5 Things to Consider When Changing Medicare Plans During Open Enrollment

Medicare Benefits Solutions
Nov 5, 2021

If it’s fall, it’s the time of the year when Medicare beneficiaries review their current coverage and compare it to other available Medicare benefits plans. The Centers for Medicare & Medicaid Services (CMS) gives all Medicare enrollees the opportunity to make changes to their coverage during the Open Enrollment Period that takes place every year from October 15th to December 7th. 

During Open Enrollment you can:

  • Switch from Original Medicare to a Medicare Advantage plan
  • Switch from Medicare Advantage back to Original Medicare Parts A and B (and enroll in a Part D plan at this time)
  • Switch from one Medicare Advantage plan to another one 
  • Switch from a current Medicare Part D plan to a different one

If you’re thinking about changing your Medicare benefits this year, our list of five things to do before Open Enrollment can help make this process easier.

1. Carefully review your current plans and all imminent changes

If you’re enrolled in a Medicare Advantage or Medicare Part D Prescription Drug Plan, you get an Annual Notice of Change (ANOC) letter by the end of September every year. Your ANOC lets you know what changes your insurance provider is making to your plan in regard to costs and benefits for the new year.

It’s important that you take time to review the ANOC to see whether there are changes that affect your healthcare coverage or the amount of money you’ll be paying. If you don’t like the changes, you might decide to look for a different plan or go back to Original Medicare insurance. 

Being aware of upcoming changes is especially important for your prescription drug coverage. Check for changes to your plan’s formulary and make sure your drugs are still covered in the new year. Also check on coinsurance costs, whether your drugs have moved to a different tier, and if your preferred pharmacy is still in the plan’s network. 

The Centers for Medicare & Medicaid Services (CMS) generally announce changes to Original Medicare costs and coverage in the fall and sends letters to inform beneficiaries. Review your benefits and costs for the upcoming year to ensure that this is a good fit for you.

2. Review changes to your plan’s network of providers

If you have a Medicare Advantage plan that requires you to use a set network of healthcare providers, medical facilities, and medical suppliers, make sure yours are still covered by the plan for the new year. 

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3. Make a detailed list of all your healthcare costs

Before the Open Enrollment Period begins, you should have a detailed list of how much money you are spending over the year. Take into account all your premiums, coinsurance, deductibles, and other out-of-pocket costs. 

If you are spending more than your budget allows, or you don’t have coverage for some of your new expenses, you should compare options for other Medicare plans in your service area to find something more economical and/or inclusive. 

4. Know where to look for new Medicare plans

Compare the Medicare coverage you have now to what’s available for 2022 by using the following tools:

  • Online comparison tools can help beneficiaries find prescription drug plans that fit their needs. You can compare plans available in your area based on your prescription drugs, the pharmacy your use, and the costs of your drugs.
  • Speak to a licensed sales agent who can help you narrow down your options and find a plan that meets your needs.  
  • Visit the State Health Insurance Assistance Program (SHIP) office or website in your state of residence. The Medicare SHIP program offers free assistance through one-on-one counseling. This is available to anyone eligible for Medicare. 

5. Enroll in a new plan

When you find a new plan, you can enroll in it during the OEP.

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