Getting Ready for the Annual Enrollment Period

The Annual Enrollment Period (AEP) happens every year from October 15 through December 7. It’s the primary time each year when you can review your current Medicare coverage and, if necessary, switch to a Medicare Advantage (MA) plan that may better fit your specific needs. In addition to assessing your health care needs, preparing for AEP should include reviewing your current plan, shopping for a new plan if yours no longer meets your needs and making sure you’re getting the most for your money.

What is AEP?

Let’s start our AEP preparation by understanding what exactly the Annual Enrollment Period is. AEP is a time when Medicare Advantage members can switch to a different MA plan or back to Original Medicare (OM) and when Original Medicare members can join a Medicare Advantage plan. It is also the time when you can join a Medicare Part D prescription drug plan, switch it to a different plan or drop it.

A couple of important notes: If your plan is still available for the upcoming year and you are satisfied with it, you don’t need to take any action. Your coverage will automatically renew on January 1. Also, this is a period for people currently on Medicare, so it doesn’t impact a newly Medicare-eligible person’s Initial Enrollment Period or any Special Enrollment Periods (SEPs). However, if you are turning 65 soon, you may find some of our tips helpful as you get ready to enroll in Medicare. Additionally, Medigap or Medicare Supplement plans are not affected by AEP unless you plan to switch to a Medicare Advantage plan, in which case you’d need to enroll during AEP or a qualifying SEP.

Shopping Tips

The Annual Enrollment Period is a time of decision-making—critical decision-making, since what you choose to do during the 54 day window will determine your health coverage for the coming year. All the information you receive may seem daunting, but these four habits will equip you with the power to make informed decisions during AEP this year.

• Read your Annual Notice of Change
• Confirm your doctors are in-network
• Check your plan’s drug formulary for prescription coverage
• Review your value-added benefits

Read Your Annual Notice of Change

 A Medicare Advantage Annual Notice of Change (ANOC) usually shows up in your mailbox on September 30 to help prepare you for the AEP season. The ANOC  clearly announces the changes to your plan or Part D drug plan that will take effect on January 1. If your current Medicare plan isn’t going to fit your needs in the coming year, you’ll be able to find that information in your ANOC. That’s why reviewing it is so important, so you aren’t hit with surprise changes starting January 1, losing your ability to switch until the next Annual Enrollment Period.

Overall, what you’ll find in your ANOC will be:

• Plan’s Status—if your current plan will no longer be available
• Next year’s prices for your premiums, maximum out-of-pocket payments, deductibles and more
• Prescription Part D coverage changes
• Provider and pharmacy network changes
• Value-added benefit changes

If one or more of these items don’t suit your needs, it may be time to consider switching to a different plan.

Confirm Your Doctors are In-Network

A big concern for people considering whether to keep or switch to a new Medicare Advantage plan is whether their doctors will be in-network. Changing providers because of a change in coverage is never easy. It can mean rehashing the same ground when it comes to your care, which can be stressful.

Some plans—such as the BSW SeniorCare Advantage plan—have robust “Find a Provider ” search tools  that allow you to check for in-network providers in your area. Some even allow you to filter by plan if they offer more than one option for Medicare Advantage. You can also call your doctor’s office and check directly with them.

Every year, Medicare Advantage plans have changes. So, even if your doctors were covered last year, they may not be covered next year. During AEP, check your current plan’s network, as well as any potential plans you may switch to. That’s the best way to ensure your visits will be covered.

Check Your Plan’s Drug Formulary

Being uncertain about whether a potential Medicare Advantage plan or Part D plan covers a medication can cause significant stress. The good news is that there’s an easy, accessible way to check. You can navigate to a plan’s drug formulary for help.

These are lists of drugs covered by your plan. No two drug lists are the same. Checking what’s covered when you are reviewing potential plans for next year will ensure your medicines are covered. Formularies can cover both generic and name-brand medications and are routinely updated.

Knowing that your prescriptions are covered means you can make an even more informed decision during AEP this year.

Review Your Value-Added Benefits

One of the key features that distinguishes Medicare Advantage from Original Medicare are added services and benefits that aren’t available with Original Medicare. That can make all the difference when you’re choosing a new plan. Each Medicare Advantage plan covers a range of “value-added services” like dental, vision and hearing care at varying prices. These services and costs may change each year, so review your current options and other options annually.

Conclusion

The Annual Enrollment Period may feel overwhelming but learning how to navigate it will put you in the best position for your next year of health coverage. Whether you’re switching from Original Medicare to Medicare Advantage or choosing a different Medicare Advantage or Part D plan based on your needs, you’ll be able to find the coverage that you need. And remember, if you are happy with your current plan, you don’t need to take any action during AEP.

If you’re still feeling overwhelmed, or if you want a second opinion, talk to a Baylor Scott & White Health Plan licensed insurance agent over the phone or in person. You can find a location that’s close to you and meet with an agent to discuss your options and needs. We believe that everyone deserves healthcare coverage, and we are excited to help you find the right plan.