A: For 2017 Medicare coverage, open enrollment is in the fall of 2016, from October 15 to December 7. (The specific dates changed in 2011, but have been the same ever since, and should remain as-is for the foreseeable future.)
During this annual enrollment period (AEP) you can make changes to various aspects of your coverage.
- You can switch from Original Medicare to Medicare Advantage, or vice versa.
- You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
- And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.
If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.
- You must be enrolled in Medicare Part A and B.
- You must live in the plan’s service area.
- You cannot have End-Stage Renal Disease (some exceptions apply).
Is auto-renewal available?
If you’re already enrolled in a Medicare Part D prescription plan or a Medicare Advantage Plan and you don’t want to make changes to your coverage for 2017, you don’t need to do anything during open enrollment, assuming your current plan will still be available in 2017. If your plan is being discontinued and isn’t eligible for renewal, you will receive a non-renewal notice from your carrier prior to open enrollment. If you don’t, it means you can keep your plan without doing anything during open enrollment.
But be aware that your benefits and premium could be changing for 2017. So even if you’re confident that you want to keep your current coverage for the coming year, it’s important to make sure you understand any changes that may apply, and that you’ve double checked to make sure that your current plan is still the best available option. The available plans and what they cover changes from one year to the next, so even if the plan you have now was the best option when you shopped last year, it’s important to verify that again before you lock yourself in for another year.
Changing Medicare Advantage coverage after the AEP
Between January 1 and February 14 each year, if you are enrolled in a Medicare Advantage plan, you can leave your plan and return to original Medicare. You cannot switch to another Advantage plan unless you have a circumstance that affords you a Special Enrollment Period.
After you leave your plan, you will have until February 14 to enroll in a Part D plan that will begin the first day of the following month that you enroll.
Enrolling in Original Medicare
If you didn’t sign up for Medicare A and B when you were first eligible, you have a chance to do so each year from January 1 to March 31, with coverage effective July 1. You may be subject to a late enrollmentpenalty however. For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12 month period that you were eligible but not enrolled.
2017 Medicare coverage changes
Changes to be aware of for 2017 include:
Medicare recipients reaching the donut hole will benefit from better prescription drug discounts. The gap in prescription drug coverage (the donut hole) starts when someone reaches the initial coverage limit ($3,700 in 2017), and ends when they have spent $4,950. Prior to 2011, Medicare Part D enrollees paid the full cost of their medications while in the donut hole. But the ACA has been steadily closing the donut hole, and it will be fully closed by 2020. At that point, enrollees will pay just 25 percent of the cost of their drugs all the way up to the catastrophic coverage threshold. For 2017, while in the donut hole, enrollees will pay 40 percent of the cost of brand name drugs (down from 45 percent in 2016) and 51 percent of the cost of generic drugs (down from 58 percent in 2016). The Medicare Part D deductible will be $400 in 2017.
- Medicare Part B premiums will increase for those who didn’t see an increase in 2016. In 2015, most Medicare Part B enrollees paid $104.90/month for their Part B premium, although enrollees with income above $85,000 had higher premiums. For 70 percent of Part B enrollees, their premiums are deducted from their Social Security checks, and net Social Security checks cannot decrease from one year to the next. Since there was no cost of living adjustment (COLA) for Social Security in 2016, Part B premiums couldn’t increase for those enrollees (otherwise it would have resulted in a smaller net Social Security check, which is prohibited by law). But Part B costs increased, which meant premiums needed to increase for the rest of the enrollees. Ultimately, Part B premiums ended up at $121.80/month for enrollees whose premiums are not deducted from their Social Security checks, and for people who are new to Medicare in 2016. But 70 percent of enrollees are still paying $104.90/month (high-income enrollees pay additional premiums). For 2017, there’s expected to be a COLA for Social Security, so the $121.80/month Medicare Part B is expected to apply to all enrollees, with higher premiums for high income enrollees.
- Medicare Advantage plans continue to see changes. While healthcare reform is slowly reducing rebates paid to Medicare Advantage plans, these plans continue to be popular. 30 percent of Medicare recipients were enrolled in a Medicare Advantage plan in 2015 – a significant increase from the enrollment total in 2009 when the ACA was signed into law. Most people will continue to have dozens of Medicare Advantage plans as well as Part D plans available to them. However, these providers can change the coverage options they offer from year to year so it’s important to stay up-to-date.
Most Medicare beneficiaries should received their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing Medicare Advantage and Medicare Part D plan providers by Sept. 30. CMS will make information available to the public on Medicare.gov in October. The Medicare website is also a tremendous asset for individuals with questions about Medicare rules, timelines, Medicare Part D, etc.
It’s important to carefully review the information sent to you by your plan provider, since this will cover any possible changes. For example, increasing co-pays, changes to drug formularies or changes to treatment coverage. Once open enrollment gets underway, you can make changes that reflect your current health coverage needs.