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Open Enrollment Period

by Ethan Bynon, October 1, 2021

What is the Medicare Open Enrollment Period?

During the Medicare Open EnrollmentIn health insurance, open enrollment is a period during which a person may enroll in or change their selection of health plan benefits. Health plan enrollment is ordinarily subject to restrictions. Period (OEP), Medicare Advantage and Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan members can change, switch, or drop a plan they chose during the Annual Election Period. OEP starts on January 1 and ends on March 31.1Medicare.gov, “Joining a health or drug plan“, Accessed September 25, 2021

Key Takeaways

  • The OEP allows Medicare Advantage planMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). and Medicare Part D members to make a change to their plan.
  • Medicare Advantage members can switch plans, drop a plan, and switch to Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. during the OEP.
  • Medicare Part D members can switch between or drop their prescription drug plans.
  • The Open Enrollment Period for Medicare Advantage is not the same as the Annual Enrollment PeriodThe Annual Enrollment Period is when Medicare beneficiaries can join, drop or change Medicare Advantage and Medicare Part D prescription drug plans. AEP begins on 15 October and ends on 7 December. and General Enrollment PeriodThe General Enrollment Period (GEP) allows beneficiaries to enroll in Medicare Part A and Part B  from January 1 to March 31 if they missed their Initial Enrollment Period. Beneficiaries can also enroll in a....

Medicare Advantage plan members can switch between Advantage plans or drop Advantage for Medicare Part A and Part B, and optionally Part D. Medicare Part D members can change drug plans or drop them altogether.1Medicare.gov, “Joining a health or drug plan“, Accessed September 25, 2021

The OEP is not the same thing as the Annual Enrollment Period (October 15 to December 7), nor is it the same as the General Enrollment Period (January 1 to March 31). These enrollment periodsEnrollment periods are designated time periods to enroll or disenroll from the various parts of Medicare. There are six Medicare enrollment periods. have different purposes and different rules for Medicare Advantage and Medicare Part D members.1Medicare.gov, “Joining a health or drug plan“, Accessed September 25, 2021

The OEP allows Medicare Advantage and Medicare Part D members to make a single plan change1Medicare.gov, “Joining a health or drug plan“, Accessed September 25, 2021. If beneficiaries are dissatisfied with a Medicare Advantage or Part D plan, or they unwittingly enrolled in a wrong plan during the fall Annual Enrollment Period, they are not stuck with it for a year. They may be able to take advantage of the OEP to shop around for a plan, but they can only make that change once.

The Open Enrollment Period is also not the same thing as the Medigap Open Enrollment PeriodUpon initial enrollment in Medicare Part A and Part B, beneficiaries have a one-time, six-month period to buy a  Medicare supplement policy with guaranteed issue rights. This is the Medigap Open Enrollment Period.. Beneficiaries enrolled in Medicare Part A and Part B can add, switch, or cancel a MedigapMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. policy at any time. If a beneficiaryA person who has health care insurance through the Medicare or Medicaid programs. does not have guaranteed issue rightsGuaranteed-issue is a right granted to Medicare beneficiaries and applies to Medicare Supplement insurance (aka, Medigap plans). All states and the federal government enforce this essential right, which protects Medicare beneficiaries from medical underwriting., medical underwriting may be required.

Citations

  • 1
    Medicare.gov, “Joining a health or drug plan“, Accessed September 25, 2021

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