Changes that can be made during AEP are the following:
- Switch from Original Medicare to a Medicare Advantage Plan
- Go back to Original Medicare from a Medicare Advantage Plan
- Change from one Medicare Advantage Plan to another
- Add or cancel a Part D plan
- Transition from one Part D plan to another
1. Enrollment for the 2020 period is over. The enrollment period for the 2021 year will begin soon.
Open enrollment for 2021 will begin on October 15, 2020, with coverage changes becoming effective January. Enrollment will end on December 7, 2020.
2. Medicare Advantage open enrollment is from January 1 – March 31
This enrollment only applies to those who already have Medicare Advantage plans. You will be allowed to make one change to your plan. The change to your plan will take place one month after the submission of your enrollment.
3. Annual 5-star Medicare Advantage enrollment period ends on November 30
Medicare uses a rating system for Medicare Advantage and Medicare Part D prescription drug plans. The best Medicare contracts receive 5-star ratings, which beneficiaries can join if those plans are available in their area. The majority of plans will not receive 5-stars, nor will 5-star plans typically be available everywhere.
4. Medicare Part A & Medicare Part B general enrollment period is from January 1 – March 31
For enrollment in Part A and Part B, a penalty may apply for late enrollment for each part. Those who enroll in Part A and B during this period will be given three months to enroll in a Medicare Part D plan to add to their coverage or enroll in a Medicare Advantage plan.
- 5. Medicare Advantage and Medicare Part D plan benefits fluctuate every year.
The change in benefits may affect your monthly premium costs and costs for certain healthcare services. In September, you will receive an Annual Notice Change that will detail the changes in benefits that impact your coverage.
6. Medicare coverage for prescription drugs
A new year of coverage can also mean possible changes to your prescription drug plan’s formulary (list of covered drugs), the pricing tiers drugs are put in, or copayment requirements for different types of drugs. Be sure to research if your current prescription drugs will be covered in 2021.
7. Medicare Advantage Plan and Medicare Part D
There will be a second pricing tier for specialty prescription drugs, which will lower the cost-sharing for Medicare beneficiaries. This will allow better negotiations between manufacturers and insurance companies.
8. Cost of Medicare Part B premium
Given the reports from CMS (Center for Medicare & Medicaid Services), it has been estimated that the projected cost of Medicare Part B premium will be $148.50 a month. Official costs will not be announced until the fall.
9. Medicare Advantage Enrollment for ESRD beneficiaries
Starting in 2021, those with ESRD (End-Stage Renal Disease) receiving dialysis will be eligible to enroll in Medicare Advantage plans.
10. Telehealth availability
Beginning in 2021, there will be more flexibility in Medicare plans to include telehealth providers in certain specialties. Telehealth providers will be given a 10% reduction in beneficiary total that is needed for time and distance requirements.
Please be sure to take this AEP 2021 knowledge into consideration and always speak with your healthcare consultant if you have any questions.