January 9th, 2020 BY Jennifer Davis
If you have Medicare, then you probably know that open enrollment happens in the fall because you’re inundated with advertisements for Medicare Advantage plans. But you might also have started seeing ads in the last few weeks about a separate enrollment period. It’s called the Medicare Advantage Open Enrollment Period, a relatively new addition to the Medicare enrollment lineup.
Before 2019, Medicare Advantage enrollees could use the Medicare Advantage Disenrollment Period to switch back to Original Medicare. (If all these “enrollment periods” make your head spin, you’re not alone. We write about this stuff for a living and even we have to double-check our terminology.)
The Centers for Medicare and Medicaid Services (CMS) replaced that disenrollment period with the Medicare Advantage Open Enrollment Period.
Unlike the open enrollment period for all Medicare beneficiaries, the MA OEP sets specific limits. It starts on January 1st and runs through March 31st.
If you’re in a Medicare Advantage plan, here’s what you need to know about the Medicare Advantage Open Enrollment Period.
Who Can Use It?
First, the MA OEP is only for people who currently have a Medicare Advantage plan. These are the private plans that are sold by individual companies but still regulated by the federal government. If you’re in Original Medicare (Parts A and B together), this enrollment period is not for you. You’ll use the regular open enrollment period from October 15th through December 7th to make changes to your coverage.
If you have Medicare Advantage, you can use the MA OEP to change your plan. But there are limits, which we’ll talk about in the next section.
Limits on Enrolling
As we said, this open enrollment period for Medicare Advantage isn’t like the one that happens in the fall. Not only is it restricted to people in Advantage plans, but it comes with limits on what you can do during this 3-month time frame. During the MA OEP, you can:
- Switch from your current Medicare Advantage plan (with or without drug coverage) to a different Medicare Advantage plan (with or without drug coverage)
- Drop your Medicare Advantage plan altogether and go back to Original Medicare — and if you do, you’ll be able to join a private Part D drug plan if you want
These are your only options for changing your coverage during the MA OEP. You can’t go from Original Medicare to Medicare Advantage, change your private Part D drug plan or sign up for a Part D drug plan if you have Original Medicare during this enrollment period. These are all things that have to wait until the fall enrollment period.
It’s also important to note that you can only make one change during the Medicare Advantage Open Enrollment Period, which is different from how the regular open enrollment period works. In the fall, you can make as many changes as you need to get the right plan in place for the new year.
During MA OEP, you can only make one change — so think carefully before you change plans or drop your private plan altogether.
When Changes Take Effect
You have three full months to make a single change to your Medicare Advantage coverage during the MA OEP, but when your plan takes effect depends on when you make that change. Your new coverage will take effect on the first of the month after the month you enroll. So, for example, if you enroll on February 13th during the MA OEP, your new coverage will start on March 1st.
Special Note about Overlapping Enrollments
We wanted to mention a few things about overlapping enrollment periods. Because there are different enrollment periods for Medicare throughout the year, it’s possible that you’ll have two (or more!) enrollment periods that you can use.
When you first sign up for Medicare, you have what’s called the Initial Enrollment Period (IEP). This is the 7-month period during which you first sign up for Medicare. Your IEP could coincide with the Medicare Advantage OEP. If that’s the case, your IEP takes precedence.
If you enroll in a Medicare Advantage plan during your initial enrollment period, and it happens when the MA OEP is happening, then you can use the MA OEP to make a one-time change.
Nice and clear, right? Let’s look at an example.
- Your 65th birthday is January 11th. Your initial enrollment period for Medicare runs from October 1st through April 30th. You choose a Medicare Advantage plan that takes effect on February 1st.
- After using your plan for a couple weeks, you realize that your cardiologist isn’t in network. But the MA Open Enrollment Period runs through March 31st, so you have time to make a change.
- You use the MA OEP to switch your MA plan to a new one that covers your doctor. That coverage will take effect on March 1st since you made the change mid-February.
(Some special signup periods can get even muddier. For specifics on enrollment in your case, reach out to Medicare.)
Bottom line? If you have Medicare Advantage, you can use the MA Open Enrollment Period to make one of two changes to your coverage. As always, it doesn’t hurt to shop around a bit and see what’s out there. You may find a plan that costs less, covers more or works better for your needs.