Changes to the January - March Open Enrollment

I was recently talking with some SHIP counselors where I do volunteer counseling for Medicare, and learned that a significant change will take place early next year, 2011, to the so-called “Open Enrollment Period.” (See page 121, section 2.5.) The current rule allows a beneficiary, in the first three calendar months of a year, to go from Original Medicare into Medicare Advantage, or vice-versa, or even change their Medicare Advantage Plan, AS LONG AS THEY DO NOT CHANGE THEIR PART D STATUS. (It’s a little complicated, but Table 14 on page 122 simplifies all the details. And don’t confuse it with the Annual Coordinated Election Period (also called the Annual Coordinated Enrollment Period), which runs from November 15 to December 31 of each year.)

I understand that beginning in 2011, the only changes which beneficiaries will be allowed to make are to go from a Medicare Advantage Plan to Original Medicare. And if a beneficiary does this, they may also join a Part D stand-alone prescription drug plan, and they can do this even if the Medicare Advantage plan they left did not have Part D coverage.

On the one hand, this takes away some of the complexity of the Open Enrollment Period. But also negates a beneficiary’s ability, if they quickly find out that they do not like their Medicare Advantage Plan, to switch to another. For example, they may have been in a Plan, but used the Annual Election Period to go to a new Plan. Maybe to help avoid a big premium hike. But in January they found their new Plan very much not to their liking. Their only choice is to go back to Original Medicare, not back to their old Plan.

But at least they will have the opporunity to enroll in Part D if they had not done so.

What’s worse is that the new Open Enrollment Period will last only until February 14, 2011. You won’t have three months to make a change, only six weeks or so. And so your opportunity to decide if you like your new situation is extremely limited. In fact, it will no longer be called the “Open Enrollment Period,” but the “Annual Disenrollment Period.”

Stay tuned on this as the details are announced. But it seems to me that the clear implication is, that when beneficiaries do their yearly Medicare plan review toward the end of the calendar year, they will have to take extra care in choosing a new Medicare Advantage Plan, and perhaps pay more attention to the quality ratings shown on the Medicare website