Medicare Advantage Open Enrollment Period: Expert Insights with Jae Oh

Robert Powell: Medicare Advantage open enrollment begins January 1 and runs through March 31. Here to talk with us about that is Jae Oh, author of Maximize Your Medicare. Jae, welcome again.

Jae Oh: Thanks for having me, Bob.

Powell: So another year, another Open Enrollment for Medicare Advantage. What do folks need to know?

Oh: For existing Medicare Advantage plan members, you have the right to change plans once during the first quarter. This is called Medicare Advantage Open Enrollment Period (OEP). You need to be an existing plan member; you cannot newly enroll in Medicare Advantage during that time. Additionally, people can cancel their Medicare Advantage plan and return to Original Medicare if they choose. There are additional nuances, such as enrolling in a five-star plan, which is not subject to this particular three-month period.

Powell: Right, it's all confusing. During Medicare's Annual Election Period, you can choose whatever Medicare Advantage plan you want, however frequently you want. But the last one you choose is the one that you get. During Medicare Advantage's Open Enrollment, you only get the opportunity to do it once.

Oh: That is correct, Bob. I also want to say that if people are attempting to apply for Medigap or Medicare supplement when returning to original Medicare, securing acceptance is of primary importance and should be done first.

Powell: When I think about the opportunity to redo your Medicare Advantage choice, some reasons seem obvious. Maybe you recognize that the doctor's not in your network or the drug's not covered that you thought was covered. Any other reasons, or are those the primary ones?

Oh: There can be dental and vision portions, as well as additional enhanced dental and vision plans that certain Medicare Advantage carriers may offer. For example, raising the maximum benefit limit is an outstanding one. If someone knowingly has very expensive dental work coming in the calendar year, that can be enough to change from one Medicare Advantage Plan to another.

Powell: Now that you mentioned dental, I'll also mention hearing as well and prescription eyeglasses. This notion that may be lost on people is that there are at times caps placed on the amounts that are so-called free. Is that fair to say?

Oh: Yes, and this is a fundamental misunderstanding about dental, vision and hearing coverage. To call them insurance is a little odd to me. I would call them savings plans, meaning that all of these will have a maximum benefit limit. That can be a limit on the allowance for new frames, for example. Under dental, that will be called maximum benefit limit. Once exceeding the cap, you are responsible for 100% of the cost.

Powell: So bottom line for folks who are thinking about switching their Medicare Advantage plan during this open enrollment period, any sort of bottom line advice or encouragement?

Oh: One other point here is that we do not make outgoing calls to encourage or entice someone to look at a new plan. That has to originate from the plan member. If you're receiving a call encouraging you to change your plan during the first quarter, it's probably not allowed.

Powell: Jae, as always, it's so great to talk with you and have you share your knowledge and wisdom with our listeners and viewers. I'm sure they're enlightened and all the better equipped to deal with these topics because of our conversation. So thank you.

Oh: Privilege is mine, Bob. Thanks.