medicare Supplement) plan during AEP?

Medigap plans are not part of the Annual Enrollment Period. You can apply for a Medigap policy any time of the year, but if you’re outside of your Medigap open enrollment period, you might be subject to medical underwriting, meaning insurers can deny coverage or charge higher premiums based on your health status.

5. What if I don’t want to make any changes?

If you’re happy with your current Medicare coverage and it still meets your healthcare and financial needs, you don’t have to do anything. Your plan will automatically renew for 2025. However, it’s a good idea to review your plan’s Annual Notice of Change (ANOC) to ensure there aren’t any changes to costs, coverage, or provider networks that could affect you next year.

6. What happens if I miss the Annual Enrollment Period?

If you miss AEP, your options to change coverage are limited until the next AEP in 2025. However, certain life events (such as moving out of your plan’s service area, qualifying for Medicaid, or entering a nursing home) may qualify you for a Special Enrollment Period (SEP), which allows you to make changes outside of AEP.

Additionally, there is a Medicare Advantage Open Enrollment Period from January 1 to March 31 each year. During this period, you can switch Medicare Advantage plans or return to Original Medicare if you’re already in a Medicare Advantage plan.

7. How do I know if I need to change my plan?

It’s important to review your current plan’s coverage, costs, and network every year. Some things to consider:

                  •               Did your health needs change in the past year (e.g., new medications or specialist visits)?

                  •               Is your current plan changing its premiums, deductibles, or copayments in 2025?

                  •               Are your preferred doctors and pharmacies still in the plan’s network?

                  •               Do you have a Part D plan that covers all your medications?

By evaluating these factors, you can ensure that your plan still meets your needs.

8. How do I enroll or make changes to my Medicare plan?

You can make changes to your Medicare coverage during AEP in a few ways:

                  •               Online: Use the Medicare Plan Finder tool on Medicare.gov to compare plans and enroll online.

                  •               By phone: Call 1-800-MEDICARE (1-800-633-4227) 24/7.

                  •               Through your plan provider: If you’re staying with your current plan, you can call them directly for assistance.

                  •               Through an insurance agent or broker: Independent agents can help you compare plans and understand your options.

9. What’s the difference between Original Medicare and Medicare Advantage?

                  •               Original Medicare: This includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You can see any doctor who accepts Medicare, but you may need to purchase a separate Part D plan for prescription drugs and Medigap coverage for additional costs.

                  •               Medicare Advantage (Part C): This is an all-in-one alternative to Original Medicare offered by private insurers. These plans often include Part D coverage, and some offer additional benefits like vision, hearing, and dental care. However, they may have more restricted networks and require referrals for specialists.

10. What should I consider when selecting a new plan?

When comparing Medicare plans, think about:

                  •               Costs: What are the premiums, deductibles, and copayments?

                  •               Coverage: Does the plan cover your medications, preferred doctors, and other healthcare services?

                  •               Convenience: Are the plan’s pharmacy and provider networks accessible to you?

                  •               Benefits: Does the plan offer additional perks like dental, vision, hearing, or wellness programs?

Final Thoughts

Navigating Medicare’s Annual Enrollment Period doesn’t have to be overwhelming. By understanding your options and being proactive, you can make informed decisions that best suit your healthcare needs for 2025. Review your current plan, compare alternatives, and reach out for help if you need it. A little preparation can go a long way in ensuring you have the coverage that’s right for you.

If you have more questions or need further assistance, visit Medicare.gov or speak with a licensed Medicare representative.

 Primetime Health Plan can be contacted at 330-363-7407 or 800-577-5084

Do you have more questions about Medicare or the Annual Enrollment Period? Drop them in the comments below, and we’ll be happy to answer!

Thanks for listening today! We’d like to remind our listeners, if you suspect you have a medical issue, please contact your healthcare provider. Thanks to our sponsor Aultman Health System. As always, we thank our listeners for joining us on Health Matters with the Medicine Center Pharmacy. Have a healthy week and we’ll see you again next Friday right here on News Talk 1480 WHBC.