A Better Way to Shop for Medicare & Health Insurance

• Total care costs – In addition to your monthly premium, you should also evaluate other out-of-pocket costs like the deductible and maximum out-of-pocket amounts before selecting your health insurance plan. Understanding these will help you determine which plan may be financially right for you.
• Prescription drug coverage – It’s essential to check if the plan covers prescription drugs, and if so, which drugs.
• Additional benefits – Many health insurance plans offer perks for their members. For example, some Medicare Advantage plans include free memberships to gyms. Other plans provide services such as virtual doctor visits or even making an appointment online.

When enrolled in a Medicare Advantage plan, you receive the same coverage you get from Original Medicare and additional benefits like dental and vision insurance from the Medicare Advantage insurance provider. Most Medicare Advantage coverage includes additional prescription drug coverage too!

Medicare

• Initial Enrollment Period – Most people can first enroll in Medicare Part A, Part B, Part C, and/or Part D during a seven month window: three months before the month you turn 65, the month you turn 65, and three months after the month you turn 65.
• Special Enrollment Period (SEP) – You can qualify based on certain life events like if you move or lose current coverage. Depending on your circumstance, you generally have two full months to enroll.
• Medicare Part C & D Annual Enrollment Period (AEP) – October 15 to December 7, every year. Existing Medicare beneficiaries can use this period to re-evaluate and make changes to their Medicare Advantage (Part C) and Medicare prescription drug plans (Part D). You cannot use AEP to enroll in Part A and/or Part B for the first time. Coverage starts on January 1 of the following year.
• Medicare General Enrollment Period – January 1 to March 31, every year. While most people will get Part B coverage when they sign up for Medicare, this time is reserved for those that did not enroll in Part B when they were first eligible. Coverage starts July 1 of the same year.
• Medicare Advantage Open Enrollment Period (OEP) – January 1 to March 31, every year. During this time, you can switch to a different Medicare Advantage plan with or without drug coverage, or switch to Original Medicare and also join a standalone Medicare Prescription Drug plan. You however cannot switch from Original Medicare to a Medicare Advantage plan, join a prescription drug plan if you’re in Original Medicare, or switch from one prescription drug plan to another prescription drug plan.

Health Insurance

• Open Enrollment Period – For most states, the Open Enrollment Period for major medical insurance is November 1 to December 15 every year. Coverage starts on January 1 of the following year.
• Special Enrollment Period – Based on qualifying life events or becoming eligible for or even losing Medicaid or CHIP. Certain qualifying life events within the past 60 days include moving, having a baby/adopting a child, getting married, getting divorced, losing coverage, changing job status, etc.

If you are unsure if you are eligible to enroll, give us a call, and we can check for you.

Most Medicare Advantage plans already cover prescription drugs (Part D), along with Part A and Part B. During the Medicare Annual Enrollment Period, you can drop your extra Part D coverage if your Medicare Advantage plan covers prescription drugs.

If you qualify for Medicaid in addition to Medicare, you can change your coverage once per quarter. Everyone else must be eligible for a Special Enrollment Period (SEP) like moving outside of your plan's service area or if you unexpectedly lose your current coverage.

If you’re enrolled in Medicare Advantage and want to switch plans or go back to Original Medicare (Parts A and B) you will be able to use the Medicare Advantage Open Enrollment Period from January 1 to March 31. You are allowed to switch coverage one time. Coverage selections made during Open Enrollment will be permanent for the entire year unless you have a special enrollment period. Coverage would start the first of the following month. During this period, you can:

• Switch to Original Medicare and enroll in a Part D prescription drug plan.
• Switch to a different Medicare Advantage plan.

You are also able to change Medicare Advantage plans for next year’s coverage during Medicare’s Annual Enrollment Period, which is from October 15 to December 7, every year.

Most people are automatically enrolled in Medicare Part A when they turn 65. If you didn’t enroll in part B during your Initial Enrollment Period, you can enroll during the Medicare General Enrollment Period from January 1 to March 31. Coverage becomes active on July 1. However, if you didn’t enroll in Part B when you were first eligible, you may be subject to the lifetime Part B late enrollment penalty.

You may also be able to enroll in Part A and/or Part B during a Special Enrollment Period, based on certain life events.