Navigating Medicare Open Enrollment


Navigating Medicare Open Enrollment

The open enrollment period for Medicare begins October 15, running through December 7. The changes made during the period take effect on January 1 the following year. When enrolling in Medicare, it is important to be aware of all four parts/types.


Part A: This is coverage for hospital stays, home care, and nursing homes.
Part B: This is coverage for doctor visits, diagnostics, and outpatient procedures.
Part C: This is a Medicare Advantage plan. These are offered through private insurance companies.
Part D: This is coverage for prescription drugs and is only offered through private plans.


Your initial enrollment period begins three months before you turn 65, the month you turn 65, and the three months following your 65th birthday. This can be at any point during the year (if it’s within the time constraints).


During the open enrollment period, you can switch between original Medicare, an Advantage plan, or from an Advantage plan to an original plan. You can switch between different Part D plans. You may also enroll in a Part D plan for the first time if you had not done so before.


If you are happy with your current Medicare coverage, you do not have to do anything in order to keep the coverage you already have. However, if one or more of your plans has been discontinued – that is, it will no longer cover you after December 31 – you will need to seek a new Medicare plan provider. You should receive a letter from your insurance provider ahead of the open enrollment period.


Even if you do not anticipate switching from one plan to another for any part of Medicare, it is still a great idea to research the options that are available to you. Open enrollment is a time to optimize your health insurance plan.


To reiterate, during the open enrollment period, you may:


  1.   Switch from one Part D plan to another.
  2.   Switch between Advantage Plans.
  3.   Switch from an Advantage plan to an original Medicare plan.
  4.   Switch from an original Medicare to an Advantage plan.
  5.   If you have Parts A or B, you can add or drop a Part D plan.


After the annual enrollment period, there is still a chance to switch your plan. Medicare Advantage disenrollment period runs from January 1 through March 31. During this period, you may switch from an Advantage plan back to an original Medicare plan and purchase a Part D prescription plan. You may also switch between the available Advantage plans. This time period was extended by a new law, the 21st Century Cures Act. This allows three months to switch instead of one and a half months (originally January 1 to February 14).


While during the normal annual enrollment period (October 15 through December 7), you can switch between all the available plans as many times as you like; you may only switch once during the disenrollment period. This means that if you enroll in an Advantage plan during the annual enrollment period and then decide you do not like that plan once the new year begins, you have until the end of March to rectify your insurance plan.


Why would you want to switch plans? Not all Medicare plans are the same. Be sure to investigate the coverage each plan provides. Some Part D prescription plans may make your prescriptions cheaper. Your doctors may suddenly become “out of network” and cost more each time you visit them. Make sure your plan allows you to keep the doctors with whom you have a relationship. Each Medicare plan is rated on a five-star system. If your current plan is marked as being three stars or less, it might be time to find a plan with a higher rating.


If you did not enroll in Medicare Part A and B during your original seven-month window when you turned 65, you may do so between January 1 and March 31 with the coverage taking effect on the first of July. There may be a penalty of 10% of your monthly premium for each year you were eligible but did not enroll. It is very important to review your options around turning 65, even if you are still employed, to avoid the 10% premium penalty.


You can check your enrollment status at the official Medicare website, It also offers many valuable resources for finding the right Medicare coverage for you. You may also find information on covered procedures and doctors in your network, as well as compare procedure costs and more. Medicare can also be reached at 1-800-633-4227.


Let us know if you have any questions or want to discuss how Medicare affects your retirement plan.


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