Begins Jan 1, 2024
Medicare is offered to U.S. citizens and other eligible individuals based on:
Your first chance to sign up is generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.
OEP is only available to those enrolled in an MA plan.
During OEP, MA Plan members may have an opportunity to switch MA plans (with or without drug coverage) or to disenroll from an MA plan and obtain coverage through Original Medicare (with or without a stand-alone PDP). Members enrolled in stand-alone PDP plans are not eligible for the Open Enrollment Period election.
Include persons ages 65 and older, under 65 and receiving Social Security Disability Insurance (SSDI) for a certain amount of time, or under 65 and with End-Stage Renal Disease (ESRD). Those who have participated in open enrollment previously know there are a lot of choices when it comes to Medicare. While the most important might be choosing to take charge of your Medicare decisions in the first place, it's also a good idea to make sure the choices you make aren't costing you unnecessarily.
Your Medicare Part D or Medicare Advantage plan renews every year on January 1, unless you decide to change it. Automatic renewal may make your life easy, but it might not be the best way to make your Medicare decisions. This is especially true if your health care needs changed in the last year if you are taking more medications, if you wish you had more benefits, such as dental or hearing, or if your finances changed. Plans also may change what they cover from year to year, including what you will pay in deductible, premium, copay or coinsurance amounts. This information will be contained in the Annual Notice of Change, which is discussed next.
Typically delivered to mailboxes by September 30, ANOC letters ensure that plan members have up-to-date plan information before AEP begins. This document explains any changes in your plan benefits and costs for the upcoming year. The changes may affect your health care and your budget, so it's important to know what to look for in the ANOC, as it can help you decide early whether to keep your current plan or alert you that you may want to look for a new one during the AEP
It is easy to focus only on premiums when looking at Medicare costs, but it's a good idea to look at the big picture. Let's take a look of the plan options:
You might count on a friend's word when deciding what new restaurant to try, but a Medicare plan is a personal choice. What works for one person may not fit with the needs for another. You have several plans to choose from, so it's a good idea to look at all your options, keeping your healthcare needs and your budget at the priority. The medicare.gov website suggests considering seven things when choosing a plan:
Several programs offer financial assistance with Medicare premiums and other costs. In some cases, Medicare Savings Programs may pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance and copayments if you meet certain conditions.
There are four kinds of Medicare Savings Programs:
1. Qualified Medicare Beneficiary (QMB)
2. Specified Low-Income Medicare Beneficiary (SLMB)
3. Qualifying Individual (QI)
4. Qualified Disabled & Working Individuals (QDWI)
If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get extra help paying for Medicare drug coverage. You may want to look into them, even if you think you might not be eligible.
Enroll in Medicare drug coverage when you're first eligible.
Even if you don’t take drugs now, you should consider joining a Medicare drug plan or a Medicare Advantage Plan with drug coverage to avoid a penalty. You may be able to find a plan that meets your needs with little to no monthly premiums.
Enroll in Medicare drug coverage if you lose other creditable coverage.
Creditable prescription drug coverage could include drug coverage from an employer or individual health insurance coverage. Your plan must tell you each year if your non-Medicare drug coverage is creditable coverage. If you go 63 days or more in a row without Medicare drug coverage or other creditable prescription drug coverage, you may have to pay a penalty if you sign up for Medicare drug coverage later.
3. Keep records showing when you had other creditable drug coverage, and tell your plan when they ask about it.
If you don’t tell your Medicare plan about your previous creditable prescription drug coverage, you may have to pay a penalty for as long as you have Medicare drug coverage.
Avoid late enrollment penalties
It’s important to sign up for Medicare coverage during your Initial Enrollment Period, unless you have other coverage that’s similar in value to Medicare (from your employer). If you don’t, you may have to pay an extra amount, called a late enrollment penalty.
Late enrollment penalties:
Not affiliated with the U. S. government or federal Medicare program. Deborah DeLynn Wilson Insurance Independent Insurance Agent. "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”