Medicare Advantage (also known as Medicare Part C) has an open enrollment period during the first quarter of 2025.
Robert Powell, CFP (Certified Financial Planner) of TheStreet Retirement Daily, and Jae Oh, also CFP and author of Maximize your Medicare, discuss some key nuances of the open enrollment period.
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Powell notes that the Medicare Open Enrollment Period begins January 1 and runs through March 31. He asks Oh what people need to know about it.
“Between all of these plan-switching windows, existing Medicare Advantage plan members have the right to switch plans once during the first quarter,” Oh said.
Oh further explained a reality that retirees should be aware of.
“You have to be a member of the plan first,” Oh said. “You cannot enroll in Medicare Advantage again during that time.”
Oh discussed an additional important fact about open enrollment.
“This is also the period when people can cancel their Medicare Advantage plan, meaning they can cancel their plan and return to Original Medicare if they want. These are the standout features,” Oh said.
“There are additional nuances,” he continued. “For example, if you're trying to sign up for a five-star plan, that is, not subject to this particular three-month period.”
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Powell explains a fact about the annual Medicare election period
Powell acknowledges that it can be a confusing process and raises a key point.
“During the annual Medicare election period, you can choose the Medicare Advantage plan you want, as often as you want,” he said. “But the last one you choose is the one you get. But during Medicare Advantage open enrollment, you only have the opportunity to do it once.”
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Oh agreed with Powell and offered some additional thoughts.
“That's right, Bob,” he said. “And I also want to say that as part of the ability to cancel your Medicare Advantage plan, if you want to go back to Original Medicare, again, just like when people try to transition from Medicare Advantage to Original Medicare, I always tell them that the order matters and that if they are trying to apply for Medigap, or the Medicare Supplement, ensuring acceptance is of paramount importance and must be done first.”
Powell explained that when you think about the opportunity to redo your Medicare Advantage choice, some of the reasons seem obvious.
For example, you might recognize that a doctor is not in your network or that a drug you thought was covered is not covered.
Oh offered some ideas about other situations in which a Medicare beneficiary might decide to change their plan.
“There are additional enhanced dental and vision plans that certain Medicare Advantage companies may offer,” Oh said. “And, for example, increasing the maximum out-of-pocket benefit limit is something exceptional.”
“If someone knowingly has to do very expensive dental work during the calendar year,” Oh continued, “that may be enough to switch from Medicare Advantage Plan number three to Medicare Advantage Plan number nine. Certainly, these combinations exist.” .
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Powell discusses Medicare options for hearing and prescription glasses
Powell mentioned that, with respect to hearing coverage and prescription glasses, limits are sometimes placed on the amounts that are “toll-free.”
Oh added his thoughts on the topic.
“This is like a fundamental misunderstanding about dental, vision and hearing coverage,” he said. “Calling them insurance is a little strange to me. I would call them savings plans, which means they will all have a maximum limit of benefits that someone can get.”
“This may be, for example, a limit on the allocation of new frames,” Oh added. “In dental, that will be called the maximum benefit limit. That amount has a limit. Once the limit is exceeded, you are responsible for 100% of the cost.”
To learn more about this discussion and watch the video, check out Retirement Daily's coverage of the conversation.
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