Fall is the time for Medicare beneficiaries to explore their options regarding traditional Medicare, Part D prescription drug plans and Part C Medicare Advantage plans. The Annual Coordinated Election Period (ACEP) starts on October 15th and ends on December 7th. This means that Medicare beneficiaries have to analyze their options and make choices by December 7, 2015.
During the ACEP, often referred to as "open enrollment," Medicare beneficiaries can return to traditional Medicare from a Medicare Advantage (MA) plan. Those who do not have a Part D plan can enroll in one, and those who do have Part D coverage can change plans. Beneficiaries can also enroll in an MA plan, or change MA plans. Enrollment requests made during the ACEP will have an effective date of January 1 of the following year.
Even Beneficiaries Who Were Satisfied with 2015 Plans Need to Review their Plan Options for 2016
Part D and MA plans may have made changes to their coverage, provider networks and other plan features. Plan information for 2015 will be available on the Medicare Plan Finder at www.medicare.gov. For the computer-savvy, the Medicare Plan Finder is an excellent plan comparison tool, allowing users to enter all their drugs and drug dosages, compare up to three plans at a time, save their drug information for later use, and actually enroll in a plan on-line. This is the best – if not only – way to truly compare the many plans available to choose from. People who cannot use the Plan Finder themselves may contact 1-800-Medicare, or their State Health Insurance Assistance Program (SHIP), for assistance with evaluating, selecting, and enrolling in a Part D plan.
People with Medicare Advantage or Part D plans should also receive an Annual Notice of Change (ANOC) from their current plan by September 30, 2015. The ANOC describes changes in plan coverage, costs, or service area.
For more information about the Part D program, see our website at: https://www.medicareadvocacy.org/medicare-info/medicare-part-d/; for more information about Medicare Advantage, see our website at: https://www.medicareadvocacy.org/medicare-info/medicare-advantage/, including advice about choosing between Traditional Medicare and Medicare Advantage, at: https://www.medicareadvocacy.org/choosing-between-traditional-medicare-and-a-medicare-advantage-plan/.
Missing the Deadline May Result in Lack of Coverage and a Financial Penalty
Beneficiaries who miss the ACEP deadline may have to wait until next year to enroll in Part D, and may therefore face a "lifetime" late enrollment penalty, unless they qualify for another Medicare enrollment period, or a Special Enrollment Period (SEP). Individuals who qualify for the Part D Low Income Subsidy (including all full and partial dual eligibles) have a continuous SEP that allows them to enroll in or change plans at any time of year, regardless of the ACEP.
Additional Opportunity to Return to Traditional Medicare
Beneficiaries will once again have an opportunity to disenroll from a Medicare Advantage Plan during a special period beginning January 1 through February 14, 2016, known as the Medicare Advantage Disenrollment Period (MADP). This period allows beneficiaries to drop their Medicare Advantage plan, enroll in traditional Medicare, and pick up a Part D plan. The MADP does not allow beneficiaries to switch from one Medicare Advantage Plan to another. Beneficiaries who wish to change from one MA plan to another must do so during the ACEP between October 15, 2015 and December 7th 2015.
Beneficiaries should review their plan options carefully each year to make sure they are getting the coverage they need.