There are definitely rules that dictate when and how you are allowed to switch your coverage. Right now, until March 31, you have three potential opportunities to change your insurance. One is the Medicare Advantage Open Enrollment Period. The second is a Special Enrollment Period- The FEMA New York State of Emergency due to COVID-19 protections, the third is the Medicare General Enrollment Period for those who need to sign up for Medicare Part B. Now I will explain in more detail what the three different situations are.
The Medicare Advantage Open Enrollment Period (MA-OEP) is a three month opportunity when any individual with a Medicare Advantage Plan (MA) can switch to any other type of insurance product they choose, with or without drug coverage.
There are 46 MA plans available in our area. All have different monthly premiums, co-pay structures and networks of providers. Most MA plans include Prescription Drug Coverage.
The Medicare Advantage Plans are health plans that replace traditional Medicare, such as HMO’s (Health Maintenance Organizations), PPO’s (Preferred Provider Organizations), and PFFS (Private Fee For Service) plans. Each year, insurance companies adjust coverage, these changes include premiums, co-pays and deductibles, extra benefits, etc. During this Enrollment Period, you can go from a MA Plan (with or without drug coverage) to a different MA Plan (with or without drug coverage), or Original Medicare AND a Stand-Alone Drug Plan (PDP) or Original Medicare and NO drug coverage. So if for some reason you chose NOT to get drug coverage as part of your Medicare Advantage Plan, you could change that choice from January 1 to March 31.
It is also important to remember that if you are returning to Original Medicare, you should seriously consider adding on a Medicare Supplement Plan.
During this MA-OEP,(Open Enrollment Period) your new coverage will begin the first of the following month. If you change your insurance during March, your new plan will begin April 1.
The Special Enrollment Periods (SEP’s) available is the State of Emergency COVID SEP. In this situation you can use this SEP to change your Medicare coverage to any other coverage available to you in your area. This SEP is available because many individuals had difficulties accessing services and agencies during the Annual Open Enrollment Period (October 15 to December 7) and therefore could not make the change they wanted to. You do not have to prove the hardship, simply living in New York State and having Medicare makes you eligible to use this SEP. This SEP also ends March 31st. If using this SEP your new coverage would begin April 1.
The last situation is the Medicare General Enrollment Period. This is the annual opportunity for anyone who did not enroll into Medicare Part B when first eligible and who didn’t have creditable coverage from an employer has an opportunity to enroll in Medicare Part B. In this situation you would complete the paper application for Medicare Part B, turn it in to the Social Security Administration and your coverage would not begin until July 1, 2022. This is a significant delay to your Medicare Part B starting. You also may have a penalty for the period of time you were without creditable insurance. That penalty is 10% for each 12 months without creditable insurance coverage.
Now that March is finally here, it is nice to think about all of the opportunities coming our way. Warmer weather is certainly one. The one I look forward to the most is the opportunity to improve and change the insurance we have to a product that meets our needs in a better way. March will move along pretty quickly so don’t put this off any longer.