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Medicare Fall Open Enrollment

Medicare Fall Open Enrollment

Fall Open Enrollment runs October 15 through December 7, and is the time of year when you can make changes to your Medicare coverage. You can make as many changes as you need to your Medicare coverage during Fall Open Enrollment. The last change you make will take effect on January 1, 2020. Take action to make sure your coverage will meet your needs in 2020.

Know the changes you can make during Fall Open Enrollment.

  • Joining a new Medicare Advantage Plan or Part D prescription drug plan
  • Switching from Original Medicare to a Medicare Advantage Plan
  • Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan)

Medicare coverage options

Original Medicare

  • Medicare coverage directly through federal government
  • Includes Part A (hospital insurance) and Part B (medical insurance)
  • Drug coverage through separate stand-alone Part D plan
  • Can see any provider who accepts Medicare

Medicare Advantage

  • Medicare coverage through private health insurance plan
  • Includes Parts A, B, and usually D
  • May cover certain services that Original Medicare doesn’t, like dental cleanings or a gym
  • Usually have to see an in-network provider to receive covered services at lowest cost
Part D (prescription drug coverage)
  • Stand-alone Part D plan or part of a Medicare Advantage Plan
  • Covered drugs and costs vary by plan
  • Preferred network pharmacies offer the lowest costs

Review your coverage.

Medicare Advantage and Part D plans usually change each year. Make sure that your drugs will still be covered next year and that your providers and pharmacies will still be in the plan’s network.

If you have Original Medicare, visit medicare.gov or read the Medicare & You handbook to learn about Medicare’s benefits for the upcoming year.

If you have a Medicare Advantage Plan or a stand-alone Part D plan, read your plan’s Annual Notice of Change and/or Evidence of Coverage (EOC).

Explore other plan options in your area. You may find a cheaper plan that meets your health care and prescription drug needs. Research shows you can lower your costs by shopping around.

Starting in 2019, Medicare Advantage Plans were granted more flexibility in the supplemental benefits they are allowed to offer to their members. This includes the ability to offer benefits that are not directly considered medical care, like nutrition services. These changes mean that there may be more factors to consider when comparing Medicare Advantage Plan options during Fall Open Enrollment. Carefully review your plan’s Evidence of Coverage and any other plan materials.

If you are considering a new plan that offers its members additional supplemental benefits, make sure to find out about the costs and coverage restrictions associated with those benefits.

Know whom to contact if you have questions..

Know whom to contact if you have questions.

State Health Insurance Assistance Program (SHIP): Contact your SHIP if you have questions about any notices you receive. SHIP counselors can help you review your options and pick a plan that meets your needs. Visit www.shiptacenter.org or call 877-839-2675 to contact your SHIP.

Senior Medicare Patrol (SMP): Contact your SMP if you receive any notices that seem suspicious. SMP representatives can teach you how to spot and protect yourself from potential Medicare fraud. Visit or call 877-808- 2468 to contact your SMP.

Medicare Advantage Plan/Part D plan: Contact a plan directly if you have questions about its benefits, coverage, or costs. If you do not receive your ANOC or EOC, contact your plan to request copies.

This content was created and copyrighted by the Medicare Rights Center ©2019. Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. These materials are presented here with support from YourMedicare.com and may not be distributed, modified or edited without Medicare Rights’ consent.

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