Medicare News

Medicare Open Enrollment Guide

Medicare Open Enrollment period kicks off October 15 and continues through December 7. During this time-frame, most Medicare beneficiaries can make necessary changes to their health and drug coverage options.

If you missed your Initial Enrollment Period in October or qualify for a Special Enrollment Period, now is your only chance to enroll for Parts A and B this year.

Medicare Open Enrollment Period

Reevaluating Medicare annually can be essential in many ways, allowing you to ensure that it still meets your healthcare needs and compare options which might better fit into your budget and coverage requirements.

READ ALSO: How to Apply for Medicare in Texas

Medicare plans often vary in costs, coverage limits and benefits from year to year; by understanding your options and making changes accordingly, you can ensure maximum coverage with less likelihood of unexpected out-of-pocket expenses.

Medicare Open Enrollment Period typically runs from October 15 through December 7 of each year for most individuals, giving you time to make any necessary changes to your Medicare Advantage and Part D plans, with effects being seen starting January 1.

For newcomers to Medicare, an enrollment window known as the General Enrollment Period (GEP) exists from Jan 1 – March 31 each year and allows you to sign up for Part A, B and/or prescription drug coverage during this time-frame. Otherwise, an ongoing penalty will apply;

Review your Medicare coverage, develop a strategy and plan ahead so as to prevent unexpected medical bills and maintain financial health in general. By doing this, it can prevent unexpected bills while keeping overall finances strong.

Special Enrollment Periods provide you with an opportunity to enroll, switch plans or dis-enroll from them without incurring an application penalty. They’re activated by various qualifying life events – for instance:

SEPs may also be available if you have recently moved outside of your plan’s coverage area, lost creditable employer-sponsored coverage involuntarily or experienced a long-term care event. Individuals can qualify for an SEP if their medical condition requires treatment quickly – which CMS regulates according to duration and circumstances.

Key Facts About Medicare Open Enrollment

The Medicare Open Enrollment Period runs annually between October 15 and December 7 and allows those with Medicare to make changes to their health insurance coverage, with any modifications taking effect January 1. Beneficiaries can take this opportunity to select either a new Medicare Advantage plan, Part D prescription drug plan, or Medicare Supplement policy to help cover Original Medicare costs more cost effectively.

Beneficiaries should carefully assess their healthcare needs when making decisions about Medicare coverage plans, taking into account factors like current medications, coverage and costs as well as whether their doctors and pharmacies are part of their plan’s network. They should also determine their financial circumstances to see if they qualify for any federal assistance programs to cover Medicare premiums and co-pays.

Those approaching Medicare eligibility who have yet to enroll should take action early – the initial enrollment period for Medicare Part A and B begins three months before your 65th birthday and lasts three months postage due. Only during this period can Medicare Part A/Part B enrollment occur without incurring late enrollment penalties.

As with traditional Medicare enrollment periods, Medicare Advantage Open Enrollment runs from January 1 through March 31 and provides you with the only opportunity to switch from one Medicare Advantage plan to another or back into original Medicare. There may be special cases which allow for modifications outside this time frame; please consult Medicare.gov for details.

READ ALSO: An Overview of the Different Parts of Medicare

If you are eligible for Medicare but not currently enrolled in either an Advantage or Part D plan, now is the time to do it! Enrolling during the Medicare Advantage Open Enrollment period will ensure you have coverage to meet all of your healthcare needs for 2019. Visit Medicare’s plan finder tool on their website to enroll or find an agent or broker in your area who can assist in the enrollment process.

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Medicare Open Enrollment Dates and Schedule

Medicare Open Enrollment Period is the one opportunity you have each year to make changes to your Medicare health and prescription drug coverage plan, from October 15 to December 7. During this time you can also add on a Medicare Advantage plan – private insurers that offer extra benefits beyond Original Medicare such as dental, vision and hearing coverage – in the form of dental, vision and hearing coverage.

Most Medicare open enrollment periods offer you the chance to make changes, though there may be exceptions: if you miss your initial enrollment period for Medicare Part A and B – three months prior to turning 65th birthday – during a general enrollment period that runs from January 1 through March 31 each year, general enrollment period can still allow you to sign up and enroll.

READ ALSO: Which Medicare Part D Drug Plan is the Best One?

Existing Medicare Advantage recipients can make changes or switch plans between October 15 and December 7. Your new coverage will start in January of next year.

Those who miss their initial enrollment period, or don’t meet criteria for special enrollment periods, will have to wait until the general enrollment period (typically Jan 1 through March 31) to sign up for Medicare Part A and B coverage. This usually occurs around January or February of every year.

Many seniors miss out on taking advantage of Medicare open enrollment period every year, which offers an invaluable chance to review coverage, make any needed modifications and save money. According to experts, taking this step could save hundreds or even thousands by finding an individual plan tailored more closely to their needs. During open enrollment period, it’s easy to locate an insurance policy that best meets your needs by comparing prices and benefits offered by various companies. Check whether the doctors and hospitals you want are part of the network of your preferred provider; otherwise, discover any other options. This is a critical consideration if you use Medicare Advantage plans as many are structured around networks that limit where care can be obtained.

Changes in Medicare Open Enrollment

As you indulge in leftover turkey and browse holiday sales, Medicare Open Enrollment presents the perfect opportunity to consider your future health needs. Running from Oct 15 – Dec 7, this period allows individuals to make changes that will take effect in 2019.

Changes that could take place during this period include switching Medicare Advantage plans, selecting a different prescription drug plan (Part D), or returning to Original Medicare with Parts A and B. If you opt out of Medicare Advantage altogether and return to Original Medicare with its respective parts A and B, you’ll also have the chance to add on an stand-alone Part D plan as a stand-in plan.

At Annual Enrollment Period (AEP), you have one opportunity each year to review your options and select one that best meets your individual needs. Your new plan is guaranteed acceptance at this point! It’s your only chance to find something suitable.

Compare plans based on their premiums, costs, out-of-pocket limits and participating providers and pharmacies – these details may change over time depending on your personal health needs and what’s offered through Medicare Advantage plans and prescription drug plans.

READ ALSO: Medicare Supplement Plans Comparison

Other than the annual Medicare Open Enrollment Period, other opportunities exist for enrolling or making changes to your coverage. You may qualify for special enrollment periods (SEP) when certain life events happen – for instance if you leave your job and lose employer-sponsored coverage like employee or retiree insurance policies, for instance; then SEPs could help you enroll in Parts A and B through Medicare.

An SEP becomes active if you marry, divorce or have a baby, so it is advisable to contact either your Social Security office or local Medicare Advantage plan to find out your options.

Although AEP is more commonly known, there is also a Medicare Advantage Open Enrollment Period (MAOEP), running annually between January 1 and March 31. MAOEP applies specifically to people enrolled in Medicare Advantage plans and allows them to switch or return to Original Medicare without incurring extra penalties; they cannot add or drop Part D coverage during this time.

John Claeys

John Claeys is the Founder of Claeys Group Insurance Services, as well as a frequent contributor to the Medicare Blog. John lives with his wife of 30 years in Tyler, Texas. Unsure about Medicare coverage options in East Texas? Contact John for guidance and help navigating the Medicare coverage process.

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