Do I Need to Renew My Medicare Plan?

Many people find them asking themselves, “do I need to enroll in Medicare every year”?

The short answer is NO.  Why, because you enroll in Original Medicare once when you become eligible either at age 65 or if you are on disability for 24 months or longer.

The real question here is do you need to renew your Medicare Supplement, Medicare Advantage Plan, and Medicare Part D plan?

That answer is YES, but it depends on the situation.  Below are those details.

Medicare Renewal Frequently Asked Questions (FAQ)

1. When is Medicare open enrollment? October 15^th through December 7^th.  This is the only time you can openly change your Medicare Advantage plan or Part D plan.  Any other changes throughout the year require a special enrollment period which we’ll explain in further detail below.
2. Do I have to renew my Medigap during open enrollment? No, Medigap plans are not subject to the open enrollment guidelines of the Centers for Medicare and Medicaid (CMS).
3. When do I renew my Medicare Part D?  Medicare Part D plans must follow the CMS guidelines for enrollment.  You can openly change your Part D drug plan during open enrollment, but must have a special enrollment period if you want to change any other time during the year.
4. Do you have to apply for Medicare every year? No, but you absolutely should review your Medicare Advantage Plan and Medicare Part D prescription drug plan for changes.  Again, Medicare Advantage and Part D plans must follow the open enrollment guidelines from CMS, so make sure you review during those times with a licensed agent.
5. Do I have to re enroll in Medicare each year? No, you enrolled when you became eligible for Medicare and will not have to re enroll.
6. How to renew Medicare online? First you should speak with a licensed agent to review the available plans for the upcoming year. Then you should determine if the Medicare Advantage Plan you are enrolling in has an e-application platform.  If they do, then you can coordinate with your agent how to get enrolled online.  If you aren’t changing your plan, then there is no reason you need to renew online.
7. Why do I need to renew my Medicare every year?  You don’t need to renew your Medicare plan every year, but you need to REVIEW it.  Plans change and unless you review your plan each year, you may get hit with an unexpected bill.

Let’s dive into all the details you need to know about your Medicare renewal below.

Medicare Renewal Basics

In general, you do not need to renew your Medicare plan as long as you are happy with your current MA-PD or Part D drug policy. Medicare renewal is not required since, in most cases, Medicare coverage continues each year without the need to re-enroll in the same plan. In other words, Medicare automatically renews as long as you are continuing to pay the required premiums.

This applies both to beneficiaries enrolled in Original Medicare (Medicare Part A and Part B).

However, if you are currently enrolled in a private Medicare Advantage plan or Medicare Part D prescription drug plan, you’ll want to make sure and understand when you can renew each year.

Medicare Part D renewal should always be considered as the drug companies change their formulary (published drug list) every year.  The last thing you want is to get a surprise at the pharmacy and realize your generic drug is now considered brand or your tier 2 is now a tier 3.

So, the take away here is make sure you review your Medicare Advantage Plan or Medicare Part D prescription every year before it auto renews.  This is your only time to change.

When Medicare Renewal May Be Required

Although renewing Medicare is not required, there are certain situations in which you may need to take action regarding your policy. If any of the following situations applies, you may need to re-enroll in a new Medicare Advantage policy:

• Your Medicare plan’s coverage area has changed, and you no longer live within that coverage area.
• Your plan did not renew its Medicare contract for the following year.
• Your plan left the Medicare program.
• Medicare ended its contract with your plan.
• You currently have a group health plan through your employer (NOT RETIREMENT PLAN) which would allow you to enroll in Medicare Part A and Part B outside of the IEP once you stop working.
• 8 month SEP after you stop working.
• You qualify for state pharmaceutical assistance plan (SPAP) which is a prescription drug discount program based on your household income.
• You drop your Medicare Advantage plan to try a Medigap Plan for the first time.
• You are enrolled in a Medicare Special Needs Plan (SNP) for conditions such as diabetes and heart disease.
• You are a dual eligible for Medicare and Medicare and enrolled in a Medicare Dual Eligible Special Needs Plan (D-SNP).

In these situations, you may be given a Special Election Period (SEP) in which you will have an extended amount of time to decide on a new Medicare plan. SEP is an extension of the Medicare renewal period, or otherwise known as the Annual Election Period (AEP), or open enrollment which you must qualify for.

Medicare Enrollment Period Basics

What is the Medicare Initial Election Period (IEP)?

IEP is the period of time when you initially become eligible for Medicare and enroll in Medicare Part A, Medicare Part B, Medicare Part D, and your Medicare Advantage Plan or Medigap Policy.  You only have one Medicare IEP.

When is Medicare open enrollment (AEP)?

Annual Election Period (AEP) or otherwise known as Open Enrollment occurs from October 15th to December 7th, and allows Medicare plan beneficiaries to make changes to their policies, such as:

• Switch from Original Medicare to Medicare Advantage
• Switch from Medicare Advantage to Original Medicare
• Change Medicare Advantage plans
• Enroll in or drop Medicare Part D prescription coverage (Medicare Part D)

What is Medicare Special Enrollment Period (SEP)?

This is enrollment period you must qualify for to change your Medicare Advantage Plan or Medicare Part D prescription plan outside of the AEP window as outlined above.  If you cannot qualify for an SEP, then you will not be permitted to change your Medicare Advantage Plan or Part D prescription drug plan outside of AEP.

Medicare Plan Non-Renewal

In the case that your Medicare plan is not renewing its contract for the upcoming year or is leaving the Medicare program, you should be given a 90-day notice of its termination, outlining your options for enrolling in a new plan.

Yes, this happens often.  Companies are always moving in and out of the Medicare market.

You will also receive the SEP notice, giving you extra time to review your options and decide on a new Medicare plan.

If by the end of your SEP you have not taken any actions regarding the selection of a new policy, you may be automatically enrolled in the alternative plan being offered by your Medicare Advantage provider or Original Medicare.

Make sure you are reviewing your SEP notice carefully as all SEP’s are not created equal.

Reviewing Your Medicare Policy

Even though you do not need to renew Medicare coverage, it is recommended that you review your Medicare plan each year during AEP in which you may make any necessary changes to your current Medicare coverage. As mentioned earlier, during AEP you may switch from Original Medicare to Medicare Advantage and vice versa, switch to a different Medicare Advantage plan, opt in or out of prescription drug coverage (Medicare Part D), or make any other changes to your Medicare coverage based on your current needs.

It’s important to review your Medicare coverage each year during open enrollment as your health needs may change or the policy terms or costs may be revised. For example, each year Medicare Advantage and Medicare Part D plans will send beneficiaries an Annual Notice of Change, which outlines the plan changes for the upcoming year. Once you receive the notice, you should review to make sure your plan still fits your needs or is still the best plan option available.

Does My Medicare Plan Offer Additional Benefits?

Many Medicare plans offer additional benefits that aren’t offered through original Medicare.  It’s important to review your summary of benefits to determine the additional benefits you may qualify for.  Below are some of the other benefits you may qualify for with select Medicare Advantage plans and more recently some Medigap plans.

• Dentures
• Hearing Aids
• Silver Sneakers
• Telemedicine

Medicare Plans that offer additional benefits

• AARP Medicare Complete
• Aetna
• Alignment Health Plan
• Amerigroup
• Arkansas Blue Cross and Blue Shield
• Anthem Blue Cross and Blue Shield
• Avmed Medicare Choice
• Blue Shield of California
• Caremore Health Plan
• Coventry Health Care
• Essence Healthcare Medicare Advantage
• Florida Blue
• Freedom Health
• Health Advantra
• Humana
• Kaiser Permanente
• Medical Mutual
• Medigold Medicare
• Optimum Healthcare
• Scan Medicare Plan
• United Health Care
• Wellcare Medicare Plans
• Many more.

What to Do During Medicare Open Enrollment

During AEP, you should review your Medicare Advantage plan and any changes it may be implementing for the upcoming year.  You need to decide if that plan is still the best option for you based on your current health needs. If you are not completely satisfied with your current Medicare plan, AEP is the time to make changes to your coverage.

Consider the following questions during Medicare open enrollment to help you decide whether or not you should make any changes to your current Medicare plan.

1. Is Original Medicare or Medicare Advantage a better option for me?

Medicare Advantage typically offers more benefits than Original Medicare. If you are currently enrolled in a Medicare Advantage Plan and decide that you do not need the extra benefits included in your plan, you may want to switch to a Medigap or Medicare Supplement.

Likewise, if you are currently enrolled in a Medigap Plan and want to try a Medicare Advantage plan, you can switch one time and always go back to original plan.

2. Does my current Medicare plan cover my prescriptions?

Review your plan to determine if prescription coverage is included. Depending on your prescription needs, this may mean enrolling or dis-enrolling in a Medicare Part D plan if you have Original Medicare, or changing Medicare Advantage plans.

In either instance you should take your list of medications and enter them into the drug database on Medicare’s website.  This will help you determine your estimated drug costs based on the available Medicare Advantage Plans or Medicare Part D plans in your area.

3. Am I satisfied with my current Medicare Advantage plan?

Review your Medicare plan’s coverage and costs and compare with other Medicare Advantage plans available, and decide if your current plan is still the best option for you. You may find a different plan that fits your health care coverage needs with lower premiums.  In that instance Medicare renewal might make sense for you.

Conclusion

Below is a summary of what you need to know regarding Medicare renewal.

• When is Medicare open enrollment? October 15^th through December 7^th.
• Do you have to apply for Medicare every year? No, but you absolutely should review your Medicare Advantage Plan and Medicare Part D prescription drug plan for changes.
• Do I have to re enroll in Medicare each year? No, you enrolled when you became eligible for Medicare and will not have to re enroll.
• How to renew Medicare online? First you should speak with a licensed agent to review the available plans for the upcoming year. Then you should determine if the Medicare Advantage Plan you are enrolling in has an e-application platform.  If they do, then you can coordinate with your agent how to get enrolled online.  If you aren’t changing your plan, then there is no reason you need to renew online.
• Why do I need to renew my Medicare every year?  You don’t need to renew your Medicare plan every year, but you need to review it.  Plans change and unless you review your plan each year, you may get hit with an unexpected bill.

If you have any specific questions or concerns regarding Medicare renewal, re-enrollment, or plan changes, you may contact a licensed insurance agent or Medicare benefits advisor for specific guidance during Medicare AEP.