Medicare Open Enrollment: Time to Shop and Compare

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Privately administered Medicare plans — like Medicare Advantage, Medigap and Medicare Plan D — can change their coverage on drugs and other areas, so it's a good idea to check your plan during those times of year when you can switch.

Medicare has one main open enrollment window each year from Oct. 15 to Dec. 7, when current Medicare and Medicare Advantage users get a chance to evaluate their coverage and potentially make changes. There's also a separate Medicare Advantage open enrollment period annually from Jan. 1 to March 31.

What is Medicare open enrollment?

Open enrollment is the health care user’s chance to evaluate the plan they have, take a look at what’s on the market and update their coverage for the coming year. Open enrollment is for consumers who already have Original Medicare or Medicare Advantage.

During the main open enrollment period, from Oct. 15 to Dec. 7, any changes you make will take effect on Jan. 1. During the Medicare Advantage open enrollment period, any changes you make will take effect on the first of the month after the plan receives your request.

What you can change

There are several things you can alter during open enrollment. From Oct. 15 to Dec. 7, you can do the following things:

  • Switch from Original Medicare to a Medicare Advantage Plan.

  • Switch from a Medicare Advantage Plan back to Original Medicare.

  • Move from one Medicare Advantage Plan to a different one.

  • Join a Medicare prescription drug plan.

  • Switch from one Medicare prescription drug plan to another one

  • Drop your Medicare prescription drug coverage

From Jan. 1 to March 31, Medicare Advantage open enrollment, you can do the following things:

  • Switch from one Medicare Advantage Plan to another.

  • Quit your Medicare Advantage Plan and go back to Original Medicare, with the option to join a Medicare Prescription Drug Plan.

How to compare Medicare Advantage Plans

Choosing a Medicare Advantage Plan can be a little intimidating because there are so many plans available.

There are five different types of Medicare Advantage Plans:

  • Health Maintenance Organization, or HMO, plans: This kind of plan requires you to see an in-network provider unless it’s an emergency situation. Most require you to get a referral to see a specialist.

  • Preferred Provider Organization, or PPO, plans: This kind of plan allows you to see both in-network and out-of-network health care providers, although it typically is more expensive to go out of network.

  • Private Fee-for-Service, or PFFS, plans: This kind of plan allows you to see any Medicare-approved health care provider as long as they accept the plan’s payment terms and agree to see you, and you may also have access to a network of providers. You can see doctors that don’t accept the plan’s payment terms, but you might pay more.

  • Special Needs Plans, or SNPs: This kind of plan provides benefits to people with certain diseases, such as cancer, or health care needs, such as living in a nursing home. It also provides benefits to people with a limited income.

  • Medical Savings Account, or MSA, plans: These combine a high-deductible insurance plan with a medical savings account that can be used for health care costs.

Choosing between Medicare Advantage Plans will require you to understand your health care needs and think about what each type of plan offers. If you have a chronic health condition and you love your doctors, you’ll want health coverage that they accept. If you take prescription drugs, some plans may result in lower out-of-pocket costs than others.

How to switch Medicare Advantage Plans

If you’re already in a Medicare Advantage Plan, you can switch to a different Medicare Advantage Plan during either open enrollment period: Oct. 15 to Dec. 7, or Jan. 1 to March 31. After you join a new plan, you’ll be automatically unenrolled from your old plan once your new one starts.