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5 questions to ask when choosing a plan during AEP

Choosing the right plan for you

This article was last updated Sept. 16, 2022.

If you’re over age 65 or nearing Medicare age, you’ve likely heard of Medicare’s Annual Enrollment Period (AEP). AEP runs every year from Oct. 15 to Dec. 7. During this time, you can review your Medicare plan options to make sure you have the right plan for you and your health care needs.

What you can do during the Annual Enrollment Period

Depending on the type of Medicare coverage you have, there may be yearly changes to your cost, benefits, coverage and network of health care providers and pharmacies. That’s why AEP is so important — it’s your one chance every year to review your Medicare coverage.

During AEP, you can:

  • Switch from your current Medicare Advantage plan to a new Medicare Advantage plan
  • Switch from your current Part D prescription drug plan to a new Part D plan
  • Change from Original Medicare to Medicare Advantage
  • Switch from one Medicare drug plan to another Medicare drug plan.
  • Drop your Medicare Advantage plan or Part D prescription drug plan and return to Original Medicare

AEP technically applies to Medicare Advantage and Medicare prescription drug coverage. However, even if you’re enrolled in Medicare Supplement or are interested in exploring other Medicare options, AEP is a good time to do that.

Not sure if Medicare Advantage or Medicare Supplement is right for you?

Wellmark is here to help you find the best health coverage option. Just answer four simple questions to find out which option best fit your needs.

Any changes you make during AEP will be effective on Jan. 1 of the following year.

5 questions to ask during Annual Enrollment Period

Choosing a plan during AEP is an important decision. After all, having Medicare coverage that works for you not only saves you money, it gives you peace of mind so you can enjoy your retirement years.

To make sure you choose the right plan for you, ask yourself these five questions before enrolling in a plan during AEP.

 Is my doctor in the plan’s network?

If your current doctor doesn’t accept Medicare or isn’t part of your plan’s network, you may need to find a new doctor, or find a different plan that includes your preferred doctor. Easily find an in-network doctor for Medicare Supplement plans from Wellmark Blue Cross and Blue Shield and Medicare Advantage plans from Wellmark Advantage Health Plan, using the Medicare provider, pharmacy or formulary finder Opens New Window.

 Is my pharmacy in the plan’s network?

If your pharmacy is not part of your plan’s network, you may have to find a new pharmacy, or find a different plan that includes your pharmacy of choice. Finding a pharmacy in your network is similar to finding an in-network doctor. For Medicare Advantage plans from Wellmark Advantage Health Plan, simply use the Medicare health care provider, pharmacy or formulary finder.

  Are my prescriptions covered?

You should list out the prescription drugs you take regularly and make sure they are covered under the plan you’re considering. It may also be helpful to determine what you might pay each month for your prescriptions. You can do this by reviewing the plan’s formulary, also known as a drug list.

  What will my monthly costs be?

You will need to continue paying your Part B premium each month, plus any monthly premiums to pay for your additional coverage. Knowing how much you’ll pay each month will give you the confidence and freedom to enjoy retirement.

  Does this plan cover everything I need it to?

All plans have different coverage levels. If you want coverage for dental, vision, hearing, fitness programs and over-the-counter drug allowances, make sure the plan you choose has these coverage options available.

The difference between AEP and the Open Enrollment Period (OEP)

The Open Enrollment Period happens every year Jan. 1 through March 31. It only impacts you if you currently have Medicare Advantage and want to consider different coverage, like Original Medicare and a Medicare Supplement plan.

If you switch coverage during OEP, your effective date will be the first day of the following month.

Find the right Medicare coverage for you

No matter what type of Medicare coverage you decide to enroll in, Wellmark can help you understand the plan options available to you Opens New Window. Wellmark has a variety of plans to fit your budget, lifestyle and health care needs. To get started, request a free Medicare Get-Ready guide Opens New Window and learn more about the basics of Medicare, when you’re eligible to enroll and your medical, dental and vision coverage options.

If you live outside Iowa or South Dakota, go to External Site or call 888-630-2583 to find a Blue Cross Blue Shield plan near you.

Wellmark Advantage Health Plan, Inc. is an independent licensee of the Blue Cross and Blue Shield Association.

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