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10/15/16 at 05:15 AM 0 Comments

Medicare Annual Enrollment Period Explained

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Medicare offers multiple plans based on each beneficiary’s needs. These can be categorized broadly as Part A and B (Original Medicare), Part C (Medicare Advantage), Part D (Prescription Drug Coverage) and Medicare Supplement (Medigap). With so many choices, you’ll certainly want to get the most value out of the plan you choose. Knowing when to enroll is also an important consideration.

If you are enrolled with Medicare, you do not have to sign up every year, but during certain periods of the year, you have the opportunity to be enrolled in new plans, or to change the plan you are with according to your needs. Here is an overview explaining what you can do in each of these periods.

Initial Enrollment Period

This is the time around your 65th birthday: your birthday month; 3 months before it; and 3 months after. During this time, you can enroll with Part A and B, if not automatically enrolled. You will automatically be enrolled with Medicare Part A and Medicare Part B when you turn 65 of age, if you are receiving benefits from Social Security or the Railroad Retirement Board. But if you have to sign up because you are not automatically enrolled, you should sign up during this period; otherwise, you will very likely pay higher premiums. You are exempt from these penalties if you qualify for Special Enrollment Period, which is explained in a separate section below.

You can also enroll with Part C, and Part D during this time. The failure to sign up for Part C or D during this period, and enrolling later in the General Enrollment Period, also explained below, will cost you more in the form of larger premiums.

Medicare Supplement enrollment is also available during this time. The specific period to enroll with Medigap starts from the month of your 65th birthday, up to 6 months after that (inclusive). If you miss this enrollment window, insurers can deny you Medicare Supplement plans.

Note: You need to be enrolled with Part A and B in order to sign up for Part C, Part D or Medicare Supplement. But if you are newly eligible due to a disability you can sign up for a Part C plan (with or without drug coverage) or a Part D plan during your Initial Enrollment Period. Concurrently, if you already had Medicare due to disability, but have now turned 65, you can sign up for Part C and Part D, or change plans in the Initial Enrollment Period.

If you do not sign up for Part A and/or Part B during this time, and you are not eligible for a Special Enrollment Period, you can sign up during the General Enrollment Period.

General Enrollment Period

If you miss the Initial Enrollment Period, you can sign up from January 1 through March 31 each year. Your coverage will begin starting July 1. You will have to pay a higher premium for late enrollment.

Your monthly premium for Part A can go up by 10%, as compared to what you would have paid if you had enrolled during Initial Enrollment Period. This will be compounded for every year you do not sign up from the year you were initially eligible.

If you do not sign up for Part B in the Initial Enrollment Period, you will end up paying a late enrollment penalty for as long as you are enrolled with Part B. The monthly premium may go up by 10% for each year that you could have had Part B, but did not sign up for it.

Premiums may differ for Part C and D depending upon the kind of plan in which you are enrolled.

Special Enrollment Period

If you have missed the Initial Enrollment Period, but qualify for this period, you do not pay late enrollment penalties.

This Special Enrollment Period is available to people working and insured by their employer or work union at the time they turn 65. These people can wait for the employer’s insurance to end before enrolling with Medicare. This is only if you or your spouse (or family member if you are disabled) is working, and you are covered by a group health plan through the employer or union, based on that work. You have an 8-month Special Enrollment Period to sign up for Part A and Part B. This period starts from the month after the employment ends, or the health insurance plan ends, whichever occurs first.

This period is also available to international volunteers serving in a foreign country. Other examples of qualification for the Special Enrollment Period include relocating, qualifying for Medicaid, qualifying for extra help with Medicare Prescription Drug coverage, qualifying for skilled nursing or long term hospital care, and/or switching to a 5-star Medicare Plan.

Annual Election Period

At this time you can change your Medicare coverage; that is, you can switch plans. This period lasts from October 15 through December 7. Coverage begins January 1 of the following year.

Your options include changing from Part A and Part B to a Part C plan; changing from a Part C plan back to Part A and B; switching from one Part C plan to another; switching from Part C that does not offer prescription drug coverage to one that does, and vice versa; joining a Part D plan; switching among various Part D plans; and dropping your Part D coverage completely.

Details on what is acceptable in each period can be found on www.medicare.gov

You can also speak to a certified Medicare insurance provider like e-TeleQuote Inc. at http://www.etelequote.com/for more information.

Sources:

https://www.medicare.gov/Pubs/pdf/10050.pdf

https://www.medicare.gov/your-medicare-costs/part-a-costs/penalty/part-a-late-enrollment-penalty.html

https://www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html

http://obamacarefacts.com/medicare/medicare-enrollment/

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