Medicare Open Enrollment: The When, Who and How

Medicare’s annual Open Enrollment Period is coming. During this time, Medicare beneficiaries get to make some big decisions that will impact their health care options and out-of-pocket payments for the next year.

Medicare beneficiaries have two major choices: Original Medicare or Medicare Advantage.

  • Original Medicare consists of Medicare Part A and Medicare Part B. Many people get Medicare Part A for free, but they have to pay for Medicare Part B.
  • Medicare Advantage, sometimes called Medicare Part C, refers to private alternatives. These plans often offer additional benefits, such as dental and vision care, but the network of providers may be more limited.

This is a big decision, so it’s important to understand the Open Enrollment process.

When It Happens

The Medicare Open Enrollment Period for 2020 coverage starts on October 15, 2019 and ends on December 7, 2019. Coverage decisions made during this time will go into effect starting January 1, 2020. During this time, you can make the following decisions.

  • If you are enrolled in Original Medicare, you can stay in it, or you can switch to a private Medicare Advantage plan.
  • If you are enrolled in Medicare Advantage, you can stay in your plan, switch to a new Medicare Advantage plan or switch to Original Medicare.
  • If you are enrolled in Original Medicare or in a Medicare Advantage plan without prescription drug coverage, you can enroll in a prescription drug plan. You can also switch or drop your prescription drug plan.

Who Can Participate?

Current Medicare beneficiaries can participate in the Open Enrollment Period that lasts from October 15 to December 7.

If you are not currently enrolled in Medicare, your enrollment period will depend on your situation.

  • When you turn 65, you age into Medicare. Your Initial Enrollment Period will last for seven months and includes your birthday month, the three months before and the three months after.
  • Certain life events qualify you for a Special Enrollment Period. For example, if you move or lose job-based coverage, you may qualify for a Special Enrollment Period.
  • If you missed your Initial Enrollment Period and do not qualify for a Special Enrollment Period, you will have to wait to enroll during the General Enrollment Period. This occurs every year between January 1 and March 31. It’s important to note that you may have a gap in your coverage, and you may have to pay a late penalty.

How to Enroll

Depending on where you live, you may have several Medicare Advantage plans to choose from. You may also have multiple Medicare Prescription Drug Plan options.

  • Check your current plan to see what is changing. You should receive an Annual Notice of Change with this information.
  • Look at the plans in your area and compare your options. Pay attention to the costs, benefits, provider networks and prescription drug formularies.
  • Select the most appropriate plan for your needs.
  • Complete the application for the plan you have chosen.

You can use the Medicare Plan Finder to compare Medicare Advantage and prescription drug plans in your area. You can also get help from a licensed insurance agent through Insurance Line One by completing the online request form here.

Sources
  • https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html

  • https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods

  • https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/part-a-part-b-sign-up-periods

  • https://www.medicare.gov/plan-compare/#/

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