Medicare’s Annual Enrollment Period: What You Need to Know
For many older adults, enrolling in Medicare is a positive step in their healthcare journey. Medicare helps make necessary medical services more affordable.
We’ve already covered how to enroll in Medicare to help you get started. However, many new Medicare beneficiaries have questions about how the enrollment period works.
In this post, we’ll take a closer look at Medicare’s enrollment periods and how they work to help you get started.
1. When Is the Enrollment Period for Medicare?
If you’re a new Medicare beneficiary, you can sign up for coverage during the initial enrollment period. This is a seven-month period that starts three months before you turn 65 and ends three months after you turn 65. You may also be automatically enrolled if you are already receiving Social Security benefits.
If you don’t sign up for Part B during this time frame, you can enroll for the first time during the general enrollment period, which happens from January 1st to March 31st each year. Some beneficiaries may also qualify for a special enrollment period. Note that these enrollment periods are only available to new beneficiaries.
Current beneficiaries can review and change their current Medicare Advantage or Part D coverage during the annual enrollment period, which happens from October 15th to December 7th each year. This is the one of the only times of the year when you can make changes to your existing Medicare policy, which is why it’s so important for Medicare beneficiaries to be aware of. Unfortunately, many beneficiaries do not take advantage of the annual enrollment period. Recent research from KFF found that 69% of Medicare beneficiaries did not compare plan options during the 2021 open enrollment period.
2. Changes You Can Make During Annual Enrollment
The annual Medicare enrollment period gives beneficiaries the opportunity to make changes to various aspects of their health insurance coverage. These changes include:
- Primary coverage types: Beneficiaries can switch from Original Medicare to Medicare Advantage or vice versa during this period. Switching between plan types is common in 2022, 80% of Medicare beneficiaries had switched plans at some point.
- Medicare Advantage: If you already have a Medicare Advantage plan, you can switch between different coverage types or providers.
- Prescription drug coverage: During this enrollment period, you can join, switch, or drop a Medicare Part D prescription drug plan.
Even if you do not plan to switch your Medicare coverage, the annual enrollment period is still an ideal time to review your current plan and think about your long-term healthcare needs. Keep in mind that coverage can change from year to year, so you’ll want to make sure your plan still aligns with your budget and medical needs.
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3. Why You Might Need to Review Your Coverage Annually
Medicare plans can change from year to year, so even if you’re currently happy with your medical insurance, it’s still worthwhile to review it during the enrollment period.
Your plan’s monthly premiums and out-of-pocket costs can change annually, as can healthcare provider networks. This is true for both Original Medicare and plans administered by private insurance companies.
Additionally, your budget and healthcare needs will change from year to year. A plan that worked well for you in the past may no longer be viable if you develop a chronic illness or injury.
For example, you might have a Medicare Advantage plan that covers services from your preferred healthcare providers. However, your insurance provider announces they are changing coverage for the next year, and your doctor will no longer be in the network but your preferred providers will be accepting Original Medicare or a different Medicare Advantage plan company.
In this case, it makes sense to switch to Original Medicare with add-on Part D coverage for prescription drugs so you can continue seeing your doctor of choice, or review changing to a different Medicare Advantage plan carrier.
4. Common Enrollment Mistakes to Avoid
Medicare enrollment can be complicated, and if you’re not informed, you could end up making mistakes that negatively affect your healthcare coverage. Here are some of the most common Medicare enrollment mistakes and how to avoid them.
Procrastination
Don’t wait until the last minute to check your Medicare plan for next year. Make sure you give yourself enough time to thoroughly review your policy for the upcoming year, get clarification on any questions you may have, and make changes if necessary. This process can take time, so don’t wait until December 6th to get started.
Ignoring Important Details
Before renewing your plan, check in on key details like monthly premiums, formularies, and covered providers to see what’s changed. You will receive a Plan Annual Notice of Change (ANOC) document in September detailing these adjustments. If you don’t check in on these factors, you could end up sticking with a plan that costs you more money in the long run.
Not Considering Future Needs
It’s normal for your health to change as you get older. When reviewing your Medicare coverage, it’s important to consider how your needs may change over the next year and what type of coverage you will require, and choose your plan accordingly.
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Start Your Medicare Enrollment With Senior Insurance Agency
Knowing when Medicare enrollment periods take place will empower you to change your coverage as your needs change. As annual enrollment for Medicare is approaching, now is the perfect time to review your plan and decide what you’d like to do for the next year.
At Senior Insurance Agency, we help clients navigate the Medicare system and are here to help you, whether you’re enrolling in Medicare for the first time or have been using the system for years. Our insurance agents in Sparks can help you review your plan options and complete the enrollment process so you have the coverage you need.
Get in touch today to schedule a free consultation.
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FAQs About the Medicare Birthday Rule
No, enrolling in Medicare is not mandatory when you turn 65. Some people who are still working at this age prefer to stay on their employer’s group health plan. If you do not enroll right when you turn 65, it’s important to be aware of the general enrollment period at the beginning of each year so you can sign up later if you wish, and any potential late enrollment penalties that you might incur by delaying your Medicare enrollment.
No, not everyone is automatically enrolled in Medicare upon turning 65. You will only be automatically enrolled if you are already receiving Social Security or Railroad Retirement Board benefits. If you do not receive these benefits, you will need to sign up on your own.
If you don’t sign up for enrollment during your initial enrollment period when turning 65, you will need to wait until the general enrollment period and could face late enrollment penalties.
If you want to change your plan during annual enrollment and do nothing, you will be stuck with the same plan until the next year’s enrollment period.
If you miss your initial enrollment period for Medicare when you first turn 65, you will need to wait for the general enrollment period or use a special enrollment period, and you could face late enrollment penalties.