Medicare Open Enrollment: Do I Need It?

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Due to the various enrollment windows that Medicare has, most people tend to get confused about whether they need to do anything during them. The Medicare Open Enrollment Period starts on January 1st and ends on March 31st each year. Don’t confuse this enrollment period with the Annual Election Period, which starts on October 15th and ends on December 7th each year. Although people conflate the two, the Medicare Open Enrollment Period is not the same as the Annual Election Period. 

The purpose of the Medicare Open Enrollment Period

The Medicare Open Enrollment Period is one of the few times beneficiaries can change or drop their Medicare Advantage plans. Unlike the Annual Election Period, only beneficiaries who already have a Medicare Advantage plan can use the Medicare Open Enrollment Period. If you don’t have a Medicare Advantage plan, then the Medicare Open Enrollment Period doesn’t apply to you. 

During the Medicare Open Enrollment Period, you can drop your current Medicare Advantage plan and enroll in a new one, or you can drop your plan and pick up a Part D plan which switches you back to Original Medicare. However, you can’t switch from Original Medicare to a Medicare Advantage plan during this time. Also, you can’t change Part D plans during this time. 

To help you remember what you can do during each period, here is a breakdown:

During the Medicare Open Enrollment Period, you can:

  • change from one Medicare Advantage plan to another Medicare Advantage plan
  • drop a Medicare Advantage plan and enroll in a Part D plan and Original Medicare

During the Annual Election Period, you can:

  • change from one Medicare Advantage plan to another Medicare Advantage plan
  • change from one Part D plan to another Part D plan
  • drop a Medicare Advantage plan and enroll in a Part D plan
  • drop your Part D plan and enroll in a Medicare Advantage plan
  • enroll in a Medicare Advantage plan
  • enroll in a Part D plan

Examples of people who might use the Medicare Open Enrollment Period

You may wonder why the Medicare Open Enrollment Period is so close to the Annual Election Period. If you can change Medicare Advantage plans during the Annual Election Period, then why would you need the Medicare Open Enrollment Period? 

Well, sometimes people enroll in one Medicare Advantage plan during the Annual Election Period, and once the plan goes into effect on January 1st, they quickly find out that the plan isn’t what they expected. If this happens to you, you can either change back to Original Medicare and try for a Medigap plan, or you can switch to a completely different Medicare Advantage plan that you may like more. 

Another example of someone who might use the Medicare Open Enrollment Period is someone who misses the Annual Election Period altogether. Because the Annual Election Period is only about two months, you may miss it. In this case, you will have a second chance to edit your Medicare Advantage plan.

What it is NOT for

One thing that the Medicare Open Enrollment Period and the Annual Election Period have in common is that neither are open enrollment windows for Medigap plans. You can apply for a Medigap plan anytime throughout the year. However, unless you are within your one-time six-month Open Enrollment window that starts the day your Part B is effective, then you will likely have to answer health questions to be considered for a Medigap plan. 

Therefore, you can certainly use the Medicare Open Enrollment Period to drop your Medicare Advantage plan, enroll in a Part D plan, and at that time, try to enroll in a Medigap plan, but you are not guaranteed approval. But before deciding on a plan during the Medicare Open Enrollment Period, be sure to make extra sure that that’s the plan that is most cost-effective for you.