Jan. 8, 2019
A big change has come to Medicare this year, and if you’re on Medicare Advantage you can take advantage of it.
From Jan. 1 to March 31, beneficiaries with Medicare Advantage, also known as Part C, can switch to a new Medicare Advantage plan or can leave the program altogether and return to Original Medicare (Parts A and B, with the option of buying a stand-alone Part D drug plan). Nearly 600,000 beneficiaries are expected to take advantage of this open enrollment period, according to government estimates. This doesn’t include seniors already on Original Medicare, who aren’t allowed to make any coverage changes during this time.
In prior years, this winter switcheroo was called the Medicare Advantage Disenrollment Period. It ran Jan. 1 through Feb.14, and beneficiaries had the option only to drop their Medicare Advantage plan and move onto Original Medicare. This year, the renamed Medicare Advantage open enrollment period has been extended through March 31, and beneficiaries also have the option of changing to a new Medicare Advantage plan during this time.
Just don’t expect any official notifications about this. Unlike during Medicare’s annual open enrollment each fall, which is accompanied by an advertising blitz, companies are not allowed to market during this winter enrollment period. The Centers for Medicare & Medicaid Services, which runs Medicare, mentioned the new opportunity in its annual “Medicare & You” handbook and in other materials online but is not actively reaching out directly to eligible beneficiaries to inform them.
One way a beneficiary might find out about this open enrollment period is if she calls her broker to complain about the plan that she was sold. In that case, the broker is allowed to mention the possibility of switching, says Andrew Shea, vice president of eHealthMedicare.com, an online brokerage. You can’t try out a bunch of new plans, though — each eligible person is allowed only one change during this period.
Medicare Advantage plans have become increasingly popular in recent years, with about 34% of Medicare beneficiaries currently enrolled, according to the Kaiser Family Foundation. These plans offer coverage managed by private health plans that contract with the government to provide Part B outpatient services and Part A hospitalization coverage. Beneficiaries pay monthly Medicare Advantage premiums in addition to their Part B premium, although some Medicare Advantage plans charge $0 for premiums. (Most Medicare beneficiaries don’t pay any premium at all for Part A.)
One reason Medicare Advantage plans have become more popular in recent years is that they sometimes cover services that Original Medicare doesn’t, such as gym memberships and hearing aids. What’s more, many Medicare Advantage plans offer built-in drug coverage without the premiums or deductibles charged by the stand-alone Part D drug plans bought by many Original Medicare beneficiaries.
The trade-off for these extra perks is that most Medicare Advantage plans are HMOs and come with a relatively narrow network of participating doctors and hospitals. One reason someone might opt to switch to a new plan, or to switch out of Medicare Advantage altogether, is if he discovers that one of his doctors doesn’t participate in his plan, or if he receives a serious diagnosis, such as cancer, and wants to see a specialist his plan wouldn’t pay for.
Original Medicare doesn’t have a network: beneficiaries can visit any doctor, hospital or urgent care center that accepts Medicare.
Coverage under new plans takes effect the first of the following month after you sign up and the plan approves your application. If you’re switching to Original Medicare and want to buy a Medigap supplement plan, keep in mind that these plans are medically underwritten and, outside certain circumstances, you might be denied coverage or charged more based on your health status. Look into your options before dropping your Medicare Advantage plan.