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Keeping Healthy: Medicare Annual Enrollment Period and Advantage Plans

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By: Elsa Gillis
Updated: November 2, 2012
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For those about to turn to 65 or already enrolled in Medicare, the Annual Enrollment Period is always something that needs to be acknowledged.  Running from October 15th to December 7th, it's a time when Medicare beneficiaries are allowed to enroll in or change their Part D and/or Medicare Advantage coverage for the following year.

"Every year something could change for that person and your needs could change and that's why you want to re-evaluate in what you currently have," says Medicare Sales Representative Paula Florentino.

If you're pleased with your current plan, you can stay there and don't need to do anything.  But if you want to change, now is the time. That includes switching from supplemental plans to Medicare Advantage plans, and vice versa, or switching within your Medicare Advantage plan.  But before we dive into what the Medicare Advantage Plan is, let's rewind and break down the basics of Medicare.

"Your Part A of Medicare you automatically get once you turn 65. Your Part A of Medicare will cover your in-patient hospital care, your skilled nursing, hospice and home health care," says Florentino. "The Part B of Medicare is the one you're going to elect to take, you're going to pay for it it's not free...and then there is the Part C of Medicare which is known as the Medicare Advantage plans, and the Part D of Medicare is the stand alone prescription drug plan.

Florentino says because Medicare doesn't cover all health care costs, consumers can purchase additional coverage through Medicare Advantage or traditional supplemental plans. If you choose the supplemental plans, Medicare is your primary insurer.  It doesn't include a drug plan, but does include all co-pays.

"When you go with the Medicare Advantage plans, you are going to be responsible for co-pays, but you're going to pay a much lower premium for it, plus the Medicare Advantage plan will include extra benefits."

Some include a prescription drug plan as well.  And that's where the open enrollment period comes in. This is the time to choose which Medicare Advantage plan you'd like to have.  Florentino says the process begins by contacting someone like herself, and coming with a list of questions.

" What's the premium, what am I willing to pay, how often to I visit my doctor, once a week, twice a month, twice a year, is my doctor in your network...Do I need prescription drug coverage?"

And from there you can choose which kind of plan best fits your needs.

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