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Ashford Insurance

Fall Medicare Open Enrollment

Picture of Sarah Fuhrmann

Sarah Fuhrmann

Sarah Fuhrmann is an agent of Ashford Insurance an independent health insurance agency specializing in Texas Medicare insurance.

Fall Medicare Open Enrollment for Medicare beneficiaries starts October 15 and ends December 7 each year.

Medicare Open Enrollment

Fall Medicare Open Enrollment for Medicare beneficiaries starts October 15 and ends December 7 each year. (Sometimes called Medicare’s Open Enrollment Period, Annual Election Period, or AEP.) Throughout this period Medicare recipients can make changes to their health insurance coverage, including dropping, joining, or switching their Medicare Advantage and/ or Part D coverage for next year.

Even for those still happy with their current health and drug coverage, Medicare’s Open Enrollment is the time to review what you have, compare it with other options, and make sure that your current coverage will meet your needs during the next year.

You can make as many changes as you need to your Medicare coverage during the Medicare Open Enrollment. Changes you can make are:

  1.  Joining a new Medicare Advantage Plan
  2. Joining a new Medicare stand-alone prescription drug (Part D) plan
  3. Switching from Original Medicare to a Medicare Advantage Plan
  4. Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan)

Things to consider:

 

  • Access to the primary Doctor, specialists, health care providers, and facilities you want to use.
  • Access to pharmacies you use.
  • Access to benefits and services you need
  • The total costs for insurance premiums, deductibles, and cost-sharing amounts

Listed below are six things to keep in mind while you are choosing your Medicare coverage.

 

1. Fall Open Enrollment occurs each year from October 15 through December 7.

  • Any change you make during Medicare Open Enrollment will take effect on January 1.
  • In most cases, Medicare Open Enrollment is the only time you can pick a new Medicare Advantage or Part D plan.
  • If you have a Medicare Advantage plan, you can also change over to Original Medicare and for drug coverage, you should also join a Part D plan.

2. Review your current Medicare health and drug coverage. If you are dissatisfied with your coverage for next year, make changes during Medicare Open Enrollment.

  • If you have Original Medicare, look at next year’s Medicare & Youbeside link iconbeside link icon handbook to know your Medicare costs and benefits for the upcoming year.
  • If you have a Medicare Advantage Plan or a Part D plan, you should receive an Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC) from your plan. Review these notices for any changes in the plan’s costs, benefits, and/or rules for the upcoming year.
  • Even if you are satisfied with your current Medicare coverage, look at other Medicare options in your area that may better suit your individual needs in the upcoming year. For example, check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Part D could lower their costs by shopping among plans each year. There could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices.

3. Help is out there.

  • Use Medicare’s Plan Finder Tool if you need help finding Part D plans. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you visit, and your drug costs. • If you want to join a Medicare Advantage Plan, call 1-800-MEDICARE to find out which plans are in your area.
  • If you research a plan online, also call the plan to confirm what you have learned. Make sure the plan includes your doctors and hospitals in its network. Write down everything about your conversation, including the date, the representative you spoke to, and any outcomes or next steps.
  • Contact the Area Agency on Aging of Central Texas (AAACT), your local State Health Insurance Assistance Program (SHIP). The AAACT can help you understand your Medicare coverage options and navigate any changes.

4. The best way to enroll in a new plan is to call a local Texas agency like Ashford Insurance at 817-952-3153.

5. If you are dissatisfied with a Medicare Advantage Plan you choose during Fall Open Enrollment, you can change your plan during the Medicare Advantage Open Enrollment Period (MA OEP).

  • The MA OEP occurs each year from January 1 through March 31, with changes taking effect on the first of the month following the month you enroll. During this time, you can switch from one Medicare Advantage Plan to another, or switch from a Medicare Advantage Plan to Original Medicare with or without a Part D prescription drug plan.

6. Know the difference between fall’s Medicare Open Enrollment and Open Enrollment for the state or federal Marketplaces.

  • The federal Marketplaces (also known as Exchanges) offer annual open enrollment periods for uninsured and underinsured Americans. This enrollment period may overlap with Fall Open Enrollment. The Marketplaces are typically not meant for people with or eligible for Medicare.
  • If you have or are eligible for Medicare, you should only use the Medicare Open Enrollment Period (October 15 through December 7) to make changes to your Medicare coverage.

If you have Original Medicare, visit www.medicare.gov or read the 2023 Medicare & You handbookbeside link iconbeside link iconbeside link icon to learn about Medicare’s benefits for the upcoming year. You should review any increases to Original Medicare premiums, deductibles, and coinsurance charges.

If you have a Medicare Advantage Plan or a stand-alone Part D plan, read the plan’s Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC). If you do not receive these notices by the end of September, contact your plan to request them. Review these notices for any changes in:

  • The plan’s costs
  • The plan’s benefits and coverage rules
  • The plan’s formulary (list of drugs your plan covers)

Also, make sure that your drugs will still be covered next year and that your providers and pharmacies are still in the plan’s network. If you are unhappy with any of your plan’s changes, you can enroll in a new plan. If you want assistance reviewing your options, contact Ashford Insurance at 817-952-3153.

Conclusion

Remember even if you are happy with your current Medicare coverage, consider other Medicare health and drug plan options in your area. For example, even if you do not plan to change your Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Medicare prescription drug coverage could lower their costs by shopping among plans each year; there could be another Part D plan in your area that covers the prescriptions you take with fewer restrictions and/or lower prices. You can use Medicare’s Plan Finder tool to compare your options and call Ashford Insurance for assistance.

Best of luck to you this Falls Medicare Open Enrollment Period! Following the above advice, will make sure your health coverage will meet all your needs and expectations in 2023.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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