Medicare Advantage Open Enrollment Period ends March 31
Category: Health and Wellness Issues
January, 2020 — One of confusing things about Medicare is that it has two different open enrollment periods. We are currently in the Medicare Advantage Open Enrollment Period, which runs from Jan. 1 through March 31. We have previously written about the Medicare Open Enrollment period and which type of Medicare might be best for you.
The two enrollment periods cover different sets of actions, so it is important to understand the difference.
These periods are the times when you can sign up for, switch, or disenroll from various plans.
The current Medicare Advantage period allows actions, as the name would imply, pertaining to Medicare Advantage plans. If your plan didn’t turn out to be what you were looking for, or some other event in your life suggests a change, consider what you can and can’t do now.
Here is what can be done during the current period.
1. Change Medicare Advantage (MA) plan to another MA plan
2. Change MA Prescription Drug (MAPD) plan to another MAPD plan
3. Change your MA plan to make it a MAPD plan
4. Change MAPD plan so it is only a MA plan
5. Disenroll from MA or MAPD to Original Medicare and enroll in a Part D Plan
During this period you cannot:
1. Switch a Prescription Drug Plan (PDP) to a new PDP
2. Change from a Medicare Savings Account
3. Change from a Cost Plan (These plans are ending in several states).
There are Special Enrollment Periods that allow you to make changes to Medicare plans outside of the two open enrollment periods. Those include losing coverage, changing locations, and aging into Medicare.
Comments: Have you ever made changes to your Medicare coverage during one of these periods? If you are unhappy with your coverage or costs it might be worthwhile investigating at this time.
Comments on "Medicare Advantage Open Enrollment Period ends March 31"
Janet says:
Many of you may be aware that I have researched and scrutinized MA plans and see them as the
privatization of Medicare. I believe that is a very bad thing! However, because I am healthy and on a limited budget I choose this cheaper coverage. Most important I am now able to go out of state to any UHC Dr or facility and get coverage which I couldn't do with Anthem. I was limited to CT only unless it was an emergency. Although it is still early and we are only 3 weeks in I have found that switching from the CT Anthem Advantage to the AARP UHC-Walgreens plan has been an excellent decision. So far Specialist co-pays are down $5, PCP has NO co-pay, my thyroid meds cost me zero as opposed to $80 last year (prior to $400 deductible being met, UHC is $300 but this med was excluded from rules). Routine blood work was down, also zero. I have Out of Network coverage so my own dentist is covered up to 1K annually with 35% co-pay, in network 20%, 2 routine or 3 periodontal cleanings annually are covered 100%. My Over The Counter benefits card is $100, AA went up to $59 a quarter but they stopped my purchases prior to the end of the contract year for reasons unknown. Anthem would not rectify this problem with its sub contractor. I have filed a formal complaint with them and will also report this to Medicare since they paid my premiums. Clearly Anthem falls short in their ability to provide excellent coverage to seniors. I hope UnitedHealth Care does a better job.
Check with your agent if you are interested in learning more.
Janet says:
Correction UHC OTC card is not $100 but $50 quarterly with a much larger list of approved products and easy access for purchasing unlike AA.
Clyde says:
Janet, I also have the UHC MA plan. Mine is a PPO as I assume yours is, too. Most MA plans are HMOs. I agree with you about the advantages of this plan over others. My plan is issued in Palm Beach County, FL, but we spend summer and fall in Connecticut, so having the wide PPO access to providers and facilities in network throughout the US is good. You and I are examples of people picking the Medicare plan that is best for their current situation. I don’t argue that Medicare Advantage is necessarily better than traditional Medicare. It’s always an (informed and personalized) decision that each participant needs to make each year during enrollment periods.
Clyde says:
I forgot to mention that my United Healthcare Medicare Advantage monthly premium is $0.
Ron says:
Many doctors are not accepting the Medicare Advantage plans! This is an attempt by our government to privatize Medicare which would be a disaster! Your initial rates are not guaranteed but is your doctor! Be very cautious before believing all the TV marketing hype! I am a firm believer in you don’t get something for nothing folks!
Clyde says:
Without getting back into the debate about Medicare Advantage vs. regular Medicare plans, it’s important not to reject either type out of hand. As has been pointed out, study the plans available to you during the open enrollment period and use your judgment and research to select the one that appears to work best for your particular situation. It’s also helpful to use a competent and qualified professional insurance agent to assist you. It doesn’t cost you anything more than if you didn’t use one.
hcbury says:
I have had no problems with Doctors accepting my United Healthcare PPO Medicare Advantage nor Anthem PPO Medicare Advantage. I have used one or the other for three years now. If you opt for a HMO plan, usually for a lower price, there can be restrictions to who you can use. Ask a Veteran how the government has done with healthcare through the VA. Not a good case study.
Janet says:
Ron, I couldn't agree with you more on the fact that the privatization of Medicare is well underway by
the current administration and is being dismantled as we speak.
Clyde as you are aware from past posts I do agree wholeheartedly with you on the need to do the research and make one's choice on individual needs, your comments are helpful and informative.
hcbury and Ron - I have found doctors in CT who accept Anthem and also Medicare. Unfortunately these SAME docs will not accept Anthem Advantage plans. I am certain that this could change as insurance companies will insist providers participate. However, I suspect more docs will stop taking those insurances. It's already started with Concierge Medical Care growing. I was told the Anthem Advantage plans reimbursement rates are unacceptable because they are so much lower. I suspect that is across the board with all insurance companies Advantage plans.
Barry Snider says:
RE:Medical Advantage plans,I have one for 7-8 years.Not only NO problems but GREAT!
I suspect that you two are dealt with inferior programs, unhappy with doctors.
Jennifer says:
Since healthcare is a "business" and not a right in the USA, doctors can refuse to accept insurance plans leaving patients out in the cold if they cannot afford out of pocket medical care. I hope that one day in the future it will be a condition of licensure for all doctors to accept Medicare and other plans. My husband was a surgeon and I am a former nurse. It is wrong not to be able to treat a sick patient because of their lack of insurance. Doctors, even if paid less in other countries, like in the UK or Canada, still make a good living. It is a privilege to be a healthcare provider and medical care should be available to all citizens in the USA. Medicare Advantage plans vary in that they pay different rates from state to state--so while some people love theirs in one state, they may hate their plan in another state. Often, rural states do not leave much choice in insurance plans for their residents. Doctors and hospitals may be miles and miles away. So one must do their research carefully since what seems great when one is healthy may not be so great once an illness sets in.
Barb says:
Thank you Jennifer! Very well stated! I could not agree more. People need to educate themselves and take responsibility for their decisions.
Partagas says:
I have tried to do some investigation about Medicare Advantage to learn more about it. Here are a couple links to interesting articles by the Kaiser Family Foundation: https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage-in-2019/ & https://www.kff.org/medicare/fact-sheet/medicare-advantage/. You can read the whole articles, but a few interesting facts that struck me: Enrollment in Medicare Advantage plans has doubled in the last decade (2010-2019), fully a third (34%) of all Medicare enrollees are in Medicare Advantage, and the Congressional Budget Office projects that will be 47% by 2029; as Clyde alluded to, half of all MA enrollees pay no premium (other than the part B premium everyone in Medicare has to pay); prescription drug premiums paid by enrollees have been decreasing since 2015; Most MA enrollees have access to extra benefits not covered by traditional Medicare such as vision, dental and fitness plans; per capita expenditures for Medicare vs. Medicare Advantage enrollees are equal. From these facts, I take some messages that address some of the issues noted above. If doctors accepting MA plans is a problem, it doesn't seem that MA plan enrollment would be seeing the dramatic growth it has, and is expected to continue to have into the forseeable future. Since most of this growth in the last decade occurred under the prior administration, it seems inappropriate to blame the current administration for being the cause for privatizing and dismantling Medicare. Since the government per capita expenditure is the same in traditional Medicare and Medicare Advantage, it wouldn't appear that MA enrollees are being shortchanged in the care they receive. Certainly there are variations from state to state, and urban vs rural ares, but overall it would appear that these plans are popular, and successful at addressing the needs of a significant portion of the Medicare population.
Clyde says:
I want to say I’m not in favor of privatization of Medicare to insurance companies exclusively. There should be a choice between regular Medicare and other plans, such as Medicare Advantage. I think the concern that Janet and others have is that MA might in years to come be selected by 70-80% or so of participants and Congress might say “Why don’t we just go to MA exclusively?” Of course, that would have to be passed by Congress and signed by the president in office, so our votes for Congress and President are important. I don’t believe going to MA exclusively is likely to happen, but the future can’t be predicted.
I want to point out something about the availability of doctors and hospitals under MA. An online directory of care providers and hospitals is available for MA plans during open enrollment and also the rest of the year. Participants considering MA need to make sure the providers and hospitals they want for the next year are on the list. If not, that MA plan is not likely for you. Contracts that MA insurance companies have with providers generally require that doctors and hospitals may not drop out during the calendar year. Any doctor or facility can choose not to participate in regular Medicare as well. Most of us know of some doctors that don’t take any form of Medicare.
So, again, study the Medicare plans available during open enrollment and review the online directory to see the providers in network. Then make a decision as to which plan works best for your needs. I don’t think either regular Medicare or Medicare Advantage should simply be rejected out of hand. As has been mentioned in articles and other posts on this site, the advice of a competent, qualified professional insurance agent is helpful. They charge no fees for their services and any commissions they receive are the same by law, no matter what policy they enroll you in. They have no financial incentive to recommend any particular plan over another.
Admin says:
We moved a number of comments about Medicare and Medicare Advantage to this post because they fit better:
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A question – if anyone happens to know: If you are on Medicare with an added Medicare supplement plan, can you go to doctors in any state? I thought you had to go to doctors in the state where you have your plan/residence. I mean as far non-emergency PCP and regular specialists. When we moved my elderly dad from one Assisted Living residence to another in a nearby town (all within Massachusetts) I called his supplemental Med plan insurance (I think it was Harvard Pilgrim) to update dad’s address. They were all freaking out because his zip code had changed. Fortunately his premiums didn’t go up but I got the impression that the coverage is based on your zip code. I don’t understand what it is based on – would your coverage and rates change if you live closer to a hospital or a large city?? Confused…. Cindy
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Cindy,
It probably depends on the plan, try checking it the company has a "find a dr" link for your plan on their website and search for out-of-state Drs. As for the zipcode q. never assume the people at the ins co you speak to on the phone have a clue about what they ae doing. My husband recently started Medicare and decided to take a supplemental plan from the company he had been using for his individual plan (pre Medicare). He was told different things from different people each time he called them and was even send a form letter that gave the wrong instructions for using the plan. My supplement plan is covered by my former employer (although I pay a lot for it) , and had to call them earlier this year. They have outsourced to a large plan management company and when I called the person on the other end said "that question has to be answered by someone in the US, I will transfer you" , so the default call center wasn't even in this country (from the accent sounded like it's in India).
...Jean
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Are you referring to a Medi-gap plan or a Medicare Advantage plan? That could be the difference. Medicare Advantage plans sometimes have limitations on their service area especially if the MA plan is an HMO. They also often require pre-authorization for any treatment outside of their area. We have had this discussion before.
Traditional Medi-gap plans are portable and have no such limitations, that was my reason for choosing a traditional plan. I travel a good bit of time and did not want any limitations on my insurance should an accident or illness occur. Any doctor that accepts Medicare assignment must also accept the secondary Medi-gap policy. This is the law. ....Jennifer