Medicare’s Fall Open Enrollment, officially known as the Annual Enrollment Period (AEP) is happening now. It runs from October 15 – December 7, and is the time beneficiaries can change their Medicare health plan and Part D coverage and/or return to Original Medicare. Coverage changes become effective January 1, 2021.
It’s an important time to review your coverage, and any health plan and Part D plan changes for 2021. Each year plans can change their premiums, out-of-pocket costs, drug formularies, network of covered providers and more, so it is good to see whether or not your current plan will still be a good fit for 2021.
Note that in 2021:
- Some Part D plans will offer enhanced coverage of insulins. Some, but not all, Part D plans will participate in the new “Part D Senior Savings Model”. Participating plans will offer enhanced coverage of insulins on their formulary with a $35 maximum out-of-pocket copay per 30-day supply per insulin prescription. If you receive Part D Extra Help (aka the Low-Income Subsidy program), you will not be eligible for this limited copay because the Extra Help already limits copays for all prescription drugs. Read CMS’ Q&A about the Part D Senior Savings Model for more information.
- Medicare Advantage plans continue to offer supplemental benefits in 2021. With what started in 2020, MA plans can continue to offer new health and non-health related supplemental benefits in their 2021 plans. These benefits can be a bit misleading as they are not necessarily offered to all enrollees; they have specific eligibility criteria and limitations; and they could overlap with Medi-Cal benefits for dually eligible beneficiaries. Make sure to closely review the plan member handbook, as MA plans are required to clearly spell out the eligibility requirements for any supplemental benefits. See our past article for more info: Tips to Navigate Medicare Advantage Plans’ New Supplemental Benefits.
Learn more about the AEP, the options you have and the changes you can make. You can also contact your local Health Insurance Counseling and Advocacy Program (HICAP) for free counseling and information on your health care options in your area.
Medicare Open Enrollment vs. Covered California Open Enrollment
Also not that the timing of Medicare’s Open Enrollment is similar but different than Covered California’s open enrollment, health insurance offered through the Affordable Health Care marketplace. Covered California’s open enrollment is from November 1 – January 31 (enroll by December 15 for coverage to start January 1).
Older adults who aren’t eligible for Medicare or Medi-Cal, can sign up for health coverage through Covered California during the Open Enrollment. This may be the case for some older immigrants, especially those who don’t qualify for premium-free Medicare Part A due to insufficient work history in the US. See the resources below from some of our partner organizations for information on what older immigrants need to know about eligibility for Medicare, Medi-Cal, and Covered California:
- Older Immigrants & Medicare, Justice in Aging
- Public Charge & Immigrant Seniors, Justice in Aging
- Public Charge Update: What Advocates Need to Know Now, Protecting Immigrant Families Campaign
- Immigrant Eligibility for Public Programs During COVID-19, Protecting Immigrant Families Campaign
