Our new year is off to a great start and the Oregon Senior Health Insurance Benefits Assistance (SHIBA) program wants to remind Medicare beneficiaries and their caregivers about other enrollment periods they may be able to use to switch plans before the next Medicare Annual Election Period begins on Oct. 15.
The Medicare Advantage Open Enrollment Period (MA OEP) is from Jan. 1 to Mar. 31. You must have an MA plan on Jan. 1 to use this enrollment period. Coverage will start the first day of the month after you enroll.
Switch MA plans (with or without drug coverage)
Enroll in a stand-alone Part D plan (which returns you to Original Medicare.)
Getting Part D is not guaranteed unless you were in an MA plan on Jan. 1. There is only one change allowed during this enrollment period.
You cannot switch from one standalone PDP to another standalone PDP.
Special Enrollment Periods (SEP)
Special enrollment periods are opportunities to make plan changes outside of the standard enrollment periods.
These are made available because you may be moving permanently outside your plan’s service area or start qualifying for any limited-income assistance.
SEPs are generally 60 days but may vary. At these times, you may use your SEP to:
Join a different Medicare Advantage plan.
Switch to using only Original Medicare.
Switch to Original Medicare and purchase a Medigap. Insurance companies may require that you undergo underwriting unless you have guaranteed issue.
Medicare uses a star rating system based on complaints it receives. Five stars is excellent and one star is poor.
Five-star SEP — You may enroll in a plan with five stars once from Dec. 8 to Nov. 30.
Low-performing plan SEP — If you are in a low-performing plan you will receive a letter in late October. You must call 800-MEDICARE (633-4227) to enroll in another plan.
If you need help comparing and enrolling in plans, consider contacting a SHIBA counselor who can help you understand plan options and plan rules, such as how and when you may make changes.
For a SHIBA contact in your area call 800-722-4134 (toll-free). Visit shiba.oregon.gov to view an online copy of the 2020 Oregon Guide to Oregon Medicare Insurance Plans. ☸
Lisa D. Emerson is an analyst for Senior Health Insurance Benefits Assistance and Oregon Health Insurance Marketplace in the Oregon Department of Consumer and Business Services.