Do you Have the Right Medicare Advantage Plan?

As the New Year begins, many Americans with Medicare Advantage plans (also known as Medicare Part C) may think their choices for the year are set in stone. However, it’s crucial to know that there is still time to make changes if your current plan doesn’t meet your needs. The Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31, gives beneficiaries a valuable opportunity to reassess their coverage and ensure it’s the best fit for their health and financial circumstances.

What Is the Medicare Open Enrollment Period (OEP)?

Medicare OEP, which takes place each year from January 1 to March 31, is a time when those enrolled in Medicare can make certain changes to their coverage. During this time, beneficiaries can:

• Switch from one Medicare Advantage Plan (Part C) to another.
• Switch from a Medicare Advantage Plan back to Original Medicare (Parts A and B).

However, it’s important to note that OEP is different from the Medicare Annual Enrollment Period (AEP), which occurs from October 15 to December 7 each year. The AEP is when you can make a broader range of changes to your Medicare coverage. OEP, in contrast, is specifically for making changes if you’re already enrolled in a Medicare Advantage Plan.

Who Is Eligible for OEP?

Only those who are enrolled in a Medicare Advantage Plan (Part C) are eligible to make changes during the OEP. If you are on Original Medicare (Parts A and B) and have a standalone Part D plan, OEP doesn’t apply, as this period is meant for those who already have a Medicare Advantage Plan.

Why Should You Review Your Plan?

The New Year is a perfect time to review your health coverage. Medicare Advantage plans and Part D prescription drug plans can change their benefits, networks, and premiums every year, so it’s important to ensure your plan still meets your healthcare needs. During the OEP, you have the chance to switch to a plan with more appropriate coverage, potentially saving you money or providing better access to your preferred doctors and medications.

Key Considerations

• Coverage Options: If you are enrolled in a Medicare Advantage Plan, you may want to evaluate whether the plan still meets your needs or if switching to a different plan could give you better coverage, especially for prescription drugs or specialist care.
• Plan Costs: Check if the monthly premiums, deductibles, and out-of-pocket costs have changed in your current plan, or compare different plans to find one that may offer more affordable coverage.
• Prescription Drugs: If you have a Medicare Advantage Plan with drug coverage, review whether your medications are still covered at the best price, or if a standalone Part D plan would be more cost-effective.
• Provider Networks: Ensure your preferred doctors and hospitals are still in your plan’s network. If not, you might want to switch to a plan that includes your providers.

How to Make Changes During OEP

Making changes during the OEP is relatively straightforward. Please reach out to a local Medicare Agent, such as myself, for guidance. A knowledgeable agent can help you compare your options and make an informed decision.

Final Thoughts

The Medicare Open Enrollment Period from January 1 to March 31 is a valuable opportunity to reassess your coverage. Whether you’re unhappy with your current plan or just want to explore your options, now is the time to make changes. Review your healthcare needs, assess your current plan, and make informed decisions that will provide you with the best coverage for the coming year.

Remember: once the Open Enrollment Period ends on March 31, you will not be able to make changes unless you qualify for a Special Enrollment Period. So don’t wait—take advantage of this opportunity to ensure your healthcare needs are fully covered in 2025.

About the Author: Al Haghdan began his career as a financial planner and insurance agent in 2000. He launched a mortgage company in 2002, running it until 2012, and joined the banking industry in 2013. Since 2018, Al has focused on helping individuals with Medigap insurance options. With over 20 years of experience working with retirees and their budgets, Al is an Independent Health Insurance Agent serving New Hampshire, Massachusetts, and Maine. He is committed to being a trusted guide on your Medicare journey, offering the support you need to navigate Medigap options with confidence. Helping beneficiaries with Medigap insurance is the start of a lasting relationship.