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Medicare Refresh: What is the Medicare Advantage Open Enrollment Period (OEP) and Why Should You Care?

Just the Essentials...

  • The Medicare Open Enrollment Period (OEP) is a three month period at the start of each year (January 1 – March 31) in which you can switch between Medicare Advantage plans, or return to Original Medicare (Medicare Part A and Medicare Part B).

  • Unless you qualify for another reason (such as Initial Enrollment, a different type of Medicare enrollment period), you cannot enroll in a Medicare Advantage plan for the first time during this period. You may only change from one plan to another, or switch to Original Medicare (Medicare Part A and B) with an optional Part D plan (Medicare drug plan) and Medicare supplement or Medigap coverage.

  • Your new coverage will begin on the 1st of the following month, at which time you will automatically be unenrolled from your previous plan.

Is it time to change your Medicare Advantage plan?

If you’re not satisfied with your coverage as Medicare beneficiaries, the Medicare Open Enrollment Period is the time to make a change. For a three-month period at the beginning of every year, people enrolled in Medicare Advantage plans may either switch to a different plan, or to switch to Original Medicare and Medicare Part D. Still, if you’re unfamiliar with Medicare enrollment periods, this can be a pretty confusing time of year! Here’s a breakdown on how the Medicare Advantage Open Enrollment Period works, and how you can make the most of it.

When is Open Enrollment for Medicare?

Yellow roadsign that says "open enrollment ahead"

Open Enrollment takes place during the first three months of each year: January 1 – March 31. If you change your plan during this period, your new coverage will come into effect on the first of the following month.

What is the Medicare Advantage Open Enrollment Period?

If you’re transitioning from general health insurance, you’re probably familiar with the concept of an enrollment period: the period of time when you’re allowed to enroll in an insurance plan. Medicare has several enrollment periods, with specific rules regarding who is eligible to apply. For open enrollment, the eligibility requirements are as follows.

  • You must currently be enrolled in a Medicare Part C/Medicare Advantage plan. If you enrolled recently (either during the Medicare Annual Enrollment Period from October 15 – December 7, or during an Individual or Special Enrollment Period), you may still take advantage of OEP.

  • You cannot undergo initial enrollment in Medicare or Medicare Advantage during this period, unless you are eligible for an Initial or Special Enrollment Period.

  • You may only switch plans once per open enrollment period, unless you are eligible for a Special Enrollment Period.

That all can feel a bit confusing, so let’s break it down into simpler terms: The Open Enrollment Period applies to people currently enrolled in a Medicare Advantage plan who wish to change their coverage, and who are not otherwise eligible to enroll in a new plan. Think of it as a coupon that lets you swap your coverage: you get one per year, and that’s it. Here are some potential cases where the open enrollment period does (and does not) apply.

I’ve been enrolled in a Medicare Advantage plan for years, but it no longer fits my needs. Can I change plans during the OEP?

Yes. In fact, this is exactly what the OEP is intended for. Our needs and circumstances change, and the enrollment period exists to facilitate these changes.

I’ve just become eligible for Medicare. Do I need to enroll during the OEP, or do I need to wait until it’s over?

A senior's birthday party

You can enroll in Medicare at any time during your seven-month initial enrollment period. If you initially enrolled in a Medicare Advantage plan, started coverage, and want to change your coverage during the OEP, you can.

I enrolled in Medicare during my Initial Enrollment Period, but I don’t turn 65 until late February. Can I change my plan during the OEP?

Your plan does not come into effect until the month you turn 65: the beginning of February, in this case. If you are not satisfied with your coverage, you can change it after it comes into effect.

I am enrolled in a Medicare Advantage plan, but want to switch to Original Medicare. Can I do that during the OEP?

Old-style Medicare cards.

Yes! You can add a Medicare Part D and Medigap plan during this time as well.

I’m enrolled in Original Medicare. Can I enroll in a Medicare Advantage plan during OEP?

No, sorry. You’ll need to wait until the Medicare Annual Enrollment Period (October 15 – December 7) for that.

I swapped my plan during the OEP, but I’m not satisfied. Can I swap my plan again?

Unfortunately, no. You can only swap plans once during this enrollment period.

I swapped my plan, but then became eligible for a Special Enrollment Period. What should I do?

A notebook that says "Special Enrollment Period"

If you become eligible for a Special Enrollment Period, you can take advantage of it even if you’ve already swapped plans. Similarly, if you haven’t swapped plans yet, you can use the Special Enrollment Period first, then swap during the OEP if you change your mind.

If this is all still confusing, don’t worry. MedicareInsurance.com is here to help. Call one of our agents at (800) 950-0608 to begin exploring your options!

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