5 Things To Know About Medicare’s Open Enrollment Period

Staying on top of your health insurance is critical for getting the care and coverage you need. If you are a current Medicare member, you have one opportunity each year to make changes to your Medicare Coverage. It is called the Annual Enrollment Period, and it takes place between October 15 and December 7.

During this short, 6-week window, it is important to review your current coverage to ensure your current plan is still meeting your health and medication needs. It is also worthwhile to explore other Medicare plan options available in your area, in case switching to another plan could get you the same or better coverage for less money.

Here are five things to know about Medicare’s open enrollment for 2022 coverage.

1. Open Enrollment Takes Place From Oct. 15 To Dec. 7

The Medicare open enrollment period, also known as Medicare’s annual election period, takes place each year from Oct. 15 to Dec. 7. For people in areas experiencing emergencies or major disasters as designated by FEMA, extensions to enrollment are available. Registration during the annual enrollment period ensures continued health care coverage beginning Jan. 1 of the following year.

During this period, current Medicare beneficiaries can review and renew their existing plans. They can also re-evaluate their coverage, make changes or even purchase new policies if desired. It’s especially critical to closely review any updates to healthcare plans, as well as any changes in personal needs and circumstances, to get the best prices and coverage.

It’s important to stay on top of the annual election deadline, as it is unlikely that you will be able to change your coverage outside of this period. Additionally, not registering when you are eligible for coverage can result in penalties. (The government makes exceptions for those with special circumstances who would qualify under special enrollment periods.) The only other open enrollment period is the Medicare Advantage Open Enrollment Period, which takes place Jan. 1 and March 31 and only includes those with existing Medicare Part C plans.

2. You Can Change Your Plan Coverage

If you are an existing Medicare member, the fall open enrollment period offers the most flexibility in changing your coverage. For example, if you have Original Medicare, you can change your Part D prescription plan or even switch to a bundled Medicare Advantage plan. If you have Medicare Advantage, you can change to a different plan or go back to Original Medicare. You can also enroll in a Part D plan if you did not do so when you were first eligible. (Keep in mind that if you did not have other coverage during this period, you may be subject to a late-enrollment penalty.)

However, open enrollment does not apply to every circumstance. Medigap plans, for instance, do not have a specific enrollment period; however, most states will only guarantee Medigap coverage during the initial enrollment period or certain special enrollment periods. Additionally, if you did not register for Medicare when you were first eligible, you will need to wait until the general enrollment period (Jan. 1 to March 31) to receive coverage effective July 1.

3. Your Medicare Plan Will Send You An Annual Notice Of Change

If you are a current Medicare enrollee, your plan is required to send you an Annual Notice of Change (ANOC) each fall. This will typically be sent via mail, though some plans allow participants to opt in to electronic transmission. Your ANOC will help you compare your current premiums, copays, and coverage conditions with new rates for the next year.

The document also provides a summary of the new formulary and the list of covered drugs, plus any changes in network pharmacies. Additionally, the ANOC will indicate any changes to coverage restrictions, including prior authorization and quantity limits. It’s wise to read these sections closely and compare drug plans and coverage for each of your medications. If your prescriptions are limited or no longer covered under your plan, you may consider switching to a different one.

You may also receive brochures and other information from insurance companies that offer Medicare plans. Remember that you should only be receiving correspondence via mail or electronically. Insurance providers are not allowed to cold-call or visit your home without your express permission.

4. There Are Resources To Help

With so many options for Medicare coverage available, it can be overwhelming to determine which one is best for you. However, auto-renewing your plan without reviewing it carefully can lead to lost savings and potential confusion down the line.

Fortunately, GoodRx has just recently launched their new Medicare Center, which brings together helpful content, tools, and savings opportunities specifically for Medicare enrollees. Whether you’re looking for help understanding a complex topic, aren’t sure what benefits your coverage entitles you to, or are looking for ways to save money, GoodRx’s Medicare Center can help.

In addition to GoodRx’s Medicare Center, here are many other resources and tools available online to help you navigate the open enrollment period:

• The Medicare Plan Finder helps you compare and shop for health care coverage plans. Simply log into your account to compare plans side by side, get personalized drug coverage recommendations, and learn more about your coverage options.
• Medicare members can call 1-800-MEDICARE or start a live chat to speak to someone for help. Medicare’s website also links out to state-specific phone numbers and websites.
• The Medicare & You handbook is updated each year to include specific information on coverage, rights, assistance programs and support resources.
• Your State Health Insurance Assistance Program (SHIP) can provide you one-on-one assistance for reviewing different eligibility criteria, coverage and payment.
• MedicalInteractive.org offers free text-based resources on a series of Medicare topics, broken down by category.

5. Don’t Assume Medicare Always Has the Best Prices on Medications

Once you’re enrolled in your Medicare plan, you may find that your medication isn't covered, or that your out-of-pocket costs are still unmanageable. If this is the case, GoodRx can be a great cost-saving resource. Keep in mind that you can't use GoodRx simultaneously with Medicare or any other federal- or state-sponsored programs. However, you can always use GoodRx as long as you don't use your Medicare to pay at the same time. This guide can help you determine when to use GoodRx instead of Medicare for your health care needs.

Visit the GoodRx Medicare Center to learn more about making the most of your Medicare plan.