What is the Annual Election Period and What Do I Need to Know?

By Cindy Thompson, Simon Insurance Agency, Eaton, Ohio

October 15th through December 7th is a time known to Medicare beneficiaries as the AEP, a time to review one’s Medicare coverage and determine if it will meet health and prescription needs for the upcoming year. It is a time to buy Medicare Advantage, prescription drug plans, and possibly, Medigap policies. The options one may exercise are determined by one’s current coverage and any guaranteed issue, or trial right privileges, he or she may have. A licensed and appointed agent can be a helpful resource in aiding one in discovering solutions for one’s Medicare coverage.

Costs are subject to change from year to year on many of the Medicare Advantage and part d plans. Premiums, co-pays, formularies, networks, and maximum out of pocket costs, are a few items that can be impacted. Common options exercised during this time may be: changing from one Medicare Advantage plan to another, or, one part d to another. Many beneficiaries utilize the website, medicare.gov, to pinpoint plans that may minimize prescription costs. If looking at Medicare Advantage plans, it is necessary to visit the plan’s website to determine if one’s health care providers are in the plan’s network. It is good to note that you can enroll numerous times during the AEP, but the latest enrollment as of December 7th, is final. Coverage chosen during the AEP is effective January 1st, 2019.

Many may use this time to exercise a trial right. An example of a trial right is, if one purchased a Medicare Supplement plan when first eligible for Medicare and has never tried a Medicare Advantage plan. This person has a trial right to try a Medicare Advantage plan for 12 months. If during those 12 months, it is decided that there is a desire to return to the supplement plan, one may return (information obtained from 2018 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare). Another example of a trial right is for those who bought a Medicare Advantage plan when first eligible for Medicare. Those folks may have a guaranteed issue Medicare Supplement for up to 12 months after first being eligible for Medicare (also taken from 2018 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare). It is important to note that outside of guaranteed issue and trial rights, Medicare Supplement policies can ask health questions to determine eligibility and may increase the rate, or decline coverage, due to health conditions.

January, 2019, begins the implementation of the 21st Century Cures Act. There will be a change from the Medicare Advantage Disenrollment Period (January 1- February 14th) to the Medicare Advantage Open Enrollment Period (January 1- March 31st). During this time, Medicare Advantage members may make a one-time change to a different MAPD, or, return to Original Medicare and/or a part d plan.

It is good to be aware of the options one has during these enrollment periods and any guaranteed issue and trial right status. These can come into play in exercising your options for finding the right Medicare coverage for you.

Cindy Thompson resides in Eaton, Ohio and works for Simon Insurance Agency. She has been selling Medicare products for 13 years and represents several national carriers.