New York’s Medicare Advantage Open Enrollment Period (MA OEP) is just one of many Medicare-related enrollment periods, all of which occur at different times and allow you to do different things.
Other enrollment periods include:
- - Initial Enrollment Period (IEP)
- - Special Enrollment Period (SEP)
- - Annual Election Period (AEP)
Understanding the differences between each enrollment period is often a point of confusion for Seniors. This blog will focus on what Medicare Advantage Open Enrollment Period (MA OEP) allows you to do in New York and how it differs from other Medicare-related enrollment periods.
First, let’s review other enrollment periods.
1. Initial Enrollment Period (IEP)
You are first able to sign up for Medicare during your Initial Enrollment Period (IEP).
IEP takes place when you turn 65. It lasts for seven months total:
- - The three months preceding your 65th birthday month,
- - the month of your 65th birthday, and
- - the three months following your 65th birthday month.
2. Special Enrollment Period (SEP)
Special Enrollment Periods (SEPs) allow those on Medicare Advantage or a Medicare drug plan to make changes to your Medicare Advantage plan and Medicare prescription drug coverage provided certain events occur in your life. Each SEP has its own rules about when and what type of changes you can make.1
Examples of life events that may prompt an SEP include:1
- - You change where you live
- - You lose your current coverage
- - You have a chance to get other coverage
- - Your plan changes its contract with Medicare
3. Annual Election Period (AEP)
Medicare beneficiaries looking to change their current coverage may do so during AEP, which occurs every year from October 15 to December 7.
For example, a Medicare Advantage plan could be less expensive than a Medicare Supplement insurance policy, but consider these factors when assessing the value of the cost.
AEP allows you to make these changes to the way you receive your Medicare benefits:
- Change from a Medicare Advantage plan back to Original Medicare.
- Change from Original Medicare to a Medicare Advantage plan.
- Switch from one Medicare Advantage plan to another Medicare Advantage plan*.
- Join, drop, or switch a Medicare Part D (prescription drug) plan.
*with or without prescription drug coverage
Now that we’ve briefly discussed IEP, SEP, and AEP, let’s discuss Medicare Advantage Open Enrollment Period (MA OEP).
Medicare Advantage Open Enrollment Period (MA OEP)
MA OEP takes place every year from January 1 to March 31. It allows Seniors who are enrolled in a Medicare Advantage plan to make changes to the way they receive their Medicare benefits.
You can make either of the following changes during MA OEP:
- Switch to Original Medicare (Medicare Part A and Part B) and add a Medicare Part D (prescription drug) plan if desired or
- Switch to a different Medicare Advantage plan*
*with or without prescription drug coverage
If you have Original Medicare with or without Medicare Part D (prescription drug) coverage, you can’t make any changes to your Medicare coverage during MA OEP.
2 key differences between AEP and MA OEP:
1. You can make a greater number of changes during AEP than MA OEP.
During the MA OEP, you can only make a single change.
Unlike during AEP, you can not make the following changes during MA OEP:
- Switch from Original Medicare to a Medicare Advantage plan.
- Join a Medicare Part D (prescription drug) plan if you’re in Original Medicare.
- Switch from one Medicare Part D (prescription drug) plan to another if you’re in Original Medicare.
2. MA OEP does not apply to Seniors with Original Medicare.
AEP allows Seniors with Original Medicare to make changes to their Medicare coverage. MA OEP does not.
Whatever enrollment period you are facing, it can be difficult to choose the best way to receive your Medicare coverage in New York. Keep in mind the following when researching and trying to decide what Medicare coverage is right for you:
Medicare Supplement insurance policy eligibility and enrollment
For Medicare beneficiaries enrolled in Original Medicare, a Medicare Supplement insurance policy can be added to help pay some of the deductibles and coinsurance that Original Medicare doesn't cover.
Medicare Supplement insurance policies are guaranteed issue in New York. Seniors can enroll in them throughout the year. This means a New York Senior’s application to participate in Medicare Supplement insurance can’t be denied, nor can any premium rate distinctions be made “because of health status, claims experience, medical condition, or whether the applicant is receiving health care services.”2
You can find a list of insurers and Medicare Supplement plan rates here.
Differences between a Medicare Advantage plan and Original Medicare with or without a Medicare Supplement insurance policy.
While many Seniors focus on price when comparing Medicare Advantage plans and Original Medicare with or without a Medicare Supplement insurance policy, there are more factors to consider.
Consider these factors when deciding how to receive your Medicare coverage:
Guaranteed renewable.
A Medicare Supplement insurance policy added to Original Medicare is guaranteed renewable. This means that as long premiums are paid on time, the policy can’t be canceled.
Medicare Advantage plans are not guaranteed renewable. The carrier may cancel the plan or send a non-renewal notice, which requires enrollees to find new coverage.
Network of doctors, hospitals, and specialists versus no network.
A Medicare Advantage plan generally requires you to stay in a network of healthcare providers. This helps avoid denial of coverage or higher out-of-network costs. This may work well for you if your favorite providers are in-network. However, you’ll likely have to find new doctors, hospitals, and specialists if they are not covered under the Medicare Advantage plan’s network.
Original Medicare with or without a Medicare Supplement insurance policy allows you to choose any doctor, hospital, or specialist nationwide that accepts Medicare. This allows you more freedom to choose healthcare services regardless if you’re at home or traveling.
Enrollment Periods let New Yorkers change the way they receive their Medicare coverage.
You have a choice about how you receive the Medicare coverage you’re entitled to. Enrollment periods enable you to make changes to the way Medicare coverage is delivered to you if you are unhappy with it or want to change it for any reason. The coverage you need is dependent on your specific life factors like: age, health, budget, and lifestyle.
MA OEP takes place every year from January 1 to March 31. It allows Seniors who are enrolled in a Medicare Advantage plan to make changes to the way they receive their Medicare benefits.
Learn more about Medicare and enrollment periods at medicare.gov. Or, speak to a licensed insurance agent, as they can give you one-on-one guidance tailored to your needs.
Sources:
- Medicare.gov, Special circumstances (Special Enrollment Periods), accessed September 2021
- Department of Financial Services, Information for Medicare Beneficiaries, accessed September 2021
Categories: Insurance, Medicare Supplement