Dear Marci,
I enrolled in Medicare earlier this year. My sister told me that Fall Open Enrollment for Medicare is coming up. What is Fall Open Enrollment, and what do I need to do during this time?
-Abigail (Redding, CA)
Dear Abigail,
Fall Open Enrollment runs from October 15 through December 7 each year. This period is also sometimes called the Annual Election Period. During this time, you can make changes to your health insurance coverage, including adding, dropping, or changing your Medicare coverage. Even if you’re happy with your current health and drug coverage, Fall Open Enrollment is the time to review what you have, compare it with other options, and make sure that your current coverage still meets your needs for the coming year.
You can make as many changes as you need to your Medicare coverage during Fall Open Enrollment. The changes you can make include:
Joining a new Medicare Advantage Plan
Joining a new Part D prescription drug plan
Switching from Original Medicare to a Medicare Advantage Plan
Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan)
Regardless of how you receive your Medicare coverage, you should consider:
Your access to health care providers you want to see
Your access to preferred pharmacies
Your access to benefits and services you need
The total costs for insurance premiums, deductibles, and cost-sharing amounts
If you have Original Medicare, visit www.medicare.gov or read the 2024 Medicare & You handbook to learn about Medicare’s benefits for the upcoming year. You should review any increases to Original Medicare premiums, deductibles, and coinsurance charges.
If you have a Medicare Advantage Plan or a stand-alone Part D plan, read your plan’s Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC). Review these notices for any changes in:
The plan’s costs
The plan’s benefits and coverage rules
The plan’s formulary (list of drugs your plan covers)
Make sure that your drugs will still be covered next year and that your providers and pharmacies are still in the plan’s network. If you are unhappy with any of your plan’s changes, you can enroll in a new plan. If you want assistance reviewing your options, contact your State Health Insurance Assistance Program (SHIP) for individualized counseling.
Even if you are happy with your current Medicare coverage, consider other Medicare health and drug plan options in your area. For example, even if you do not plan to change your Medicare Advantage or Part D plan, you should check to see if there’s another plan in your area that will offer you better health and/or drug coverage at a more affordable price. Research shows that people with Medicare prescription drug coverage could lower their costs by shopping among plans each year. There could be another Part D plan in your area that covers the drugs you take with fewer restrictions and/or lower prices.
-Marci