• Brad Gunning

Medicare Open Enrollment Misconceptions

Updated: May 22, 2019


Each Fall Medicare's Annual Open Enrollment begins with an onslaught of Medicare-related advertisements. TV commercials starring doctors with clipbooks, radio ads touting competitive rates, and newspaper clippings offering to find a plan that covers everything. Clearly Medicare's Annual Open Enrollment is an important time, but unfortunately, the volume of advertising often leads to confusion. Let's address some of the main misconceptions about Medicare's Open Enrollment Period and clear up the confusion.

Misconception #1: Medicare Annual Open Enrollment Applies to Medigap Plans

The biggest misconception about Annual Open Enrollment is that it related to Medigap plans. Medigap plans (also known as Medicare Supplement plans) do not have an annual enrollment period. The most important enrollment period for a Medigap plan is your personal Initial Enrollment Period. Your Medigap Initial Enrollment Period is keyed off your 65th birthday and enrollment in Medicare Part B. It has nothing to do with the Fall Annual Open Enrollment.

In fact, while your Initial Enrollment Period allows you to sign up for a Medigap plan on a guaranteed issue basis, if you're willing to go through underwriting you can sign up for (or switch) Medigap plans at any time during the year.

There is, however, one way the Annual Open Enrollment relates to a Medigap plan: if you have a Medicare Advantage plan, you can leave your plan during AEP and sign up for (through underwriting) a Medigap plan with a January 1 effective date.

Misconception #2: You Need to Re-Enroll in Your Prescription Drug Plan Each Year

Each year during Open Enrollment, we get calls from our newer clients asking if they need to re-enroll in their Medicare Part D plan during AEP. Unless you've received notification that your plan is being cancelled, the answer is no. Your enrollment in your Part D plan will automatically continue if you take no action.

That said, this brings us to our third misconception.

Misconception #3: If You Already Have a Prescription Drug or Medicare Advantage Plan, Open Enrollment Can be Ignored

"I've been very happy with my plan; I'm all set." Even if you had the perfect plan for the current year, it's vital that you review your prescription drug (or alternatively, Medicare Advantage) options each Annual Open Enrollment.

If you had any changes in your personal prescription drug list, the reason for an annual review might be obvious, but even if nothing on your end changed, Part D and Medicare Advantage plans change annually. The plan you're currently enrolled in might make changes to its drug formulary that impact your drug prices or another carrier might enter the market with a plan that saves you money over your current plan.

On average, not reviewing your prescription drug plan can cost you nearly an additional $400 each year.

Our consultants are happy to offer a free review of your current plan to ensure you're all set for 2019.

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