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The Medicare Annual Enrollment Period is here. If you have relatives benefitting from Medicare, here's how to help them navigate the process.

By Kat Tretina
Updated August 30, 2021

What You Need to Know:

  • The Medicare Open Enrollment Period runs from October 15 to December 7 each year

  • Beneficiaries can make changes to their Medicare Advantage plan or prescription drug coverage

  • Your loved ones can switch to a new plan from their current insurer or change insurance companies

  • If any changes are made, they'll go into effect on January 1

If your loved one is one of the 59 million enrolled in Medicare, it's important to know that the Annual Enrollment Period (AEP) is just around the corner. Every year, the AEP runs from October 15 to December 7. During this time period, Medicare enrollees can review their healthcare needs and make changes to their coverage.

For some, the AEP can be overwhelming. To help your loved ones navigate this process, follow these five steps:

1. Pay Attention to Deadlines

The AEP window closes on December 7, 2021. Until this time, during the AEP, your loved ones can:

  • Switch from Original Medicare to a Medicare Advantage plan

  • Change from a Medicare Advantage plan back to Original Medicare

  • Choose a new Medicare Advantage plan that offers prescription drug coverage

  • Join a stand-alone Medicare prescription drug plan

  • End their prescription drug plan coverage

If your loved one doesn't make any changes during the AEP, their existing plan will automatically be renewed for 2021.

2. Discuss Alternatives to Original Medicare

While Original Medicare will cover a large portion of your loved ones' healthcare expenses, it doesn't cover everything. Original Medicare only includes Part A (hospital) and Part B (medical) insurance. It doesn't include the following:

  • Prescription drug coverage

  • Additional services, like eye exams or fitness programs

  • Healthcare expenses when traveling outside of the United States

Depending on your loved one's health, they may want to consider enrolling in a Medicare Advantage plan rather than Original Medicare. Medicare Advantage plans, also known as Medicare Part C, are separate from Original Medicare and are offered by private insurance companies. These plans combine Part A and Part B benefits and typically offer prescription drug coverage as well. They may also cover other services that Original Medicare does not, such as hearing aids and eye exams.

If your loved ones enjoy traveling, Medicare Advantage plans can be useful. This is because Original Medicare doesn't typically cover healthcare services or supplies used outside the United States. Some Medicare Advantage plans do offer additional coverage for healthcare services when enrollees travel abroad.

Want to learn more about your Medicare options?

3. Review Your Loved Ones' Prescription Medications

Original Medicare doesn't include prescription drug coverage. This means if your loved ones take any prescription drugs, they will likely need to purchase additional insurance.

There are two ways to get coverage during the AEP:

  • Medicare Advantage plans: Many Medicare Part C plans include prescription drug coverage. While beneficiaries still have to pay a Part B premium, Medicare Advantage Plans are often affordable. The average premium for Medicare Advantage plans is expected to be just $21 in 2021.

  • Medicare Part D (prescription drug coverage): With a Medicare Part D plan, your relative can have prescription drug coverage added to their policy. To qualify for a separate Part D plan, they must have Medicare Part A and/or Medicare Part B insurance. Part D plans can vary widely in cost, but the average premium for a basic Part D plan will be approximately $30 in 2021. The premium is based on coverages and the plan's deductible and copay or coinsurance costs.

When you are looking at plans, check the plans' formularies. The formulary is the list of drugs the plan covers. If your loved ones take any prescriptions on an ongoing basis, make sure their specific medications are on the plan's formulary.

4. Double-Check if Their Plan Will Still Be Available

If your family member is pleased with their current plan and wants to keep their existing coverage, make sure you double-check that their same plan will still be available in 2021. This is because plans can change from year to year, and some insurance companies will even opt to end certain plans.

If the insurer makes any changes, they have to send your relative "Annual Notice of Change" and "Evidence of Coverage" information detailing what's being altered and what the new costs will be. If there are substantial changes, your loved one may not get the same coverages they had before, and it may be more cost-effective to select another plan.

5. Compare Available Plans

One of the best ways to help your loved one get ready for the Medicare AEP is to sit down with them and compare available Medicare and Medicare Advantage plans for 2021 using the Medicare Plan Finder tool. With this online tool, you can enter details about your relative's health, such as their existing prescriptions, then compare plan costs based on their unique, individual criteria.

You can even filter plans based on price and covered benefits to help your loved one pick the best plan and have peace of mind that they made a good decision.

Looking for further help selecting a Medigap policy? Check out the best Medicare Supplement plans of 2020 or contact a licensed Medicare professional to weigh options for your friend or family member.

Kat Tretina is from Orlando, Florida and specializes in writing about finance and healthcare.