Medicare has roughly 61,000,000 beneficiaries, and Saturday December 7th marks the day their coverage is locked in for 2020….Sort of. The Fall enrollment period, which is from October 15th through December 7th, is when you can make certain changes to your Medicare coverage, effective Jan 1st.
This includes going from Original Medicare (Medicare Part A and B) to a Medicare Advantage plan, or vice versa. You can also switch from one Medicare Advantage Plan to another, or from a standalone Part D prescription drug plan to a different one. If you take no action at all, you will automatically be enrolled in the same plan you had for 2019.
However, you may be able to change your coverage after the New Year, depending on your specific situation. Also noteworthy, is that this year, due to some reported technical issues with the revamped Medicare.gov “Plan Finder” tool, there’s a chance you will discover something about your coverage that isn’t suitable if you used that online tool.
“That’s definitely something we’re worried about,” said Julie Carter, senior federal policy associate at the Medicare Rights Center, a nonprofit group. “There have been issues that have cropped up and we can’t be sure how often, how many people they’ve affected or how many people made decisions based on it.”
For Advantage Plans, there is already another enrollment period in place from January 1st to March 31st, when you can make the switch from either one Advantage Plan to another, or to Original Medicare and a stand-alone Part D prescription plan. However, if you determine that something is wrong with your coverage that can’t be changed during the window, there may be another route. If it turns out that your choice was based on bad information, you might be granted a special enrollment period (generally two months) to change your coverage. You will be able to change plans and make other changes if you qualify for a Special Enrollment Period. Qualifications for the Special Enrollment Period would be getting married, having a baby, getting a divorce or other qualifying major life events.
Experts recommend that all Medicare beneficiaries take time to review their coverage and check for whether there’s another option that could be more suitable and cost less. Even if you’re happy with your 2019 coverage, changes made from year to year could affect your premium, copays and deductibles along with in-network providers and pharmacies. Depending on your location, new coverage options could be available that weren’t in the past.
Despite all of that, most Medicare beneficiaries don’t switch plans during Fall Open Enrollment, according to Kaiser. Also be aware, that if you are dual enrolled in both Medicare and Medicaid, the rules applying to when you can change plans are different. If you are signing up for Medicare for the first time your window for signing up is separate from this current fall enrollment period. Medicare supplemental insurance policies, also known as Medigap, also operates under separate rules.
Medicare coverage changes: Important Dates
- January 1 to March 31 – General enrollment for Medicare Part B, for people who didn’t sign up when they were first eligible (this is also the general enrollment period for people who have to pay premiums for Medicare Part A and didn’t sign up when first eligible).
- January 1 to March 31 – Medicare Advantage open enrollment period: People who already have Medicare Advantage can switch to Original Medicare (plus a Part D prescription drug plan) or to a different Medicare Advantage plan.
- October 15 to December 7 – Open enrollment period for Medicare Advantage and Medicare Part D.
- December 8 to November 30 – Special enrollment for 5-star plans
- First year of Advantage coverage – One-time trial period during which it’s possible to switch from Medicare Advantage to Original Medicare, Medigap or Part D plan.
One of the biggest mistakes people eligible for Medicare make is dealing directly with Medicare and directly with the insurance carriers. This ultimately fragments the process and can just add more confusion. What’s more, is that you could be sold a product that is more beneficial to the salesperson than it is to you. Working with an experienced broker has some really wonderful advantages. Below are just some of the ways we can help you navigate the complexity that Medicare can be.
How we help with Medicare Insurance
- Choosing the right Medicare Supplement plan
- Understanding Original Medicare vs. Medicare Advantage
- How to choose the most cost effective prescription drug plan
- How to minimize your out-of-pocket expenses
- Understanding enrollment periods and penalties
- How to avoid higher Medicare premiums
- No upfront cost to you for our services
For more information, please call us at 623-889-7600 or fill out the contact form below!!