The ABCs of the AEP
By Paul Carbone, Senior Director, Medicare Sales & Marketing, UPMC Health Plan

Fall is coming to western Pennsylvania. It’s a time to enjoy the cooler temperatures, leaf color, and plenty of Steelers victories. But for people 65 and over, fall is also when Medicare’s Annual Election Period (AEP) happens. Specifically, the AEP runs from October 15 to December 7.

What’s the big deal about the AEP?

It is when you can:

• Switch your coverage from Original Medicare to a Medicare Advantage plan.
• Switch from a Medicare Advantage plan back to Original Medicare.
• Switch from a Medicare Advantage plan to a different Medicare Advantage plan.
• Add or drop a Medicare Advantage plan that includes prescription drug coverage.
• And more.

Wait, what’s the difference between Original Medicare and Medicare Advantage?

Original Medicare is insurance offered by the federal government to those 65 and over and certain other individuals, and includes Part A and Part B coverage. Part A includes services you receive from hospitals, and Part B includes outpatient services you receive from providers and non-hospital facilities. Medicare Advantage is considered Part C. It is coverage you receive through a private insurance company. Medicare Advantage includes Part A and B coverage and often comes with additional benefits such as hearing, dental, vision, and Part D prescription drug coverage.

Three key things to keep in mind about the upcoming AEP

With certain exceptions, the Annual Election Period, or AEP, is the only time you can make changes to your Medicare coverage. It is the time to:

Confirm your eligibility to enroll. For example, if you’re hoping to enroll in a Medicare Advantage plan, you must be enrolled in Medicare Part A and Part B, and live in the service are of the Medicare Advantage plan you would like to join.

Review your current coverage to see if it still meets your needs. For example, consider what health services you usually use and decide if you’re getting covered for them at a reasonable cost. Or, if you have Original Medicare but know that you’re going to need vision or dental care in the next year, you may want to enroll in a private Medicare Advantage plan that includes vision or dental coverage.

Look for the best price for the coverage you need. The AEP is the perfect time to review your coverage needs, as well your present and projected health costs. Even if you like the coverage you have, for example, you may find a plan with similar or better coverage at a lower cost. Also, remember that most Medicare Advantage plans charge a monthly premium for coverage, but your overall cost-sharing expenses may be lower than with Original Medicare.

For questions about Medicare, including how to confirm your enrollment eligibility, call 1-800-772-1213 or visit www.medcare.gov.

Western Pennsylvania Guide to Good Health. All rights reserved.