Medicare Open Enrollment 2023 Guide

Everything you need to know about the annual election period, including opportunities to change coverage, eligibility details and enrollment deadlines.

What Is Medicare Open Enrollment?

Medicare open enrollment – also known as the annual election period (AEP) or annual
coordinated election period – refers to an enrollment window that takes place each fall,
during which Medicare plan enrollees can reevaluate their existing Medicare coverage
— whether it’s Original Medicare with supplemental drug coverage, or Medicare
Advantage — and make changes if they want to do so.
This guide is all about Medicare’s annual election period. If you’re interested in learning
about additional opportunities to enroll or change your Medicare coverage, we’ve
covered those here.

When Is Medicare Open Enrollment?

Medicare open enrollment starts October 15 and continues through December 7 each
year. (Extended enrollment opportunities are available to some people in areas where
FEMA declares an emergency or major disaster that hampers their ability to complete
their signup during the normal window.)
What plan changes can I make during the Medicare open
enrollment period?
During the Medicare open enrollment period – if you’re already enrolled in Medicare
coverage – you can:

  • Switch from Original Medicare to Medicare Advantage (as long as you’re enrolled
    in both Medicare Part A and Part B, and you live in the Medicare Advantage
    plan’s service area).
  • Switch from Medicare Advantage to Original Medicare (plus a Medicare Part D
    plan, and possibly a Medigap plan, although medical underwriting might be
    required for Medigap, depending on the state and the person’s circumstances).
  • Switch from one Medicare Advantage plan to another.
  • Switch from one Medicare Part D prescription drug plan to another.
  • Enroll in a Medicare Part D plan if you didn’t enroll when you were first eligible for
    Medicare. If you haven’t maintained other creditable coverage, a late-enrollment
    penalty may apply.

Can I change my mind before the December 7 deadline?

Yes. You can change your mind and pick a different plan later in the AEP. There’s no limit on the number of plan changes you can make during the AEP. The last plan selection you make will be the plan that takes effect January 1

If I make a mistake when I change my coverage during the AEP, what can I do to fix it?

If you realize that you’ve made a mistake while the AEP is ongoing, you can simply pick
a different plan instead (by the December 7 deadline) and the new choice will take effect
on January 1.
If the AEP has ended and you’ve enrolled in a Medicare Advantage plan but believe you
should have picked a different plan, you can use the Medicare Advantage Open
Enrollment Period (MAOEP) to pick a different Advantage plan or switch to Original
Medicare and a Part D plan.
For instance, maybe you picked an Advantage plan that doesn’t cover an expensive
medication you need, or that doesn’t include a conveniently located hospital in its
network. Or maybe you let your existing Advantage plan auto-renew and didn’t realize
that the premium or benefits would be changing as of January. Regardless of the
reason, the MAOEP gives people with Medicare Advantage one “do-over” opportunity at
the start of the year.
The annual MAOEP window runs from January 1 to March 31.

If the AEP has ended and you’ve enrolled in a stand-alone Part D plan that doesn’t fit
your needs, your options are more limited. There is nothing like the MAOEP to make
changes to a stand-alone Part D plan. Changes to these plans can generally only be
made during the fall AEP.
However, if you believe that you were given inaccurate or misleading information that
led you to make the wrong plan choice, you can call 1-800-MEDICARE and explain the
details. Depending on the circumstances, the call center may allow you to make a plan
change at that point.

Medicare Open Enrollment

Who’s eligible to make coverage changes during Medicare open enrollment?

If you’re currently covered by Original Medicare or Medicare Advantage, then you’re
eligible to make changes during open enrollment.
However, the annual Medicare open enrollment period does not apply to Medigap plans,
which – in most states – are only guaranteed-issue during a beneficiary’s initial
enrollment period, and during limited special enrollment periods. So to clarify, you
cannot use the annual Medicare open enrollment period to enroll in a new Medigap plan
on a guaranteed-issue basis. You can certainly apply for a new Medigap plan during this
window – just as you can at any time of the year. But if your six-month initial enrollment
period for Medigap has ended, the Medigap insurer will use medical underwriting to
determine your eligibility and premium.
(Note that 11 states have rules that allow for at least some guaranteed-issue access to
new Medigap plans, although in most cases it’s limited to switching from one Medigap
plan to another with equal or lesser benefits.)
In addition, if you didn’t enroll in Medicare Part B when you were first eligible, you may
not use the AEP to sign up. Instead, you’ll use Medicare’s general enrollment period,
which runs from January 1 to March 31. The general enrollment period is also for
people who have to pay a premium for Medicare Part A and didn’t enroll in Part A when
they were first eligible. (Most people do not have the pay a premium for Part A.)

Can I sign up for Medigap during the AEP?

You can certainly apply for a Medigap (Medicare supplement) plan during the AEP or at
any other time of the year. But unlike Part D and Medicare Advantage plans, there is not
a federally required annual enrollment opportunity for Medigap plans.
If you apply for a Medigap plan after your six-month initial enrollment period has
passed, however, the Medigap insurer is likely to use medical underwriting to determine
your eligibility and premium.
There are 11 states that offer an annual window during which existing Medigap
enrollees can select from at least some other plans without medical underwriting, and a
few of those states also extend that option to people who are newly enrolling in
Medigap.

How did plan costs change for 2023 Medicare coverage?

  • You can see a detailed summary of Medicare premium and out-of-pocket changes here.
    But in general:
    The Inflation Reduction Act will cap the cost of insulin products at $35/month in
    2023, and ensure that Part D enrollees no longer have to pay for recommended
    vaccines.
  • Part B premiums and deductibles decreased for 2023 (the first decrease in more
    than a decade).
  • Part A premiums (for those who have to pay for Part A), deductible, and
    coinsurance increased for 2023.
  • Average Part D premiums are expected to decrease slightly for 2023.
  • The threshold for having to pay Medicare’s IRMAA (high-income surcharge) for
    Part D and Part B increased significantly, but the high-income Part B premiums
    decreased, just like standard Part B premiums.
  • The maximum allowable cap on out-of-pocket costs for Medicare Advantage

plans (not counting prescription costs) increased to $8,300 for in-network costs.
But most plans will continue to have out-of-pocket caps well below this limit.

How many people change their coverage during the AEP?

Most Medicare beneficiaries do not switch plans during Medicare’s AEP. An analysis by
KFF found that over the course of a decade, the percentage of beneficiaries who
switched to a different Part D plan ranged from 10% to 13% per year. And for Medicare
Advantage beneficiaries it was even lower, ranging from 6% to 11%.
More troubling is the fact that seven out of ten beneficiaries didn’t even compare their
coverage options during a recent open enrollment period. It may well be that the plan
you already have will continue to be the best option for the coming year. But there’s no
way to know that without actively comparing the available alternatives, and the majority
of Medicare beneficiaries aren’t doing that.

What will happen if I don’t change my Medicare coverage during the annual election period?

If you don’t make a plan change, your existing coverage will renew for the 2023. But
that could come with cost and benefit changes. The plan you have might have changes
to its drug formulary (covered drug list) or its provider network, meaning that a specific
medication or doctor may no longer be covered under the plan. And the plan could also
have premium and/or cost-sharing structure changes.
This is why it’s so important to actively compare the available options each fall. You’ll
want to check to see how your doctors and prescription will be covered in the coming
year, both by the plan you already have and by the other plans that are available in your
area.

After the annual election period ends, you will not be able to make a change to your
stand-alone Part D plan until the next annual election period. If you have a Medicare
Advantage plan, you will still have an opportunity to use the Medicare Advantage Open
Enrollment Period (MAOEP) that runs from January through March. You can make just
one plan change during this window.
But it’s important to note that the new plan selection would take effect in February at the
earliest (and as late as April, depending on when you make the plan selection). This
means your out-of-pocket costs for the year would reset to zero when the new plan
starts, regardless of how much you had spent in the early part of the year under your
old plan.
So, if there’s any chance you’ll want to make a plan change, the best approach is to
select your new plan by the annual election period deadline (by December 7) so that the
coverage takes effect January 1 and covers you for the entire year.

Contact Epolicy Review Today

Keeping you and your family safe and protected is Epolicy Review‘s company’s top priority.
For more information on Medicare Open Enrollment for 2023, or to get a quote, please call 813-524-5556.

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