Don't Get Ghosted by Your Coverage: Medicare Fall AEP Is Here!

Your Options During Medicare Fall Open Enrollment Period

It’s officially October, which means the Medicare Annual Enrollment Period (AEP) kicks off from October 15th through December 7th! This is your yearly window to review your health and prescription plan, ensure your favorite doctors stay in-network, and make sure your medications don't turn into a financial fright. Don't auto-pilot your plan—a quick review now ensures zero spooky surprises come January.

Review your current Medicare health and drug coverage. If you are enrolled in Medicare Advantage or a Part D plan, you should also take this time to look at your current plan to ensure your doctor is still in the insurer's network and any medications you need are still covered. If not, you may want to look at other plans.

There's a lot to consider during this time, but here are the options you have:

Enroll in a new Medicare Advantage plan

An MA plan is an alternative way to get your Original Medicare (Part A and Part B) benefits from a private insurance company.

 MA plans cover everything that Original Medicare covers, at a minimum, and some may even offer extra benefits for things like routine vision, dental, and hearing care. Most also include Part D coverage for prescription drugs.

In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage plan. In 2023, the standard Part B premium amount is $209.50 for most people, but some may pay more if they have an annual income exceeding $109,000.

If you are currently enrolled in a Medicare Supplement plan or Original Medicare, you can choose an MA plan during open enrollment. Or you can switch from your current MA plan to another.

Explore a Medicare Supplement plan (not guaranteed)

Medicare Supplement plans cover some or all of your out-of-pocket expenses from Original Medicare, such as copayments, coinsurance, and deductibles. They do not cover any costs associated with prescription drugs under Part D, so you may need to secure additional coverage for that.

The Oct. 15-Dec. 7 period permits changes to Medicare Advantage and Part D coverage, but it does not itself grant a new Medigap open enrollment or guaranteed-issue right. Under Medicare rules, when you first become eligible for Medicare, you have guaranteed-issue rights for six months, and the insurer can't charge you a higher premium based on your health history.

However, if you apply after that time, the insurer can require that you submit to a medical review. They can turn you down or charge you higher premiums for any reason unless they have their own special enrollment period.

Join a new Part D drug plan

If you are currently enrolled in just Original Medicare, you can enroll in a Part D drug plan that can help pay for your prescription medications.

Optimally, you should have enrolled in a Part D plan when you first became eligible for Medicare. If you don't enroll at that time, you may be required to pay a surcharge penalty that increases with each year you go without coverage.

Medicare Part D helps cover the cost of prescription drugs. It is optional and is only provided through private insurance companies approved by the federal government. However, Part D is offered to everyone who qualifies for Medicare. Costs and coverage may vary from plan to plan.

The takeaway

Take the time to review your current Medicare plans to make sure you will be able to see the doctors you have come to depend on and that your plans cover the medications you are taking. 

We stand ready to assist you in making the right choices to help keep your health care on track and protect your finances.