Medicare OEP 2020: How Mrs. Jones Made Changes to Her Medicare Advantage Plan

medicare open enrollment period

The new year is upon us and so is Medicare Open Enrollment Period (OEP) 2020. Yes, just when Annual Enrollment Period 2020 has finished, it’s time for OEP 2020! We know the Medicare system can be difficult, so today we’re going to follow Mrs. Jones through the Medicare Open Enrollment Period. 

Mrs. Jones is a little confused since the Medicare rules can be complicated. But we’re here to help!

 

 

What is Medicare Open Enrollment Period?

Mrs. Jones wasn’t happy with the Medicare Advantage Plan she chose in the fall during AEP, and she’s been waiting for January 1st so she can make a change to her Medicare coverage. She has until March 31st, and she’s allowed to make just one change to her plan. 

During the Medicare Open Enrollment Period, she:

  • CAN switch from one Medicare Advantage plan to another Medicare Advantage Plan
  • CAN disenroll from a Medicare Advantage Plan and return to Original Medicare (with or without a Part D drug plan). 

But Mrs. Jones:

  • CAN’T switch from Original Medicare to a Medicare Advantage Plan
  • CAN’T add or switch a Medicare Prescription Drug Plan (if enrolled in Original Medicare). 

If Mrs. Jones was in the first three months of her Initial Enrollment Period, she would also be able to:

  • Change to another Medicare Advantage Plan (with or without drug coverage
  • Or go back to Original Medicare (with or without a drug plan).

What kinds of changes can be made during OEP?

Mrs. Jones changed her Medicare Advantage Plan during AEP. That plan became active on January 1st. But just a month after her new plan began, she realized that plan doesn’t cover her prescription drug needs.

Fortunately for Mrs. Jones, she can make a change because it’s Open Enrollment Period. She’s choosing to switch from the Medicare Advantage Plan she chose during AEP to another Medicare Advantage Plan that covers her prescription drug needs. This is a one-time change for Mrs. Jones that will go into effect on March 1st.

But what if her new Part D plan begins, and she finds she doesn’t need the coverage? Unfortunately, she’ll have to wait until AEP on October 15th to make additional changes.

But she may qualify to change her coverage during a Special Election Period (SEP). Here’s how. 

What is a SEP?

A Special Election Period is a time when you can make changes to your Medicare Advantage and prescription drug coverage outside the typical AEP and OEP periods. 

SEPs are granted for many different circumstances. A few of these are:

  • a change of address that impacts your coverage;
  • residency in an area affected by a FEMA-sanctioned emergency or natural disaster during a previous enrollment period (either for the beneficiary or caregiver); or
  • moving into or out of an institution.

Also, if you lost your previous insurance, whether it’s Medicaid or employer-provided, you may be eligible to enroll in Medicare Advantage during an SEP.  

Medicare is complicated, but MySeniorHealthPlan.com is here to help you confidently navigate your health insurance decisions. 

If you have questions or need to talk to a licensed Medicare specialist, visit our website or call (877) 255-6273. You’ll be able to talk to a knowledgeable member of our team who will help you find the right plan for you.