Medicare Open Enrollment Retrospective
Ann Kayrish, National Council on Aging, Senior Program Manager for Medicare
Each year Medicare beneficiaries have the opportunity to change Medicare plans during the annual open enrollment period which runs from October 15 through December 7. While selecting a new plan is often challenging, this past year offered a few new hurdles.
The number of Medicare plans available to beneficiaries continues to grow. For 2020, the average beneficiary had 28 prescription drug plans and 28 Medicare Advantage plans from which to choose, an increase of 5% and 15% respectively.
Additionally, benefits available through Medicare Advantage plans continue to expand. Beginning in 2019, Medicare Advantage plans have had the ability to offer non-primarily health related supplemental benefits such as meal delivery services or transportation to some enrollees, and for 2020 more benefits could be offered to chronically ill enrollees. While supplemental benefits can improve enrollee health, it is often difficult for beneficiaries to determine during the enrollment process the limitations of the proposed benefit or even if they would be eligible. Additionally, Medicare Plan Finder, Medicare’s plan comparison tool, provided few details on supplemental benefits to help guide a benefits comparison.
Speaking of Plan Finder, in 2019 CMS undertook a redesign of the tool which had not seen substantial updates for over 10 years. The timing and some new features of the re-design made completing a plan comparison more difficult this year. One new feature requires users to set up a My Medicare account in order to compare plans using an individual’s personal data including current plan information, prescription drug list, and Extra Help subsidy level. A change to the default plan sort from lowest out of pocket cost to lowest premium may have also confounded users this year. Additionally, revisions to the tool continued throughout open enrollment which meant that plan cost and coverage information was often inconsistent and inaccurate.
To assist beneficiaries who may have made enrollment decisions based on inaccurate or misleading information from plan finder or other sources, CMS is reminding beneficiaries of the special circumstance special enrollment period which allows beneficiaries to change plans outside of the annual enrollment period. Beneficiaries are advised to contact 1-800-MEDICARE and explain their situation. Call center representatives are available to help beneficiaries throughout the year with options for making plan changes using the special circumstances special enrollment period (SEP).
Another opportunity to change plans is also available for individuals who are enrolled in a Medicare Advantage plan as of January 1. The Medicare Advantage Open Enrollment Period (MA OEP) allows beneficiaries enrolled in a Medicare Advantage plan the opportunity to change from one Medicare Advantage plan to another or elect/return to Original Medicare and coverage under Part D. The MA-OEP runs from January 1 through March 31 each year with changes being effective the first of the following month.