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What is the Medicare Annual Election Period (AEP)

Medicare Annual Election Period

It is not uncommon for people to confuse the Annual Election Period (AEP) with the Medigap Open Enrollment Period in the Medicare insurance industry. However, these Medicare Election Periods occur at different times. Keep reading to learn more about AEP Medicare.


Medigap Open Enrollment vs. AEP Medicare


Each year, the Medicare Annual Election Period occurs between October 15th and December 7th. During this time, individuals can change their Part D drug plan or their Medicare Advantage plan.


It is possible to make a switch from original Medicare plans to a Medicare Advantage plan during this period too, and chance from one Medicare Advantage plan to a different Advantage plan, or even revert back to original Medicare.


Now it is time to learn what AEP is not. This is not a time when a person can apply for Medigap with no underwriting. The election period applies to all Medicare Advantage plans and Medicare Part D plans for prescription drugs. It does not apply to Medicare supplements. I will explain more of the differences below.


The Open Enrollment Period for Medicare


It is possible to find a good description of what the open enrollment period is by looking at the “Choosing a Medigap Policy” resource provided by Medicare. The period starts on the first day of the month that a person turns 65 or when they opt to enroll in Medicare Part B—whichever happens at the latest date. The “open” period for an individual lasts for just six months.


The idea behind the Medigap open enrollment period is for a person who is new to Medicare Part B to enroll in the Medigap plan without having to deal with medical underwriting. This means the insurance carrier does not have the option to decline coverage because of a preexisting condition or another health concern. It is not possible for this issuer to refuse a policy to a person or to make them pay a higher rate because of an individual’s health issues. In fact, within this period, a person does not even have to answer health questions that are included in the application.


Something that is important to understand about this period of time is that, after the six-month window is over, it is gone forever. Most people will not receive any type of election period where they will be guaranteed to receive a Medigap policy.


Changing Requires Medical Underwriting


Consider if a person has a Medigap policy, and it increases within a year. This is common for most Medigap plans, and most of them will have yearly rate increases. In this situation, it is necessary to shop around for a different insurance company to figure out if better pricing is possible.


In most states, a person must answer specific health questions or submit a copy of their medical records. The underwriter may also call someone to ask health questions. Eventually, the company will likely decline some people for specific health conditions.


This is essential because some people opt for the most affordable price during their open enrollment period. They fail to research the potential rate increases that may occur.


AEP or Annual Election Period


All in all, these are just a handful of the ways you can get help with your Medicare costs. The common thread for any program that helps with Medicare costs is that these programs depend on mainly your income, as well as a few other factors.


However, that isn’t to say that just because you have a decent income, you don’t qualify for help. If you are unsure, it is always a great idea to ask someone familiar with the ins-and-outs of Medicare. That way, you can be sure you are getting the most out your coverage and not paying any extra.


Everything AEP Is Not


The AEP does not offer the opportunity for individuals to enroll in a Medigap policy without undergoing underwriting. It is possible to use the AEP for leaving the Medicare Advantage plan and to go back to original Medicare. However, if someone applies for a new Medigap policy to help supplement their Medicare, they should be ready to answer specific health questions. A person is not guaranteed to be approved for the new Medigap plan they have applied to.


There are a few exceptions when the insurance carrier for the Medigap policy may provide a guaranteed issue enrollment in a Medigap policy. This is typically something that is beyond a person’s control. If the Medicare Advantage plan is taken off the market and it is no longer available, a person has a time period to choose a new policy with no underwriting necessary.


Election periods and enrollment periods are the most confusing elements of Medicare, so people should not become too overwhelmed. The best thing you can do, besides research on your own, is to contact me. I will personally answer any questions you have and set your mind at ease.


I hope this article helped you.


I will personally respond to you and answer any question you have. If you feel this article helped you – please share it!

How Can Your Current Medicare Plan Change Next Year?

By John Ellis • 19 Dec, 2022
Many people are reluctant to change their Medicare Part D or Medicare Advantage plan coverage year-to-year. However, millions of Medicare beneficiaries will see significant changes in their Medicare costs and coverage. If you are staying with your current Medicare plan into next year, please be sure to review your plan’s Annual Notice of Change (ANOC) letter and use this list to help you look for important coverage changes that might impact your coverage next year. And remember, there are no health-related questions should you decide to change your Medicare Advantage plan or Medicare prescription drug plan (however, Medicare Advantage Special Needs Plans require that you meet the plan’s specific “need”). Your Medicare Plan May No Longer Be Offered Next Year Many folks are currently enrolled in a Medicare Advantage plan (MA or MAPD) that will no longer be available next year. We can help you determine what will be happening with the plans you are looking at, or the ones you are currently enrolled in. You May Be Automatically Reassigned to a Different Medicare Plan Next Year Every year, many people enrolled in Medicare Advantage and/or Part D Standalone plans are automatically "crosswalked" into another plan for next year. Normally, you will be notified if you are in this group but we are more than happy to help you know for sure. Your Medicare Plan May Change It's Name Sometimes, your Medicare plan (no matter what type it is) may be changing its name. Along with a name change, it could also have different features. Your Monthly Medicare Part D Premium May Be Increasing Many Medicare beneficiaries will see their monthly Medicare Part D premium increase 20% or more. Some people currently enrolled in a Part D plan will see their plan premium double next year. The good news is that there is a group of people that will see a premium decrease of 10% to 63% next year. Please keep in mind that in addition to lower-premium Part D plans, there may be low- or $0 premium Medicare Advantage plans (MAPDs) available in your area. Your Plan’s Initial Deductible May Increase Typically, the Medicare Part D deductible increases year-over-year. The exact amount can also depend on your situation. Your Medicare plan’s Initial Coverage Limit (ICL) may change Almost all stand-alone 2022 Medicare Part D plans use the standard Initial Coverage Limit (ICL), though some 2022 Medicare Advantage plans offer an ICL other than the standard — ranging higher and lower. Your drug plan’s ICL sets the boundary between your Medicare Part D plan’s Initial Coverage Phase and the Donut Hole or Coverage Gap. The ICL is measured by the total retail value of your prescription drug purchases. You can contact American Senior Benefits for detailed information on the Medicare Advantage plans that have an increased or decreased Initial Coverage Limit. Your Medicare Plan’s Cost-Sharing Can Vary Significantly Between “Preferred” and “Standard” Network Pharmacies Year-over-year, certain stand-alone Medicare prescription drug plans (PDPs) will use different cost-sharing for preferred vs. standard network pharmacies. As an example, your plan might have a co-payment of $0 for a Tier 1 medication at preferred network pharmacies and, for the same Tier 1 drug, a $5 co-pay when purchased at a standard network pharmacy. Your Medicare Advantage plan's Maximum Out-of-Pocket (MOOP) Limit May Change The Medicare Advantage plan MOOP threshold limits how much you will spend on co-payments and co-insurance for in-network, eligible Medicare Part A and Part B coverage. It can often change year-over-year for plans and it is important to be aware of these changes. The Bottom Line for Medicare Enrollees If you decide to stay with your current Medicare Part D or Medicare Advantage plan into next year– AND you understand how your Medicare plan is changing – you do not need to do anything – you will be automatically re-enrolled into your Medicare plan along with any changes your plan is making for the coming year. If your Medicare plan is being terminated in coming year and you are not merged or “crosswalked” to another Medicare plan, you may be without Medicare plan coverage on January 1st. We are always happy to clear up any confusion when it comes to these Medicare changes that you should be aware of, so please feel free to reach out whichever way is most preferable for you.

How to Compare Medicare Advantage Plans

By John Ellis • 19 Dec, 2022
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Some of the Medicare Advantage plans will have premiums that are $0; however, the individual must continue to pay their Medicare Part B premium, along with deductibles, coinsurance, and copayments, that the plan requires. What is the Annual Deductible for you? The annual deductible is another essential factor to consider. Is this something that you are comfortable paying? Are Any Additional Benefits Included? It is also important to consider if additional benefits are offered. This would include things like routine hearing, dental, vision, and other health or wellness plans. Also, find out if a prescription drug is included. Are the existing medications a person takes included with the plan’s formulary or the list of drugs that are covered? Is There a Provider Network Included If it does have a network, it is essential to find out if a person’s current doctors and their health care providers are included. What Is the Plan’s Star Rating? A star rating is one way to determine the performance of the Medicare Advantage plan. Every plan receives a rating of one to five stars. Five stars is the highest rating that a plan can receive. Medicare evaluates all plans based on the five-star rating system, and these scores are calculated yearly. Choosing the Right Medicare Plan for you Each person is unique. This means it is necessary to research each of the Medicare Advantage plan options available and how it works with a person’s budget and health needs. Remember, plan costs, provider networks, service areas, and benefits can all change from one year to another, so it is smart to review a person’s coverage regularly to ensure the plan still works. Take some time to shop around and choose a plan that will help you save the most money. I hope that you learned some valuable information from this article. Choosing a Medicare Advantage plan is a big deal, as you usually won’t be able to change it for up to a year. So you will have whatever coverage you choose for that period. If you find the plan doesn’t cover what you need, you will be stuck paying for it out of pocket. If you think you know someone who might benefit from this article, please share button it. If you'd like to talk about these things or anything else you might have questions about, please contact us whichever way is most comfortable for you.

What Are the Original Medicare Coverage Gaps?

By John Ellis • 19 Dec, 2022
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