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During Medicare’s Open Enrollment Period, which runs October 15 through December 7 each year, beneficiaries can make changes to their Medicare coverage. This is always a busy time of year for State Health Insurance Assistance Programs (SHIPs), as beneficiaries often ask SHIP counselors for help finding a new plan and understanding their options.

During Medicare’s Open Enrollment Period, a beneficiary can:

  • Join a different Medicare Advantage Plan

  • Join a different stand-alone Part D plan

  • Switch from Original Medicare to a Medicare Advantage Plan, and vice versa

Any changes a beneficiary makes will take effect on January 1, 2020. Beneficiaries can make as many changes as they want during this period, but only their last coverage choice will take effect in January.

Contact your SHIP for individualized counseling and assistance with your plan choices for 2020. Below are some open enrollment tips from SHIPs. 

Tip #1: Read important notices

Because plan coverage and costs change every year, you should read your plan notices to make sure your coverage still fits your needs. Beneficiaries receive a lot of mail during Medicare’s Open Enrollment Period, so it is important to know which mailings include information about your current coverage.

If you have Original Medicare, you can visit www.medicare.gov or read the 2020 Medicare & You handbook to learn about Original Medicare in 2020.

If you have a Medicare Advantage Plan or a stand-alone Part D plan, you should look out for your plan’s Annual Notice of Change (ANOC) and/or Evidence of Coverage (EOC). The ANOC lists changes in a plan’s coverage, costs, and network for 2020. The EOC is a comprehensive description of all the plan benefits. Beneficiaries should receive these notices in September. Note that the ANOC and EOC can be delivered electronically or as a hard copy. If you have not received the ANOC or EOC, you should contact their plan to request one.

Beneficiaries should review the notices for any changes in the plan’s benefits, coverage rules, costs, or formulary (list of drugs the plan covers).  Contact your SHIP for assistance in reviewing your notices. 

Tip #2: Review current Medicare health and drug coverage

Review your current coverage and consider:

  • Access to health care providers you want to see
  • Access to pharmacies in your area
  • Access to needed benefits and services
  • The total costs for insurance premiums, deductibles, coinsurance charges, and copayments

If you think your coverage will not meet your needs for the coming year, you can use Medicare’s Open Enrollment Period to enroll in Original Medicare or a new Medicare Advantage or Part D plan. Contact your SHIP if you need help reviewing your current coverage. 

Tip #3: Shop around

Even if you are satisfied with your current Medicare coverage, you should look at other Medicare options in your area. There may be options that better suit your individual needs in the coming year. SHIP counselors can help beneficiaries see if there is another plan in the area that will offer better health and/or drug coverage at a more affordable price. Here's how SHIP helped one Medicare beneficiary save during open enrollment.  

Tip #4: Watch out for misleading marketing or enrollment fraud

Remember that Medicare has rules about how plans and their agents can and cannot communicate with beneficiaries during Medicare’s Open Enrollment to market their insurance products. Although plans are allowed to send beneficiaries emails and/or direct mailings, they are not allowed to call beneficiaries or visit them in person to market their products without the beneficiary’s permission.

Insurance agents cannot:

  • Call a beneficiary if the beneficiary did not ask them to do so

  • Visit a beneficiary’s home or nursing home without an invitation

  • Ask for financial or personal information if they call

  • Imply they are calling on behalf of Medicare

  • Use the term “Medicare-endorsed” or suggest that their plan is preferred by Medicare

  • Sell life insurance of other non-health-related products in the same appointment unless the beneficiary asks about those products

Your SHIP can help you understand the kinds of contacts you might legitimately receive from Medicare plans. You can also report suspicious contacts by plans to your Senior Medicare Patrol (SMP) by visiting www.smpresource.org or calling 877-808-2468.