Seniors on Medicare are generally familiar with its annual open enrollment period, which runs from Oct. 15 through Dec. 7. But if you're enrolled in Medicare Advantage, there's a new set of dates you should commit to memory: Jan. 1 through Mar 31. That's because Medicare Advantage now has its own open enrollment window, and if you have an Advantage plan, it could really pay to capitalize on it.
What can you do during Medicare Advantage's open enrollment?
If you're enrolled in original Medicare, then there's no action for you to take during Medicare Advantage's open enrollment. On the other hand, if you have an Advantage plan, you can do two key things:
- Swap your existing Advantage plan for a new one.
- Drop your Advantage plan and sign up for original Medicare (including a Part D drug plan).
IMAGE SOURCE: GETTY IMAGES.
When does it pay to switch Advantage plans?
Many Medicare Advantage plans cost less than original Medicare when you factor in the cost of Part D for prescription coverage, plus supplemental insurance. And, you'll often get a wider scope of coverage with Advantage.
Original Medicare, for example, will not pay for dental care, vision exams, and hearing aids, whereas Medicare Advantage often does. Some Advantage plans also offer a number of wellness benefits that include coverage for gym memberships. And, if you have a condition that warrants it, you may even be entitled to added benefits like meal delivery to your home or special fixtures or accommodations for your living space, like carpet cleanings to eliminate asthma-inducing dust or guard rails for your shower or tub.
But there's a downside to Medicare Advantage, and it's that under it, you're limited to a specific, and often narrow, network of healthcare professionals and pharmacies. Generally, these providers are condensed to the geographic area you're based in, which is good if you're a homebody, but not great if you split your time between two different states during the year or want the flexibility to travel the country. Plus, providers can switch networks at any time, so if you do manage to find a doctor you trust, there's no guarantee he or she will be accessible to you for the long haul based on your plan.
And these are just some of the reasons it pays to shop around for a new Advantage plan during winter's open enrollment. If the providers you're limited to aren't conveniently located, or you have a specific doctor you're looking to keep, then it pays to see if switching plans gives you what you want.
There's cost to consider, too. You may be entitled to certain benefits under Medicare Advantage, and your premiums might cost less than what you'd pay for original Medicare, Parts B and D and Medigap included. But if you're constantly going out of network because of your Advantage plan's restrictions, then switching plans or even getting on original Medicare could be cheaper.
Finally, remember that coverage under the same Advantage plan can change from one year to the next. It could be that the prescriptions you take are no longer covered under your plan, or cost you a lot more. In that case, it certainly pays to think about switching.
Though the idea of finding a new Advantage plan may seem daunting, Medicare.gov has a new plan finder tool that makes comparing your options much easier. Spend a little time seeing what's out there if you have an Advantage plan you aren't completely satisfied with. And even if you do like your plan, it wouldn't hurt to see there's a lower-cost alternative that offers comparable coverage.
