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One More Medicare Special Enrollment Period for Advantage Plans

By Richard J. Schillig, CLU, ChFC, LUTCF
Independent Insurance and Financial Advisor

For the second consecutive year Medicare is providing a Medicare Advantage Special Enrollment Period. This plan is Medicare Part C. It started January 1 and runs through March 31…. note this is for Medicare folks with Medicare Advantage Plans. This enrollment period replaces the Medicare Advantage Disenrollment Period that used to be from January 1 to February 14. We no longer have this Disenrollment Period – it is now replaced with a new Medicare Advantage Special Enrollment Period and that SEP began in 2020 and continues in 2021. NOW it is important to know that the Medicare Advantage Special Enrollment is somewhat more limited than the fall Open Enrollment Period (Oct 15 to Dec 7). During this Medicare Advantage Special Enrollment Period, you generally have a one-time opportunity to:

• Change from one Medicare Advantage plan to a different Medicare Advantage Plan
• Drop you Medicare Advantage plan and return to Original Medicare, Part A & Part B

Let’s talk for a minute about Medicare Advantage Plans: Why would you sign up for one?

The type of Medicare coverage you want is entirely up to you. Here are a few facts about Medicare Advantage Plans to help you compare Original Medical Part A & B with Medicare Advantage Plans Part C:

• Most Medicare Advantage plans offer prescription drug coverage
• Many Medicare Advantage plans offer extra benefits, such as fitness programs or gym memberships
• Some Medicare Advantage plans might save money on your health-care expenses HOW? Some plans have premiums as low as $0 per month.
• Every Medicare Advantage plan has an annual out-of-pocket maximum spending limit. That means after you spend a certain amount of approved medical costs during one calendar year, you don’t have to pay for covered medical services for the rest of that year. This out of pocket maximum will vary slightly with each Advantage Plan.

With any type of Medicare Advantage plan you are required to pay your monthly Medicare Part B premium – along with any premium the Medicare Advantage plan may charge.

NOW listeners remember……if you DO NOT HAVE a Medicare Advantage Plan now… this new Medicare Advantage Special Enrollment period does NOT apply to you. BUT if you currently have a Medicare Advantage plan – you may want to change your Medicare Advantage plan choice during this Special Medicare Advantage Plan open enrollment period.

Why would you want to change Medicare Advantage plans? There are a couple reasons for considering this change.

First is – comparing the out-of-pocket maximums on each Medicare Advantage plan. Out of pocket maximums vary depending on the plan. In Iowa lowest OOP maximum is $3,700 with one plan – highest is $6,700. And remember this our of pocket maximum is per person per calendar year. In Illinois OOP maximums are the same range….low of $3,750 to high of $7,550. My experience in working with Medicare folks is sometimes Medicare people seek advice or information from non-licensed insurance people and don’t receive the full story. My experience this year is I have had some Medicare folks receive information on a Medicare Advantage Plan because the premium is $0. That sounds wonderful but it is important to understand other components of those $0 plans……especially the out-of-pocket maximums. Remember out-of-pocket maximums are per person per year.

Again listeners – if you have a Medicare Advantage plan you have an additional Open Enrollment Period that began January 1 and continues through March 31. OR during this Open Enrollment Period you may want to change from Advantage Plan back to Original Medicare Part A and B and pick up a supplement and prescription drug plan. But be careful…..there are pros and cons to each choice.

Now remember – if aging into Medicare……turning age 65 – that is your Initial Enrollment period and you have a 7 month window to enroll in you Medicare choice. You may choose Original Medicare with the Medicare Supplement and Prescription drug plan……that’s Medicare Part A & Part B issued by the government. Medicare Supplements are issued by private insurance companies and Medicare Part D prescription drug plan issued by private insurance company. This is one choice you have for Medicare during that 7-month Initial Enrollment Period. The other choice during the 7-month Initial Enrollment Period is for a Medicare Advantage Plan. Remember the Medicare Special Enrollment Period ending March 31 allows you to change your choice of Medicare Advantage Plans.

We continue our virtual community meetings during this month of March 16 and March 18. Please call to be included in these very informative meetings. 563.332.2200 or check our website www.dickschillig.com