What is AEP, and What You Need to Know: 4 Steps to prepare for SummaCare’s 2025 Medicare Advantage Annual Enrollment Period

Posted October 22, 2024 by H. Kelley Riley M.D., MBA, Chief Medical Officer

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It’s that time of year again when the leaves change color, temperatures turn cooler and the Medicare Advantage Annual Enrollment Period (AEP) begins. AEP runs from October 15 through December 7 every year.

Rather than simply letting your Medicare Advantage plan renew automatically at the beginning of each year, it’s a good idea to review it to make sure it’s still meeting your needs. And if it isn’t, this is the time to make changes. If you miss this enrollment period, you will need to wait until the following year—unless you have a qualifying circumstance.

This enrollment period is for members who want to make a change to their Medicare Advantage plan or Medicare-eligible members looking to join a plan, including:

Joining a Medicare Advantage plan for those who currently are enrolled in Original Medicare, or vice versa.
Switching from one Medicare Advantage plan to another type of plan.
Switching from a Medicare Advantage plan with drug coverage to one without drug coverage, or vice versa.

Enrollment in your new plan will begin on January 1 the following year.

Insurance companies review and refine their Medicare Advantage benefit plans annually, so it’s important to be prepared, even if you’re happy with your coverage. If you don’t do anything to your existing plan, you can wind up locked into a plan with a much higher premium or with gaps in coverage.

To ensure that you’re prepared for this year’s Annual Enrollment Period, SummaCare has four steps to make the process easier.

Review your current coverage

By understanding your current coverage, you can evaluate whether it includes the benefits you need and want and identify any gaps in coverage or limitations to your plan, such as restricting access to certain providers, facilities or specialized treatments.

To help you make an informed decision during the Annual Enrollment Period, weigh the pros and cons of your current plan and estimate your total Out-of-Pocket costs (including monthly premiums, deductibles and copays).

Consider plan changes

Insurance companies review and refine their Medicare Advantage benefit plans annually. If changes have been made, companies will send you an Annual Notice of Change letter in the fall that explains any coverage or cost changes to your plan for the upcoming year.

Take time to read and understand it. Look for changes in benefits that are being added or removed, changes to providers and hospitals in network, drug formulary changes or plan cost changes.

Evaluate your current healthcare needs

Just like your coverage can change from year to year, so, too, can your healthcare needs. If your health status has changed in the past year, consider what you might need in coverage for the upcoming year. Ask yourself:

Do I have a new or developing heath concern or diagnosis?
Do I have any planned procedures or surgeries?
Do I have any new prescribed medications?
Do I have a new doctor that I want to make sure is in-network?
Do I need more or less coverage based on changes to my financial situation and budget?

If you answered “yes” to any of these questions, you may want to consider plans with:

Broader preferred provider networks. If you require specialized care, switching provider networks can impact your access to preferred doctors, specialists and hospitals without incurring additional Out-of-Pocket costs.
More prescription drug coverage. If you require a specific prescription medication, you can add prescription drug coverage to protect you against high drug costs. If you already have drug coverage, you can explore plan formularies to find ones that cover your specific drugs and that include preferred pharmacies.
Expanded services. As your healthcare needs evolve, you can explore plans that offer additional coverage on services you now need, such as vision, dental, hearing, alternative therapies, wellness programs and preventative care.
Lower costs. Medicare Advantage plans have varying premiums, deductibles and Out-of-Pocket expenses. You may find other options that offer similar coverage but with a lower monthly premium that could save you money in the long run.

Schedule an appointment with a SummaCare Medicare Advantage advisor

Now that you’ve painted a good picture of your healthcare needs and coverage requirements, set up an appointment with a Medicare Advantage advisor. They are here to answer questions and discuss your needs to help you determine whether changes need to be made.

Even if you’re happy with your current coverage, it’s always worth having your Medicare Advantage advisor analyze your existing plans and medications to ensure you’re still in the most cost-effective plan every year during the Annual Enrollment Period.

If your plan is still the right fit for you, you don’t need to do anything during the Annual Enrollment Period to keep it. However, if you’d like to make changes, you have from Oct. 15, 2024 through Dec. 7, 2024 to do so for your 2025 plan.

About SummaCare’s Medicare Advantage Plans

SummaCare’s Medicare Advantage plans are all-inclusive, providing your medical, prescription drugs, dental, vision and other health-care coverage all in one, convenient budget-friendly plan. We go beyond basic Medicare with valuable extra benefits designed to keep you healthy, including coverage for hearing aids, travel, over-the-counter items, gym memberships, health coaching, rides to your doctor and much more.

Our growing network of providers spans from Canton to Cleveland and Youngstown to Toledo, and includes more than 25,000 providers and more than 75 hospitals.

With plan premiums starting as low as a $0/month, there’s an option for nearly every healthcare need and budget.

The Annual Enrollment Period for Medicare Advantage plans runs from October 15 to December 7, 2024. Finding the right plan can feel overwhelming. SummaCare Medicare Advantage advisors are here to answer your questions and help you enroll in the plan that’s right for you.

Let’s talk. Schedule your one-on-one health plan review by calling 888.469.1010 (TTY 711). We’re available to take your call from 8 a.m. to 8 p.m., Monday through Friday.

For more information, to compare plans or enroll, visit www.summacare.com/medicare.

From October 1 through March 31, a representative will be available to take your call from 8:00 a.m. until 8:00 p.m., seven days a week. From April 1 through September 30, a representative will be available to take your call from 8:00 a.m. until 8:00 p.m., Monday through Friday. Outside these hours, you may leave us a message and a representative will return your call the next business day. Every year Medicare evaluates plans based on a 5-star rating system. SummaCare’s Medicare Advantage Plans have been recognized with 4.5-Star (out of 5) rating for 2025 by the Centers for Medicare and Medicaid (CMS). SummaCare is an HMO and HMO-POS plan with a Medicare contract. Enrollment in SummaCare depends on contract renewal. H3660_SC1403_M.