During the 2023 Medicare Open Enrollment, What An Affiliate Need to Know about Medicare Insurance

Every fall, the Medicare Open Enrollment Period (OEP) allows you to update your plan. This isn’t the only time you can make changes to your coverage, but the fall enrollment period offers you the most flexibility.

The following information can help you prepare for Medicare Open Enrollment and maximize your Medicare coverage in 2023.

A. When is the Medicare Open Enrollment?

Medicare Open Enrollment runs from October 15 to December 7 each fall.

This enrollment period is only for current Medicare enrollees who want to make changes to their enrollment. Any changes you make during the 2022 Medicare enrollment period will affect your 2023 Medicare plan beginning January 1, 2023.

B. What can you do during Medicare Open Enrollment?

During Medicare Open Enrollment, you can change your Original Medicare, Medicare Advantage, or Medicare Part D plan, including changing your coverage, switching between plan types, and adding prescription drug benefits.

A. The different parts of Medicare help cover specific services:

a. Medicare Part A (Hospital Insurance)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

b. Medicare Part B (Medical Insurance)

Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.

c. Medicare Part D (prescription drug coverage)

Helps cover the cost of prescription drugs (including many recommended shots or vaccines).

B. What Is Medicare Advantage?

Medicare Advantage (commonly known as Part C) are offered by private insurance companies and essentially replace Original Medicare as your primary insurance. They cover all Medicare-covered benefits and may also offer some additional benefits such as dental, hearing, vision, and fitness coverage. Most plans also include Part D, which is prescription drug coverage.

C. What Is Medicare Supplement (Medigap)?

Medicare Supplement plans (commonly known as Medigap plans) are sold by private insurance companies to help fill the gaps of Original Medicare coverage.

A. When is the Medicare Advantage Open Enrollment Period?

Open enrollment for Medicare Advantage plans runs from January 1 through March 31 of each year.

During this enrollment window, anyone who is enrolled in a Medicare Advantage Special Needs Plan can change their coverage, but you don’t have as many choices as you do during Medicare’s Fall Open Enrollment Period. The changes you make to your Medicare plan will begin on the first day of the month after your insurer receives your request.

B. What Medicare Advantage changes can you make?

During Medicare Advantage open enrollment, you can switch Medicare Advantage plans, or you can change to an Original Medicare policy (Part A and Part B) and add on a Part D prescription drug plan.

A. Does Medicare Supplement have open enrollment?

The answer is NO. You can change your Medicare Supplement (Medigap) policy at any time, but the best time to change your plan is during the guaranteed issue period.

Medicare Supplement plans do not have a dedicated enrollment period to change coverage. Although you can change to a new plan at any time, if you change plans during the guaranteed issuance period, you will get the best rates and will not be denied coverage. If you are not protected by a guaranteed issue period, we recommend that you carefully consider the potential consequences of changing your coverage.

B. What changes to Medigap can you make?

You can change your Medigap plan at any time or add a supplemental plan to Original Medicare (Part A and Part B).

Please remember that Medicare Supplement plans are guaranteed renewable, so you won’t lose the coverage you already have. However, changing or adding a plan is affected by whether you qualify for a guaranteed issue period.

A. Compliance

Medicare Communications and Marketing Guidelines (MCMG) are responsible for ensuring compliance with applicable federal laws and regulations, including CMS’ marketing and communications regulations. This includes monitoring and overseeing the activities of its subcontractors, downstream entities, and/or delegated entities. Failure to comply with applicable regulations may result in compliance and/or enforcement actions, including, but not limited to, intermediate sanctions and/or civil monetary penalties.

B. Distinguishing Placement Types

Communications means activities and use of materials created or administered by the plans or any downstream entity to provide information to current and prospective enrollees. All activities and materials aimed at prospective and current enrollees, including their caregivers, are “communications”

Marketing is a subset of communications and must, unless otherwise noted, adhere to all communication requirements. To be considered marketing, communications materials must meet both intent and content standards. In evaluating the intent of an activity or material, CMS will consider objective information including, but not limited to, the audience, timing, and other context of the activity or material, as well as other information communicated by the activity or material. The organization’s stated intent will be reviewed but not solely relied upon.