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Let’s talk Medicare Open Enrollment.

Fall Medicare Open Enrollment is the time of year you select the Medicare plan that you’ll have for the entire year. During this period, you can enroll in Medicare Advantage, switch Medicare Advantage plans, even return to Original Medicare (Part A - hospital insurance or Part B - medical insurance) from a Medicare Advantage plan. You can even add or drop prescription drug coverage (Part D). And, if you’re satisfied with your current plan, you don’t have to do anything. Although, it is smart to go over your plan because changes to plans occur yearly and it might be worth it to consider all your options.

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When to enroll in Medicare.

Fall enrollment occurs every year between October 15th and December 7th. Any changes made to your plan will go into effect January 1st. In many cases, Fall Open Enrollment is the only time you can pick a Medicare Advantage or Part D plan. Not choosing a plan at this time could cost you in paying a yearly surcharge and pre-existing illnesses might not be covered in the future.

Eligibility requirements for Medicare Open Enrollment.

Adults 65+ are eligible for Medicare. People with disabilities who are under 65 may also be able to enroll. You’re eligible to sign up for Medicare 3-months before you turn 65. If you wait to sign up the month you turn 65, or during the 3-month period after you turn 65, you might experience a gap in coverage. Also, it’s worth pointing out that not everybody has to sign up for Medicare. Some people automatically get it.

Once the initial enrollment period ends, you can still sign up during a Special Enrollment Period (SEP).

Gaps in coverage white bg

But I like my existing plan.

If you are happy with the plan you currently have, then you don’t have to do anything during Fall Open Enrollment. However, many plans make changes to their cost or coverage on a yearly basis. So, having the most up-to-date information on your Medicare coverage for the up-coming year can benefit you in many ways.

I don’t want to sign up for Medicare at 65.

More people are working later in life. That means they are still on their employers group health plan. If this is your case, then you don’t have to sign up for Medicare when you’re turning 65, especially if your employers group health plan is for 20 or more employees. Anything under that number, and yes, you will need to sign up for Medicare Parts A and B, or incur costly yearly penalties. This could mean a 10% surcharge on your Medicare Part B premiums for each year you go without coverage. Since Medicare Part A is free to anyone who has at least 10 years of work, a late-fee doesn’t apply to most people in this case.

Many times it makes sense to enroll in Medicare Part A on time, even if you already have health coverage. It doesn’t cost a thing, and this way Medicare can act as your secondary insurance which could help pick up whatever your employer’s group health plan doesn’t cover.

However, it’s worth noting here that if you are contributing to an HSA account you won’t be able to continue doing so if you enroll in Medicare, even if you have coverage under your employer’s HSA-qualified high-deductible health plan.

If you look at someone age 65 or older now, that person is 75% more likely to be working than someone who was in the same age group a generation ago
Richard Johnson, Senior fellow of the Program on Retirement Policy at the Urban Institute.

You can delay enrollment, if you’re still under your employer’s group plan covering at least 20 people, and if you’re working when you turn 65. This allows you to avoid paying premiums, specifically for Part B while you’re covered under your employer’s plan. If you leave your employer during that time, you’ll get an 8-month Special Enrollment Period to sign up for Medicare. Your 8-months to find a Medicare plan begins one month after you leave your employer’s group plan, or one month after you separate from your employer, whichever happens first. If you sign up during this time, you won’t have to worry about premium surcharges for being late. The 8-month Special Enrollment Period is also available if you’re delaying Part B enrollment if you’re covered under your spouse’s employee group plan. Assuming it covers at least 20 employees

According to medicareinteractive.org, you should take a look at other Medicare options in your area, even if you are satisfied with your current plan. This could help you find a plan that could better suit your changing needs.This is especially true if you have coverage from a group health plan that isn’t heavily subsidized by your employer. You’ll want to figure out what you’re paying for group health coverage and what kinds of benefits you’re receiving under that plan. Then compare that plan to what you’ll likely be paying under Medicare. Take into account the cost of everything from, premiums, to coinsurance, deductibles and even copays.

And don’t lose sight that for comprehensive coverage under Medicare, you’ll need to select a Part D plan as well.

Missing Open Enrollment.

If you miss your Initial Medicare Enrollment Period, you will have another chance to enroll , without incurring penalty surcharges, during your Special Enrollment Period. You can sign up for Medicare Part A and B between January 1st and March 31st. Your coverage will begin July 1st. But don’t forget, if you need to buy Medicare Part A you must also enroll in Medicare Part B at this time.

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