Medicare Open Enrollment Simplified
What does Medicare Open Enrollment mean? Are we talking about Original Medicare (Part A and Part B), Medicare Advantage, Medicare Part D, or Medicare Supplement? We’ll walk you through the various types of Medicare open enrollment periods.
Medicare Open Enrollment: Original Medicare
The government health insurance program for people 65 and older and those who qualify by disability is called Original Medicare. That includes Medicare Part A (hospital insurance) and Part B (medical insurance).
“Medicare Open Enrollment” doesn’t generally refer to Original Medicare. You generally can sign up for Medicare Part A and/or Part B:
- During your Medicare Initial Enrollment Period, when you’re first eligible for Medicare
- During the Medicare General Enrollment Period, which runs from January 1 – March 31 every year
Many people are automatically enrolled in Original Medicare when they become eligible.
Medicare Open Enrollment: Medicare Advantage
Would you like to receive your Medicare Part A and Part B benefits through a Medicare Advantage plan? If you don’t sign up for a Medicare Advantage plan when you’re first eligible for Medicare (during the IEP described above, for example) – you can generally sign up during a Medicare open enrollment period that happens every year.
This “Medicare Open Enrollment” period is also known as Fall Open Enrollment, and the Annual Election Period. This Medicare Open Enrollment period happens every fall, from October 15 to December 7.
This Medicare Open Enrollment period generally lets you:
- Sign up for a Medicare Advantage plan
- Change from one Medicare Advantage plan to another
- Drop your Medicare Advantage plan and return to Original Medicare
These are just some of the coverage changes you can make during this Open Enrollment Period.
To qualify for a Medicare Advantage plan, you need to be enrolled in both Medicare Part A and Part B, and live in the plan’s service area. You might not be able to enroll in a Medicare Advantage plan if you have end-stage renal disease (permanent kidney failure), but in that case, you may be able to enroll in a special type of Medicare Advantage plan called a Special Needs Plan.
You have to keep paying your monthly Part B premium, as well as the plan’s premium (if it charges one).
Medicare open enrollment: Medicare prescription drug coverage
If you’re interested in signing up for prescription drug coverage under Medicare Part D, the enrollment periods are mostly the same as those for Medicare Advantage plans.
Most Medicare Advantage plans include prescription drug coverage. If you don’t have a Medicare Advantage plan, you can generally sign up for a stand-alone Medicare Part D Prescription Drug Plan.
During the Medicare Open Enrollment Period described above, in addition to the options listed above, you can generally:
- Sign up for a stand-alone Medicare Part D Prescription Drug Plan
- Change from one stand-alone Medicare Part D Prescription Drug Plan to another
- Sign up for a stand-alone Medicare Part D Prescription Drug Plan if you drop your Medicare Advantage plan and return to Original Medicare
To qualify for a stand-alone Medicare Prescription Drug Plan, you need to be enrolled in Medicare Part A and/or Part B, and live in the plan’s service area.
New Medicare Open Enrollment: Medicare Advantage
A new Medicare Open Enrollment Period starting January 1, 2019 might give you another opportunity to switch from one Medicare Advantage plan to another. This new Medicare Open Enrollment Period goes from January 1 to March 31 every year, starting in 2019.
During this Open Enrollment Period, you can also choose to drop your Medicare Advantage plan, return to Original Medicare, and sign up for a stand-alone Medicare Prescription Drug Plan.
Medicare Supplement Open Enrollment Period
If you decide to stay with Original Medicare (Part A and Part B), you might be able to buy a Medicare Supplement (Medigap) plan. This type of insurance can pay for some Part A and Part B out-of-pocket costs. Coinsurance and copayments are two examples. Some Medicare Supplement plans may cover your Part A and/or Part B deductible. Learn more about what Medicare Supplement plans may cover.
Generally, the best time to buy a Medicare Supplement plan is during the Medicare Supplement (Medigap) Open Enrollment Period. During this Medigap Open Enrollment Period, you can buy a Medicare Supplement plan without fear of being rejected or charged a higher premium because of a health condition. The Medicare Supplement Open Enrollment Period starts the month you’re both 65 or older, and enrolled in Medicare Part B. It goes for six months.
If you apply for a Medicare Supplement plan after your Medicare Supplement Open Enrollment Period, the insurance company can review your medical history and decide to charge a higher premium due to your health condition, or reject your application altogether.
Want to learn more about the different types of Medicare plan options? Feel free to enter your ZIP code and click the button on this page to see plans in your area. Or, if you prefer to get personalized assistance, call eHealth to speak with a licensed insurance agent. We can answer your questions.
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