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Changes to “Open Enrollment Period” for Medicare Advantage Plans in 2011

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In previous years, Medicare beneficiaries were able to switch between Medicare Advantage Plans during the Medicare open enrollment period, which ran from Jan. 1 through March 31. In 2011, Medicare beneficiaries enrolled in Medicare Advantage Plans (also known as Medicare Part C) will no longer have that option.

Beginning in 2011, anyone enrolled in a Medicare Advantage Plan on Jan. 1 will be required under most circumstances to stay enrolled in the plan for the entire calendar year. However, if a beneficiary would like to change their Medicare coverage, he or she may choose to de-enroll from any of the Medicare Advantage Plans and switch to Original Medicare. This switch can only be made from Jan. 1 through Feb. 14 (the first half of the old Medicare open enrollment period). If you elect to switch to Original Medicare, your Medicare coverage will begin the month after you de-enroll in Medicare Part C and enroll in Original Medicare. (For example, if you send in your paperwork on Feb. 13, your new Medicare coverage will begin on March 1.)

This means that if you are enrolled in a Medicare Advantage Plan on Jan. 1, 2011 and wish to switch between Medicare Advantage plans, you must wait to do so until the Annual Enrollment Period. (Important: The Annual Enrollment Period will run from Oct. 15, 2011 through Dec. 7, 2011. This is a change from previous years, when the Annual Enrollment Periods were from Nov. 15 through Dec. 31.) Exceptions can be made, if:

  • You are within three months of the month in which you turn (or turned) 65 years of age and become (or became) eligible for Medicare for the first time; or
  • You are within three months of your 25th month of disability, and you become (or became) eligible for Medicare due to that disability.

If either of the above applies, you may join, switch, or drop Medicare coverage, including Medicare Advantage Plans, at any time during the seven-month periods described above. (The seven months includes the three months prior to the month you become eligible for Medicare coverage, the month in which you become eligible for coverage, and the three months after the month in which you become eligible for coverage.)

In addition, you may be able to switch between Medicare Advantage Plans, join a new plan, or drop an existing plan without waiting for a Medicare open enrollment period, if you:

  • Move out of your plan’s service area;
  • Have low income and limited resources and qualify for Medicare’s low-income subsidy;
  • Have full Medicaid coverage;
  • Receive Supplemental Security Income (SSI) benefits; or
  • Live in a nursing home, skilled nursing facility, or rehabilitation hospital.

If any of the above applies to you, and you wish to change your Medicare coverage, contact your State Health Insurance Assistance Program for more information. Updated telephone numbers can be found online at visit www.medicare.gov/contacts/home.asp.

The 2011 changes to the Medicare open enrollment period also mean that you cannot switch from Original Medicare to a Medicare Advantage Plan, switch between Medicare Prescription Drug Plans, join or drop a Medicare Medical Savings Account Plan, or switch between Medicare Medical Savings Account Plans from Jan. 1 through March 31 unless you meet one of the exceptions mentioned above.

As mentioned above, if you would like to de-enroll from your Medicare Advantage Plan and switch your Medicare coverage to Original Medicare, you may do so during the new de-enrollment period (Jan. 1 through Feb. 14). You can do this by contacting your current plan or by calling 1-800-MEDICARE (TTY 1-877-486-2048). Remember: If you decide to de-enroll from Medicare Part C and enroll in Original Medicare, you must decide whether you need Medicare Supplement Insurance (also known as a “Medigap” policy). If your current Medicare Advantage Plan includes prescription drug coverage, you will also need to decide what kind of Medicare prescription drug coverage you want, if any. You may find information about Medicare Supplement Insurance Plans and Medicare Part D (prescription drug plans) on www.medicare.gov.

The 2011 changes to the Medicare open enrollment period may come as a surprise to some Medicare beneficiaries. If you are already locked in to your Medicare Advantage Plan for this calendar year and you do not want to de-enroll and switch to an Original Medicare plan, you should take the year to carefully compare the various Medicare Advantage Plans and other Medicare policies available. If you take the time to do so now, you can easily drop or switch your plan during the fall 2011 Annual Enrollment Period.

There are a number of different Medicare policies available, including a wide variety of Medicare Advantage Plans. The decision of which plan will best suit your needs in the coming year is a highly personal one. If you had planned to spend Jan. and Feb. of 2011 comparing Medicare policies to ensure you would find the perfect one for you, consider the changes to the Medicare open enrollment period an opportunity to carefully evaluate all of your options. Then, make sure you have everything ready to make the switch to your preferred plan in October.

 
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