What you may not know about the Fall Open Enrollment could be costly for
the following coverage year! DOWNLOAD YOUR FREE MEDICARE STARTER KIT – Click Here
Fall Open Enrollment also referred to as the Annual Enrollment Period (AEP) runs from October 15 through December 7th each year. During this time, you can make changes to your health insurance coverage, including adding, dropping, or changing your Medicare Part C and D coverage plan. To read more, CLICK HERE or contact us at 800-362-2809
Even if you are happy with your current health and prescription drug coverage, Fall Open Enrollment is the time to review what
you have, compare it with other options, and make sure that your current coverage still meets your needs for the coming year.
Prior to the Fall Open Enrollment you will receive an Annual Notice of Change (ANOC) listing the changes to your current health and/or prescription drug coverages for the new coverage year. You should be sure to review your ANOC carefully as to prepare you for any changes to your current plans coverage or the need to review other coverage options.
If you have a Medicare Advantage Plan or a stand-alone Part D plan, read your plan’s Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC). Review these notices for any changes in:
• The plan’s costs
• The plan’s benefits and coverage rules
• The plan’s formulary (list of drugs your plan covers)
Make sure that your drugs will still be covered, which Tier Level they will fall under and if there will be changes or restrictions added to your prescriptions for next coverage year. Restrictions include Quantity Limits, Step Therapy or Prior Authorization. You will
also want to make sure your pharmacy of choice are still in the plan’s network. Any changes not reviewed to your following year’s coverage could lead to higher out-of-pocket cost. Keep in mind there is not a one-size fits all Medicare Advantage or stand-alone
Part D plan.
You can make as many changes as you need to your Medicare coverage during Fall Open Enrollment. The last application received by Centers of Medicare and Medicaid Services (CMS) by end of day on December 7th will be the final change. Any changes made during
Fall Open Enrollment will begin January 1 of the new coverage year.
1. Joining a new Medicare Advantage Plan
2. Joining a new Part D prescription drug plan
3. Switching from Original Medicare to a Medicare Advantage Plan
4. Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D
plan)
Regardless of how you receive your Medicare coverage, you should consider:
• Your access to health care providers you want to see
• Your access to preferred pharmacies
• Your access to benefits and services you need
• The total costs for insurance premiums, deductibles, and cost-sharing amounts
Should you find that the change you made to your Medicare Advantage plan or joined a Medicare Advantage plan for the first time during Fall Open Enrollment does not meet your needs you will have one more opportunity to make a change. Medicare now has an
Open Enrollment Period which begins January 1st through March 31st. You will be allowed to make
one change during OEP and change to 1) another Medicare Advantage plan or 2) dis-enroll from your Medicare Advantage plan and return to Original Medicare.
If you have a Medicare Supplement Plan, these plans do not have an annual enrollment period, but rather an initial open enrollment (Also known as Guaranteed Issue Period) upon joining Medicare with no medical questions asked for the first six months from when Part B begins.
You can shop your Medicare Supplement Plan any time of the year, you will be subject to Medical Underwriting and will have to qualify to change plans outside of your Guaranteed Issue Period. If a Medicare Supplement becomes too costly, you can 1) Shop for a less
expensive supplement plan or 2) you can move to a Medicare Advantage Plan during the Fall Open Enrollment.
If you have Original Medicare (Red, White and Blue Card), visit www.medicare.gov or read the 2021 Medicare & You handbook to learn about Medicare’s benefits for the upcoming year. You should review any increases to Original Medicare premiums, deductibles, and coinsurance changes. You can expect the above mentioned changes anytime there is a cost of living
adjustment “COLA” to Social Security Benefits.
Even if you are happy with your current Medicare coverage, consider other Medicare health and drug plan options in your area. For example, even if you do not plan to change your Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Medicare prescription drug coverage could lower their costs by shopping among plans each year; there could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices. There are also other things to consider such as preferred network pharmacy vs standard network pharmacy and how using one over the other can potentially save you money.
ABM Insurance and Benefit Services also has a Medicare Starter Guide available upon request
which will provide the most up to date information on Medicare. If you want assistance
reviewing your options, contact ABM Insurance at 281-448-3040 for unbiased counseling.
Our office provides comprehensive benefits checkups to ensure you are maximizing your
benefits spending the minimal out of pocket. We have over 30 years combined experience in
the Medicare Insurance field and help build a package that will help meet your financial goals
while providing protection for your health and well-being. You can also view ABM’s Medicare
website at www.getagreatquote or CLICK HERE