Medicare Open Enrollment is one of the most important times of the year for Medicare beneficiaries. It’s your opportunity to review your current healthcare coverage, make changes, or enroll in a new plan to better suit your needs. As your trusted Medicare experts, Emerald Medicare is here to help guide you through the process with objectivity and always with your best interest in mind.

What Can You Do During Medicare Open Enrollment?
During AEP, you have several options for updating your Medicare coverage, including:

1. Switching from Original Medicare to Medicare Advantage
If you’re currently enrolled in Original Medicare (Parts A and B) which is only 80% medical coverage and no Part D coverage and may want to explore additional ancillary benefits and look at the option of a Medicare Advantage (Part C and D) plan. Medicare Advantage plans often offer coverage beyond Original Medicare, such as dental, eye exams, hearing, and prescription drug coverage.

2. Switching from Medicare Advantage back to Original Medicare
If your Medicare Advantage plan no longer meets your needs or you prefer the flexibility of Original Medicare, you may be able to switch back to Original Medicare during AEP based on the state you live in and the pre-existing rules for each state. You may also want to consider enrolling in a Medicare Supplement (Medigap) plan to help cover more of the out-of-pocket costs but with a higher premium cost. These plans are offered without some of the ancillary benefits the Medicare Advantage plans offer.

3. Changing Medicare Advantage plans
If you’re already enrolled in a Medicare Advantage plan but are unsatisfied with your coverage, you can review your doctors and medications to consider a change to a different Medicare Advantage plan during AEP that best suits your health and your needs . This is the best time of year to compare plans and ensure you’re getting the best benefits that you need or want at the cost that fits your budget.

4. Enrolling in or changing your Medicare Part D (Prescription Drug Plan)
If you’re not currently enrolled in a Medicare Part D plan and need prescription drug coverage, you can sign up for one during AEP. Also, you can change to a different Part D plan when you are on Original Medicare if your current plan’s formulary, premiums or co-pay costs has changed.

Key Dates for Medicare Open Enrollment

• October 15: Open Enrollment begins. This is your first chance to review your current coverage and make any changes or enroll in new plans for the upcoming year.
• December 7: Open Enrollment ends. After this date, you won’t be able to make changes to your Medicare coverage unless you qualify for a Special Enrollment Period (SEP). Check with your broker if you have the need to change any of your plan decisions after this date.
• January 1: Any changes made during Open Enrollment will go into effect on this date.

Tips for Making the Most of Medicare Open Enrollment

1. Review Your Current Coverage
• Before making any changes, take the time to review your current plan’s coverage for the new year. A Annual Notie of Change is the document that was sent to you with any changes that your plan is offering for the new year. Ask yourself if your needs or budget have changed over the past year. Have you been prescribed new medications or seeing any new doctors? Do you need additional coverage, such as dental or eye exam coverage?
2. Compare Plans on Medicare.gov
• One of the best tools for comparing Medicare plans is the Medicare Plan Finder on Medicare.gov. This website allows you to compare costs, coverage, and carrier ratings of different Medicare Advantage, Part D, and Medigap plans. The Emerald Medicare team uses this trusted resource to help our Medicare enrollees find the best options for their healthcare needs.
3. Consider Your Medications
• Prescription drug coverage is a critical component of Medicare. If you take medications regularly, it’s important to ensure that your Part D plan’s formulary (the list of covered drugs) still covers your prescriptions at an affordable cost. Make sure to compare different Part D plans to avoid surprises in the new year.
4. Check Your Providers
• If you’re considering a Medicare Advantage plan, it’s important to confirm that your preferred doctors, specialists, and facilities are in-network. Provider networks can change from year to year, so always verify that your healthcare team will be covered by the plan you choose.
5. Look for Changes in Benefits
• Medicare Advantage plans often update their benefits from year to year. During AEP, review the benefits offered by different plans, such as coverage for dental, vision, hearing, and fitness memberships. Be sure to choose a plan that offers the additional benefits you value most. Review your Annual Notice of Change documentation that you received in the mail. Called a ANOC.
6. Get Help from a Medicare Broker
• The Medicare Open Enrollment period can feel overwhelming, but you don’t have to go through it alone. By working with a Medicare broker, you can get expert, personalized advice based on your healthcare needs and budget. At Emerald Medicare, we can walk you through all your options and help you make the best choice for the coming year.

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Stay Prepared for Open Enrollment with Emerald Medicare

The Medicare Annual Enrollment Period is your best chance to review your healthcare coverage and make the changes that will benefit you in the year ahead. By taking the time to compare plans, review your current coverage, and explore new options, you can ensure you have the right plan for your needs.

Need help navigating Medicare Open Enrollment? At Emerald Medicare, we’re here to provide the expert guidance you need to make informed decisions. Click below to schedule an appointment with one of our expert brokers through Calendly, or contact us directly at the number or email below.

Contact Us:

• Phone: (888) 683-6372 or (845) 358-1220
• Email: office@emeraldmedicare.com

As your knowledgeable, compassionate, and trusted Medicare resource with Licensed Medicare experts, we know that your healthcare needs are unique and can change over time. That’s why it’s essential to review your Medicare plan options annually to ensure your current coverage still meets your health & budgetary needs. Even if your current plan served you well last year, changes in your health, plan benefits, industry changes, or costs could mean that a different plan is now a better fit for you.

Why an Annual Review is Essential

Changes in Health Needs
As the years pass, your healthcare needs may evolve. You or a family member might be dealing with a new health condition, which may require different medications, or the need to see a new doctor. Your current plan may not cover these needs as comprehensively as other plan options. An annual Medicare plan review allows you to adjust your coverage to meet any new health requirements.

Plan Changes
Medicare plans are not static; in fact, most Medicare plans change regularly. Carriers often change their coverage, provider networks, co-pays, deductibles, and/or drug formularies from year to year. For example, your current plan might increase premiums, adjust what services or ancillary benefits it covers, or drop certain healthcare providers from its network. Reviewing your plan annually ensures you’re not caught off guard by these changes and can switch to a plan that better suits your needs if needed.

New Plan Options
Each year, new Medicare plans become available and some are eliminated. A newer plan could offer better coverage or lower costs. For instance, a new Medicare Advantage plan in your area might include or reduce additional benefits like dental or vision coverage. By exploring these new options during the Annual Enrollment Period (October 15th – December 7th), you could find a plan that offers more value and better meets your needs to assure that you have no surprises heading into 2025.

Avoiding Penalties
Certain Medicare plan decision, such as Part B (outpatient medical services) and Part D prescription drug plans, have late enrollment penalties. If you’re not careful, you could end up paying more simply because you missed a deadline you were unaware of. When approaching age 65 or retirement taking the time to access a resource to conduct a thoughtful review of your specific situation helps you stay on top of these important deadlines and avoid these avoidable penalties.

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How to Conduct an Effective Annual Review

1. Evaluate Your Current Coverage

• • • Start by reviewing what your current plan covers. Are there any gaps in coverage, or services you didn’t use? Are there services you’d like to add? No plan offers every service, but making a list of your current healthcare needs and the benefits you are looking for can help you determine which plan(s) best addresses them.

2. Compare Costs

• • • Look at the total costs associated with your plan, including premiums, deductibles, co-pays, and out-of-pocket maximums. Compare these costs with other available plans to determine if you could save money by switching or staying the course with your current Medicare coverage decision.

3. Check Provider Networks

• • • Ensure that your preferred doctors and healthcare providers are still in your plan’s network. If they’re not, you might want to consider switching to a plan that includes them to maintain continuity of care. Medigap plans have no network and include most doctors and facilities that accept Medicare. If you aren’t sure how to check which insurances your doctors accept, call the respective Medical office or seek assistance from your Medicare broker. 

4. Consider Future Needs

• • • Think about any upcoming health changes, procedures, or treatments that might require different coverage. Choose a plan that offers the flexibility to meet your future healthcare needs, such as increased prescription drug coverage, access to a specialist or a specific facility.

Medicare’s Annual Enrollment Period is Around The Corner

Each year on October 1, your ability to review you plan begins and continues until December 7th. An annual Medicare plan review is more than just a good practice—it’s the most important step in ensuring that you’re not overspending and you are properly covered. Don’t wait until it’s too late—start reviewing your Medicare plan with the experts at Emerald Medicare! Our team of Licensed Medicare professionals is here to help you navigate the review process and find the best plan for your budget and your health care needs. 

Contact Us:
Phone: (888) 683-6372 or 845-358-1220
Email: office@emeraldmedicare.com