The Difference Between Medicare AEP vs. OEP

Author: Tiffany Wagner

Medicare Annual Enrollment Period (AEP) and Open Enrollment Period (OEP) are events that are set timelines in which you are allowed to enroll in different insurance plans or create any modification to your existing ones. 

Many people frequently need help comprehending the distinctions between each enrollment season, the AEP, and OEP. That’s why we are going to discuss what each of these enrollments means and how they differ from each other. 

Below is a detailed guide to understanding AEP and OEP to comprehend their differences better. 

What is Medicare AEP?

For starters, what is Medicare AEP? The Medicare Annual Enrollment Period, or AEP for short, is a predetermined time every year during which you can, if you so choose, change your Medicare coverage options. The enrollment runs from October 15 to December 7. New options for coverage become available on January 1.

You need to know that your coverage will determine the exact measures to take during AEP. Here are the changes that you are allowed to perform during the AEP:

• Return to Original Medicare after changing it to a Medicare Advantage plan.
• Switch to a Medicare Advantage plan from an Original Medicare.
• Change your Medicare Advantage plan to a different Medicare Advantage coverage.
• A Medicare Part D (prescription drug) plan can be joined, dropped, or changed during AEP.

However, it’s also vital to take note that you will still be given another chance every year to modify how you obtain your Medicare plan. This other chance is during the Medicare Advantage Open Enrollment Period or the OEP. Whenever the adjustments you made in the AEP, you can use OEP to change it again until it suits your needs. 

What is Medicare OEP

Subscribers of Medicare Advantage plans may switch during the Medicare Advantage Open Enrollment Period or OEP scheduled from January 1 to March 31. As mentioned, you can perform another modification on your Medicare Advantage plan when you aren’t satisfied with the alterations you made during the AEP.

During this period, there are three things that you can do. One is to change your current plan to another Medicare Advantage Plan. The second one is to change your coverage to Original Medicare, and lastly, incorporate Medicare Part D if you prefer. 

You might be eligible for a Special Enrollment Period if you need to switch plans outside the regular enrollment windows. However, you need to have an acceptable reason, such as if you are relocating outside the area covered by your plan’s policy or your plan’s agreement with the Centers for Medicare & Medicaid Services is not being renewed.

The Number of Adjustments Allowed to Make Throughout the OEP

The number of modifications you can perform will depend on whatever Open Enrollment Period you will choose. You can alter your Advantage or Part D plan as much as you like during the AEP. What you alter most recently will be retained and take effect on January 1 of next year.

You could also create as many modifications to your Medigap OEP as possible. You’ll be enlisted in the subscription you last selected. It will take effect as long as your Part B is already operational or during the beginning of the succeeding month. 

Your policy will go into effect on the first of the month if you decide to undertake another adjustment and are still in your six-month open enrollment period. You can only modify one thing during the Medicare Advantage Open Enrollment Period. Therefore, you must decide the first time carefully!

The Steps You Should Take To Prepare for Medicare Open Enrollment

Going through the Medicare Open Enrollment Plan is the ideal moment to make adjustments to or evaluate your policy, regardless of when you first became eligible for a Medicare Advantage Plan or how long you have had one.

You have to review the advantages of your policy and reflect on your prior experiences with it. In addition, the following questions can assist you in preparing for the Medicare Open Enrollment Plan if you choose to partake:

• Are your physician and other medical providers included in the policy’s network?
• Are your current rates, deductibles, thresholds, and copay appropriate?
• Are your prescription medicines listed on the formulary of your current policy?
• Do you anticipate receiving more coverage for medical services such as vision, dentistry, physical therapy, or rehabilitation?
• Are you happy with the extra perks offered by your current plans, such as the nurse connection, exercise programs, and mail-order pharmacies?

The Key Differences Between AEP and OEP

The first thing that differentiates these two from one another is that when compared to MA OEP, AEP allows for more adjustments. The second key difference between AEP to OEP is that OEP does not cover older adults on Original Medicare.

OEP forbids modifications to Medicare coverage for Seniors with Original Medicare, while AEP allows seniors to do so. 

How to Assess Whether You Need to Switch Medicare Plans

At the beginning of the year, you need to utilize and evaluate your Medicare Advantage plan to see if you’re receiving the benefits and customer support you desire.

You can select a new Medicare Advantage plan from your current insurance provider that provides you with your existing plan or from a new provider if you decide to perform the transfer. You are allowed to pick any available plan from your area. 

First, consider Part D and Medicare supplemental insurance if you return to your Original Medicare. You might have to include these services in Original Medicare to have the benefits and financial security you desire. Additionally, consider how you’ll replace any coverage you might lose with your Medicare Advantage plan, including dental and vision coverage.

Bottomline

Remember that AEP and OEP are two different seasons of Medicare Advantage. What you will need to do to differentiate the two is to understand how each of them works fully. With this article, you’ll have a better comprehension of these two periods that will help you pinpoint how you can make the most out of these periods. 

Author Bio: Tiffany Wagner is a freelance writer and seasoned contributor for various sites that talk about real estate and estate. Apart from writing, she’s also a library and coffee shop habitue. Tiffany likes to indulge in a hot cup of cappuccino while reading her favorite novel.