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Senior Moments: Medicare and the Affordable Care Act annual enrollment periods

Medicare and the Affordable Care Act annual enrollment periods
Scott Bennett

The Medicare Annual Enrollment Period (AEP) is imminent. As in the past several years it starts October 15 and ends December 7, giving those who are already in Medicare 7+ weeks to make whatever changes they want to their Parts C and D plans. The AEP only applies to those who are already in Medicare. People who are just entering Medicare during the AEP are not affected by the time constraints of the period, i.e., they are not limited to the 7-week period.

Plans will automatically roll over for the coming year unless the beneficiary changes them. I strongly urge everyone who has a Medicare Advantage plan (Medicare Part C) or a Medicare Prescription Drug Plan (Part D) to read the Annual Notice of Change for her or his plan. This will explain what changes are being made and help decide whether to stay with the current plan or seek another one. If you have questions, your agent, the insurance company or the local State Health Insurance Assistance Program ( can help.

One change that needs to be highlighted is that once again there is a decrease in the percentage that a person in a Medicare Prescription Drug Plan pays if they are in the dreaded “donut hole” (officially the coverage gap). In 2017 a person in the “donut hole” paid no more than 40% for brand name drugs and 51% for generic drugs. These percentages will be 35% for brands and 44% for generics in 2018. The Affordable Care Act put in place a schedule for the annual decrease in these percentages ending in 2020 when the “donut hole” will be eliminated.

For those who have used the Affordable Care Act (ACA), which is frequently called Obamacare) for individual health insurance the Open Enrollment Period will be November 1 – December 15. This is roughly half the time it was for 2017. The Open Enrollment Period is the only time a person can make changes to her or his insurance coverage, unless a life event (e.g., marriage, permanent change of residence, loss of group coverage …) opens up a special enrollment period. The insurance company will supply information on changes to the current plan. Plans will automatically roll over for the coming year, so you do not have to reenroll. I recommend you spend a little time updating your information in the Marketplace (, since you find that you qualify for more assistance.

Medicare Annual Enrollment Period (October 15-December 7) and Affordable Care Act Open Enrollment Period (November 1-December 15) are fast approaching, take the time to review your current coverage and make what changes you want for 2018.

The past Senior Moments articles on Medicare and Affordable Care Act plans cover other details. Check them out by searching “Senior Moments” on our diocesan web site.

There will be a presentation on Medicare at St. Andrew’s Church, Harrington Park, 9:30 AM on October 7. Everyone is welcome. If there is interest in a presentation in your parish, contact Senior Ministries at

Senior Moments is a regular column by Senior Ministries of the Diocese of Newark.