Welcome to Medicare School Daily, where we help you understand Medicare, save money,
avoid mistakes, and above all else, get the most out of your Medicare benefits. Now, today's topic
is what and when is the annual enrollment period? Now, Medicare is a system, a health care system
or a healthcare program, that defines itself with some letters as well as some acronyms. And all
these are very important. But today's topic, I'm just going to focus on this particular acronym
here called the Annual Enrollment Period, because this is a time, a very important time when people
can switch plans if they need to. So I’m going to explain the details of the annual enrollment
period. When a person decides to go on Medicare, the first decision they have to make is how
will they have their inpatient and outpatient coverage through Medicare? And so there's only
two options. We can make a decision to stay in the original Medicare A and B, or we can
get what's called an advantage plan, a replacement plan. And both of these have to do with inpatient
and outpatient care. So if someone decides to stay in original Medicare, meaning Medicare is going to
pay the bills first because there are some gaps in Medicare, the majority of people are going to add
some type of a supplemental plan to fill in the gaps that Medicare did not cover. Other
people decide they don't want to stay in original Medicare and buy a supplemental plan, so they will
enroll into an advantage plan. And so with these are officially called are replacement plans.
And this is a private health insurance company called an advantage plan that replaces original
Medicare A and B, and this advantage plan will now be responsible for your inpatient and outpatient
expenses, less your copays. Now, we're also going to have a drug plan. And so if I stay
in this system up here where I have the original Medicare supplemental plan, then the drug plan is
going to be added. We actually add a drug plan. We call those stand-alone or separate drug plans.
If I take an advantage plan, the replacement plan, then what happens is that an advantage plan will
actually include a prescription drug plan for my coverage as part of the package. All right?
And so that's what the ABC and D means. And so the annual enrollment period is a period of time. And
it's during October 15th - December 7th every year where people who are on advantage plans
or prescription drug plans can switch those plans. And so what I want you to learn from
this is that C plans and D plans are only written for one calendar year. So whether it's been added
to this type of coverage or it's included with my inpatient outpatient advantage plan, these plans
here are only written for one county here. And so if the plan changes something that I'm not happy
with or maybe the plan, you know, totally drops out of the market and it's not even going to exist
next year, then this is the time, October 15th through December 7th, that I can switch plants.
All right? So that's the significance of this date. So these are written for one year at a
time. If you take A and B, that's written for life. If you get a supplemental plan,
it's also written for life. But drug plans and advantage plans, which include
drug plans, are only written for one calendar year. So what happens is right around October
the 1st. What's going to happen? These companies: advantage companies and prescription drug plans
actually are in a mail packet called an ANOC, an annual notice of change. And they're notifying you
two weeks before the open enrollment period of what they're going to change to the plan.
And they can change anything they want to. And if they make some type of a
drastic change or a change, that's going to actually going to hurt your coverage or maybe
cost, then you're probably going to want to switch those plans. So let me show you
what plans can be switched during the October 15th through December 7th dates. Let's suppose
that you're covered by an advantage plan, and you decide that you would like to actually
switch to a supplemental plan, meaning you're going to return to original Medicare A and B,
you're actually going to add a drug plan to that. So you decide to get off of your advantage plan
to make the switch. When do we do that? We can only do it between October 15th and December 7th.
We can make that switch. Now, remember, if you're on an advantage plan and you've been on it longer
than a year, which is typically called the trial period, if we're beyond the trial period to make
this switch, you're going to have to be medically qualified. You're going to have to go through
underwriting. They're going to ask you some health questions and look at your medications,
see what you're being treated for, maybe get a statement from your doctor. So you just can't
automatically switch from an advantage plan to a supplemental plan unless you've only been on your
advantage point for one year called the trial period. This requires medical underwriting,
but this is the time you would do it if you would like to make that switch. The other thing you can
do. Let's say you're on a supplemental plan. In other words, you're up here in A and B,
you have a supplemental plan, and a drug plan; you decide I no longer want to pay those premiums. I
don't want that coverage any longer. And now you can switch to an advantage plan, and you can make
this switch as long as you do not have end-stage renal disease. That's the one thing that would
keep you from making that particular switch. OK? Get end-stage renal disease, and you're going have
to stay in original Medicare. The other thing you can do is let's say you're on an advantage plan.
Now, let's say that advantage plan decides they're not going to be in your market any longer or maybe
your doctor’s no longer be in their network or something's changed that you're unhappy with.
If I want to switch advantage to advantage, do it during the annual enrollment period October
15th - December 7th. And again, the only thing that would keep me from making that move would be
end-stage renal disease, permanent kidney failure. If you have that, you're not able to switch
advantage plans. You have to stand the advantage plan that you're on already. Can't switch. And
then lastly, if you're on a prescription drug plan, remember, the separate ones, you had A and
B, you had a supplemental plan and a separate drug plan. And let's say that prescription
drug plan change is something that is adversely affecting you. Maybe they raise their premium a
lot or maybe they dropped a medication that you're on from their formulary or maybe they re-tiered
a medication. One year you're on a two-tier and they bump into tier four or it’s a tier-three and
they bump it to a tier five. But something has changed with that plan. And you want to switch
prescription drug plans. You can do so. There's no medical underwriting whatsoever, but we have
to make that switch during the annual enrollment period. So, as you can see, this is very important
here to time if you need to switch these are the things that you can do during this election period.