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Ashford Insurance

Medicare Annual Open Enrollment Time is Here Again

Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford is the owner of Ashford Insurance, an independent health insurance agency specializing in Texas Medicare insurance.

At this time of year, current Medicare beneficiaries have the option to make changes in their coverage.

At this time of year, current Medicare beneficiaries have the option to make changes in their coverage. The so-called Medicare Annual Open Enrollment period runs from Oct. 15 to Dec. 7. If you’re enrolled in Medicare, this is an opportunity for you to make adjustments to your plan that will take effect on Jan. 1, 2021.

It is a good idea to review your coverage annually. Check the “Annual Notice of Change” that you should have already received from Medicare Advantage and prescription drug plan providers. Be sure you understand how changes for 2021 could affect your costs or coverage. Changes could impact premiums, deductibles, co-pays, drug costs, and provider or pharmacy “networks.”

At the same time, consider your situation. Have you experienced changes in your health that may affect your medical needs?

Have your prescriptions changed that may not be as effectively covered under your current drug plan? If you answer yes to either question, you’ll want to explore other options during the annual enrollment period.

Some options to consider

You have the flexibility to make meaningful changes in your coverage during this special enrollment period. Here are some options to consider:

Moving from original Medicare (Parts A & B) and Medicare Supplement (Medigap) plan to Medicare Advantage: Private insurance companies offer Medicare Advantage plans. They are designed to cover costs picked up by parts A and B and your supplement plan. Premiums can be more attractive but pay attention to how out-of-pocket costs may impact you. Most Advantage plans have a maximum out-of-pocket spending cap. Advantage plans may also provide, dental and vision coverage, something that is not typically included in more traditional coverage. Some plans also include a health club membership.

Moving from Medicare Advantage to traditional Medicare: If you are interested in moving from Medicare Advantage to traditional Medicare, you may be able to do so. If you are in your one-year trial period with Medicare Advantage, you are allowed to switch to traditional Medicare and a supplement plan at this time. If you are outside that window, your ability to pick up a Medigap policy may depend on the laws in your state. If underwriting is required to enroll in a Medigap plan, issuance is not guaranteed.

Switching Medicare Advantage Plans: You have complete flexibility to move from one Medicare Advantage to another during this time period. You’ll want to make sure your preferred medical providers are part of the network in a different HMO plan if you are looking to switch or switch to a PPO.

Enroll or change your Part D prescription drug coverage: The open enrollment period is a time to compare drug plans to see if you can find better coverage that is more cost-efficient for you. It is also an opportunity to either enroll in Part D coverage if you don’t have it or drop coverage if you think you aren’t getting much benefit from it. Be aware, however, that if you drop coverage, you must wait until the open enrollment period next year to join in again and a late enrollment penalty may apply.

Help is available: You can find plenty of information about Medicare through the program’s website Medicare.gov. But there’s a lot to sort through. You may want to work with insurance professionals at Ashford Insurance who specialize in Medicare coverage.


Photo by Wellness Gallery Catalyst Foundation

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Picture of Sonia Ashford

Sonia Ashford

Sonia Ashford, “The Medicare Insurance Lady”, has been helping Medicare eligibles in Texas with their Medicare Insurance since 2005.