2019 Open Enrollment Guide

Download 2019 Open Enrollment Guide

When Is Open Enrollment?

Open Enrollment for Medicare takes place each year from October 15 to December 7.

What Can I Do During The Open Enrollment Period? During Open Enrollment, you can: 

  • Switch from a Medicare Advantage plan to a different Medicare Advantage plan.
  • Change from a Medicare Advantage plan to Traditional Medicare.
  • Switch from a Medicare Advantage plan that does not offer drug coverage to a Medicare Advantage plan that offers drug coverage.
  • Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that does not offer drug coverage.

Consumer Sentiments on Medicare Advantage

Medicare Advantage plans continue to provide value, according to the results of a new poll.

Ninety-four percent of beneficiaries are satisfied with their Medicare Advantage coverage, according to the poll of 2,000 beneficiaries conducted Morning Consult and released by Washington, D.C.-based Better Medicare Alliance, a coalition of Medicare Advantage supporters of more than 400,000 beneficiaries and over 140 ally organizations led by Allyson Y. Schwartz, a former member of the U.S. House of Representatives from Pennsylvania.

Better Medicare Alliance commissions a poll annually to gauge seniors’ views on Medicare issues.

“Our previous polling pegged this number at 92%—so it’s remarkable that enrollees’ satisfaction rate has climbed even higher,” says Schwartz, Better Medicare Alliance president, and CEO. “What’s more, 93% of respondents are satisfied with their network of doctors, physicians, and specialists in their Medicare Advantage plan and nearly two-thirds [62%] go so far as to say that Medicare Advantage is a ‘better choice’ for seniors’ needs that traditional Medicare.”

Healthcare executives want to have their finger on the pulse of the Medicare marketplace so they know how to best respond to emerging trends, according to Schwartz.

“With this poll, we’re providing a timely snapshot of seniors’ views and it confirms what we’ve long known: they like their Medicare Advantage coverage and want to see it protected and strengthened by policymakers in Washington and health care plans and providers,” she says.

Other findings

The poll also found that nearly half of seniors on Medicare (45%) still did not know about Medicare Advantage when first enrolling in coverage, and 32% said they would have liked to have more upfront information about this option.

“These results show improvement from previous polling which has placed the share of seniors unaware of Medicare Advantage as high as 65% but it shows us that there is still work to be done,” Schwartz says. “Every beneficiary deserves complete, unbiased information about their Medicare options so that they can make an informed decision based on their unique healthcare needs.

“With half of Medicare Advantage beneficiaries enrolled in $0 premium plans; 97% having access to dental, vision, hearing, or fitness benefits unavailable in traditional Medicare; and beneficiaries experiencing lower out-of-pocket costs, it is clear that seniors are responding,” Schwartz says. “As policy makers continue discussions on healthcare policy in Washington, we must protect what works. Medicare Advantage is exactly that.”

Seniors with Complex Health Care Needs Deserve to Know Their Choices

Imagine being so burdened by health care costs that you were forced to empty your life savings or started receiving calls from debt collectors.

This is not some hypothetical scenario from ages past, it is the painful experience for 36 percent and 27 percent, respectively, of seriously ill Traditional Medicare beneficiaries today, according to new research from Harvard University and the Commonwealth Fund.

When President Lyndon B. Johnson signed Medicare into law in 1965, he inspired Americans with a promise that “No longer will illness crush and destroy the savings that they [seniors] have so carefully put away over a lifetime so that they might enjoy dignity in their later years.”

Yet, given this report’s findings that Traditional Medicare beneficiaries over the age of 85 spend an average of $10,307 annually on out of pocket costs and 23 percent of the sickest enrollees are unable to pay for basic necessities, it is clear this decades-long promise is threatened.

Medicare’s Traditional fee-for-service model is simply not living up to the vision that President Johnson and Congress made to protect older Americans’ health and financial security. This legacy and, most importantly, today’s seniors deserve better.

For us – as a former lawmaker who fought to expand affordable health coverage and a physician of more than 30 years working to address health disparities in the Hispanic community – it also highlights the importance of empowering Medicare enrollees to know their options.

For many beneficiaries, Medicare Advantage – which offers extra benefits and important cost protections, including an annual limit on out-of-pocket expenses unavailable in Traditional Medicare, could be the right choice.

Consider that half of Medicare Advantage enrollees are in $0 premium plans, whereas the average Traditional Medicare enrollee spends a whopping $2,294 on premiums alone each year.

What’s more, 58 percent of Medicare Advantage plans provide dental, vision, hearing and fitness benefits – none of which are covered under Traditional Medicare – meaning enrollees are getting more coverage at a lower cost.

In addition, there is increasing evidence that care coordination and case management available in Medicare Advantage achieves better outcomes for beneficiaries with multiple chronic conditions; complex patients who are able to receive care in the home, transportation, or meal delivery to improve their health and well-being

The problem? As many as 45 percent of seniors are unaware they have a choice in how they receive their Medicare coverage.

That means Medicare eligible beneficiaries on fixed incomes with serious health care needs are defaulting into a program that places no limit on their out-of-pocket expenses and leaves them to shoulder too much of the cost burden, not knowing that there is another way. This is flat wrong.

Better Medicare Alliance has been working to ensure that information about Medicare Advantage is clear, complete, and understandable to seniors. We’ve already seen success.

For example, the 2020 “Medicare & You” handbook includes upfront, easy-to-read information about the choice between Traditional Medicare and Medicare Advantage right on page six, instead of pages later in the more-than-100 page booklet.

When beneficiaries find their way to Medicare Advantage, they like what they find. It’s no surprise then, that Medicare Advantage enrollment has grown significantly in recent years and is projected to reach 40 percent of the people eligible for Medicare, a record of 24.4 million people, next year. The Hispanic community plays an outsized role in this trend with 57 percent of Hispanic Medicare eligible beneficiaries choosing Medicare Advantage.

One reason is that Medicare Advantage beneficiaries report an average of $1,276 less in total health care spending each year than their Traditional Medicare counterparts. Consider what this savings could mean to the widower with diabetes, the retiree battling cancer, the grandmother facing dementia, or the elderly neighbor recovering from a stroke.

For millions of our nation’s seniors facing such challenges, it is Medicare Advantage that is best honoring Medicare’s original solemn pledge to protect their health and personal finances.

As Medicare’s annual open enrollment season heads into its last few weeks, Washington must ensure that today’s beneficiaries – and those yet to come – know the value of each of their choices.

Allyson Y. Schwartz is the president and CEO of the Better Medicare Alliance. She represented Pennsylvania in the House as a Democrat from 2005 to 2015.

Elena Rios, MD, MSPH is the president and CEO of the National Hispanic Medical Association.

Event Recap: Medicare Advantage 101 Hill Briefing

Better Medicare Alliance hosted a Hill briefing for Congressional staff on Wednesday, April 17, 2019.  The event, titled Medicare Advantage 101: A Primer, introduced staffers to fundamental concepts in Medicare Advantage, highlighted the differences between Medicare Advantage and Original Medicare, and explained the Medicare Advantage payment model.

James Michel, BMA Director of Policy & Research, provided an overview of Medicare Advantage plan types, enrollment, beneficiary demographics, and access. He also presented information on payment, quality measurement, and oversight in Medicare Advantage.

The briefing included a panel discussion moderated by Allyson Y. Schwartz, BMA President & CEO. Panelists included Chet Speed, Vice President of Public Policy for the American Medical Group Association (AMGA), Griffin Myers, Co-Founder & Chief Medical Officer at Oak Street Health, and Jane Gilbert, Director of Retiree Health Care for the Teacher’s Retirement System of the State of Kentucky.  All three organizations are part of BMA’s coalition of allies. Panelists discussed key issues in Medicare Advantage and how policymakers can help modernize Medicare by supporting Medicare Advantage.

Following the panel discussion, Congressional staff had the opportunity to ask questions of the panelists to better inform their understanding of Medicare Advantage. They raised questions concerning the urban housing crisis and its impact on seniors, prescription drug costs, expansion of supplemental benefits, preventative care, and improving Medicare Advantage education for seniors.

The event was widely attended, with over 80 Congressional staff in attendance to learn more about high-quality, affordable care available with Medicare Advantage plans. Participants represented more than 45 House and Senate offices.  These are offices BMA will look to as we build support for Medicare Advantage. The briefing was a great first step towards increasing understanding and bi-partisan support for Medicare Advantage.

Medicare Advantage Enrollment Period is Great Opportunity for Active Choosers

New enrollment period part of additional consumer protections for Medicare Advantage beneficiaries

Have you heard about the new opportunity to switch your Medicare Advantage plan in 2019?  If your current plan is not satisfactory to you, read on to learn more about the new Medicare Advantage Open Enrollment Period and your options for enrolling in a different plan that would better meet your needs.

Previously, individuals enrolled in Medicare Advantage plans were able to drop their Medicare Advantage plan and return to Original Medicare during the Medicare Advantage Disenrollment Period (January 1 – February 14 annually).  These individuals could also sign up for a standalone Medicare Part D Prescription Drug plan.  This year, the Centers for Medicare and Medicaid Services (CMS), has replaced the Medicare Advantage Disenrollment Period with the new Medicare Advantage Open Enrollment Period.

The new Medicare Advantage Open Enrollment Period implements changes that were called for in the 21st Century Cures Act, a bipartisan law passed by Congress in 2017. This policy change allows those enrolled in Medicare Advantage plans more flexibility to make changes to their coverage.

During this new Medicare Advantage Open Enrollment Period, which runs from January 1 – March 31 every year, individuals enrolled in a Medicare Advantage plan will have a one-time opportunity to consider the following health coverage options:

  • Switch to a different Medicare Advantage Plan (with or without Part D Prescription Drug Coverage).
  • Drop a Medicare Advantage plan and return to Original Medicare.
  • Sign up for a Part D Prescription Drug Plan if electing to return to Original Medicare.

The reasons to consider switching your plan during the new Medicare Advantage Open Enrollment period vary from person to person.  While Medicare Advantage plans consistently deliver high quality Medicare Part A (hospital) and Medicare Part B (medical) benefits, provider networks and extra benefits such as vision, dental, and prescription drug coverage will be different depending on the plan you select.

Every fall, your plan will send out an Annual Notice of Change.  This document details any changes to your benefits or plan regulations that you should be aware of.  Additionally, if your Medicare Advantage plan includes prescription drug coverage, your plan may change its prescription drug formulary at any time.  You will receive notice of these changes from your plan as they occur.

As your health needs change, it is always important to make sure that your coverage provides for the care you need at a price you can afford.  If your current plan doesn’t meet your health care needs, or does not cover the medications you need, or doesn’t fit your budget, the new Medicare Advantage Open Enrollment Period is your opportunity to seek out an alternative. Better Medicare Alliance encourages you to review your options by using the Medicare Plan Finder, an on-line, interactive tool that helps locate plans available in your area and allows you to compare coverage.

You can also consult a broker, agent,  counselor through the SHIP program or include a family member or caregiver to help you have the information and guidance to make the decision for you.

If you choose to change your coverage during the Medicare Advantage Open Enrollment Period, your new coverage will begin on the first day of the month after your request for new coverage is received.