Reviewing Your Medicare Policy
Even though you do not need to renew Medicare coverage, it is recommended that you review your Medicare plan each year during AEP in which you may make any necessary changes to your current Medicare coverage. As mentioned earlier, during AEP you may switch from Original Medicare to Medicare Advantage and vice versa, switch to a different Medicare Advantage plan, opt in or out of prescription drug coverage , or make any other changes to your Medicare coverage based on your current needs.
Its important to review your Medicare coverage each year during open enrollment as your health needs may change or the policy terms or costs may be revised. For example, each year Medicare Advantage and Medicare Part D plans will send beneficiaries an Annual Notice of Change, which outlines the plan changes for the upcoming year. Once you receive the notice, you should review to make sure your plan still fits your needs or is still the best plan option available.
If You Dont Like Your Medicare Advantage Plan You Can Switch
It used to be possible to get stuck with a Medicare Advantage Plan until the next years MOE period. Fortunately, Medicare altered their rules beginning in 2019, permitting seniors with Advantage Plans to make additional changes after the fall open enrollment period ends. The Medicare Advantage Open Enrollment Period lasts from January 1 through March 31 each year. During this window, beneficiaries can only do two things:
- If youre in a Medicare Advantage Plan , you can switch to another Medicare Advantage Plan .
- If youre in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare. You also have the option to join a Part D Plan.
Changes made during this time are effective the first day of the following month.
Enrolling In Medicare Part D
The first opportunity for Medicare Part D sign up is when youre initially eligible for Medicare during the seven-month period beginning three months before the month you turn 65, or during the seven-month period beginning three months before your 25th month of disability.
In both of these cases whether youre turning 65 or are eligible for Medicare because of a disability you likely have the option of selecting a Medicare Advantage plan that includes Part D prescription drug coverage, and using that in place of Medicare A, B, and D
If you enroll in Medicare during the , you can enroll in a Medicare Advantage plan between April 1 and June 30. But if you already had premium-free Medicare Part A and youre just using the General Enrollment Period to sign up for Part B, youll have to wait until the fall open enrollment period to sign up for a stand-alone Part D plan. This is because Part D can be purchased when you have Part A or Part B, whereas Medicare Advantage requires you to have both. So if youve already had premium-free Part A, you were eligible for Part D as of when your Part A coverage took effect. But your eligibility for Medicare Advantage would only begin when youre enrolled in both Part A and Part B.
If youre enrolled in a Medicare Advantage plan and use the Medicare Advantage open enrollment period to switch to Original Medicare, youll also have the option to sign up for a Part D plan to supplement your Original Medicare coverage.
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A Late Enrollment Penalty
If youre eligible for premium-free Part A coverage you will not have to pay a late enrollment penalty, even if you decide to enroll after you first become eligible.
However, if you arent eligible for free Part A coverage, you will have a penalty if you dont enroll when youre first eligible. In most cases, your monthly premium will increase 10 percent, and youll have to pay that higher premium for twice the number of years you were eligible for Part A but didnt have it. For example, if you were eligible for Part A for three years but didnt enroll, youll have to pay a 10 percent higher monthly premium for six years.
The late enrollment penalty is only applicable if you did not qualify for a Special Enrollment Period.
What Is The 2022 Medicare Advantage Open Enrollment Period
There are two open enrollment periods that allow you to make changes to your Medicare Advantage plan for 2022.
From Oct. 15 to Dec. 7, 2021, you can change from:
- Original Medicare to Medicare Advantage.
- Medicare Advantage to Original Medicare.
You can also switch from one Medicare Advantage plan to another during this enrollment window.
If youre in Original Medicare, you can join a Part D plan now, too. Or you can switch from one Part D plan to another.
From Jan. 1 to March 31, 2022, you can switch from:
- One Medicare Advantage plan to another.
- A Medicare Advantage plan back to Original Medicare.
One change you cant make during this open enrollment period is to go from Original Medicare to Medicare Advantage coverage.
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Review Your Plan Annual Notice Of Change
If youre enrolled in a Medicare Advantage plan or a Medicare Part D plan, you will receive a Plan Annual Notice of Change in the mail each September.
This notice will call attention to any changes in plan costs, benefits or service area adjustments for the upcoming year.
If there are any changes made to your plan that affect your overall satisfaction with the coverage, you may have a few opportunities to make any desired changes.
Should You Wait Until 65 To Sign Up For Medicare
If you wait to sign up right before your 65th birthday , you may go for months without coverage.
Initial Enrollment Period
Your Initial Enrollment Period will last for 7 months. This Initial Enrollment Period begins 3 months before the month of your 65th birthday and ends 3 months after your birthday month. If you fail to enroll before your birthday month, your coverage will be delayed by a month or more.
General Enrollment Period
Youll have the option to sign up during the General Enrollment Period which falls between January 1 and March 31 every year if you didnt sign up during the Initial Enrollment Period. But youll potentially be charged a late enrollment penalty. Your premiums for Part B will be permanently increased by 10% for each year that you neglected to sign up for Part B and your monthly premiums for Part A will temporarily increase by 10%. As a rule, most people dont pay premiums for Part A, but then again, most people dont delay signing up for Part A. Your coverage will start on July 1, three months after the General Enrollment Period ends.
You may be able to avoid the late enrollment penalty and having to wait for the General Enrollment Period if you qualify for a Special Enrollment Period.
Special Enrollment Period
Its important to check with your insurer or HR department to make sure that your coverage is sufficient to postpone Medicare enrollment.
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Things To Remember About Medigap Renewal
Remember: although Medigap plans will be available for renewal, the plan may cost more or other plans may become available to you. Even if you do intend to renew your plan, you should always look at the plan details each year to see if anything has changed. You can always talk to an independent insurance agent for help getting quotes.
Its also a good idea to look at the overall structure of Medigap plans and to get some quotes every year to see if any new plan options are available that works better for you. But, when it comes to renewal, they will always be easily available.
Ask: What Benefits Did My Plan Not Have That I Want To Have
Medicare Part D and Medicare Advantage plans may change costs and coverage from year to year. You may have lost benefits you loved and thats why youre shopping around. Or, you may have never had them in the past and you want them now. In either case, make a list of the health benefits you want such as dental, vision or hearing coverage. Once you have your list, now you know what kind of plan you should look at and what benefits it must have.
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What Are The Options With Medigap Plans
When it comes to Medigap plans, the situation is a bit different. Every Medigap plan is guaranteed renewable. This means that the plan will be available for you to stay on even if that company is no longer working with Medicare.
This can result in some unusual scenarios. For example, you may be able to keep your plan from a specific company, even if they dont sell that plan anymore. If you then change your plan or choose to not renew it, it may not be available to you again if you want to purchase it later on.
This makes Medigap plans very easy to deal with. Medigap plans do change, but not in a way that will result in unavailability. Your premiums may go up, and Medicare may issue new requirements about Medicare Supplement plans at large. But, if you have your plan now, you will be able to renew it for another year.
How To Sign Up For Medicare
You sign up for Original Medicare Part A and Part B through the Social Security Administration or the Railroad Retirement Board .
- If you arent yet getting Social Security or Railroad Retirement benefits, you need to apply for Medicare.
- If you already get Social Security or Railroad Retirement benefits, the SSA or RRB will automatically sign you up for Medicare Part A and B so its effective the month of your 65th birthday.
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The Cost Of Medicare Part B
Unlike Medicare Part A, Medicare Part B requires a premium from everyone. The standard premium for Medicare Part B in 2021 is $148.50 a month, which applies to most people, including new enrollees. That premium changes each year, usually increasing. In 2022, the Part B premium jumps to $170.10 a month.
Youll also have an annual deductible of $233 in 2021 as well as a 20 percent coinsurance rate for covered services under Part B.
There are penalty fees for not signing up during your Initial Enrollment Period , but well discuss those in a separate section.
While most people pay the standard amounts for premiums and deductibles, some people will pay more, depending on their income. The more you make, the higher your likelihood will be for paying more than the standard amount. The extra fee per month is called the Income Related Monthly Adjustment Amount . How much more can you expect to pay if you fall outside of the standard range? The Medicare website offers a handy chart on the rates for those with higher incomes, which is updated each year. These are the rates for 2022, based on the income reported on your 2020 tax return:
These amounts reflect individual incomes only. Married couples will pay the same rates, but for different, higher thresholds. For example, a couple that earns over $182,000 per year and files a joint tax return will pay $238.10 per month for Medicare Part B premiums. Married couples who file separate tax returns also have different thresholds.
When Is Medicare Open Enrollment
Medicare open enrollment also known as Medicares annual election period runs from October 15 through December 7 each year.
During this annual window, Medicare plan enrollees can reevaluate their coverage whether its Original Medicare with supplemental drug coverage, or Medicare Advantage and make changes or purchase new policies if they want to do so.
During the Medicare open enrollment period, you can:
- Switch from Original Medicare to Medicare Advantage .
- Switch from Medicare Advantage to Original Medicare .
- Switch from one Medicare Advantage plan to another.
- Switch from one Medicare Part D prescription drug plan to another.
- Enroll in a Medicare Part D plan if you didnt enroll when you were first eligible for Medicare. If you havent maintained other , a late-enrollment penalty may apply.
Prior to 2021, patients with end-stage renal disease were unable to enroll in Medicare Advantage plans unless there was a Medicare Special Needs plan available in their area for ESRD patients. But that changed as of 2021, under the terms of the 21st Century Cures Act. People with ESRD gained the option to enroll in Medicare Advantage as of 2021, and CMS expected more than 40,000 to do so. This can be particularly advantageous for beneficiaries with ESRD who are under age 65 and living in states that dont guarantee access to Medigap plans for people under the age of 65.
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How Often Do You Have To Enroll In Medicare
In general, once youre enrolled in Medicare, you dont need to take action to renew your coverage every year. This is true whether you are in Original Medicare, a Medicare Advantage plan, or a Medicare prescription drug plan. As long as you continue to pay any necessary premiums, your Medicare coverage should automatically renew every year with a few exceptions as described below.
Do I Need To Reapply For Medicaid During Open Enrollment Each Year
Question 1: I am currently on state disability in California and receiving medi-cal benefits. Do i need to reapply during open enrollment if i have no change in my situation? In other words will my coverage continue if i do nothing?
Question 2: i will be 62 in october and am applying for social security retirement. Do i need to enroll for medicare before feb 15?
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Medicare Enrollment Period Basics
What is the Medicare Initial Election Period ?
IEP is the period of time when you initially become eligible for Medicare and enroll in Medicare Part A, Medicare Part B, Medicare Part D, and your Medicare Advantage Plan or Medigap Policy. You only have one Medicare IEP.
When is Medicare open enrollment ?
Annual Election Period or otherwise known as Open Enrollment occurs from October 15th to December 7th, and allows Medicare plan beneficiaries to make changes to their policies, such as:
- Switch from Original Medicare to Medicare Advantage
- Switch from Medicare Advantage to Original Medicare
- Change Medicare Advantage plans
- Enroll in or drop Medicare Part D prescription coverage
What is Medicare Special Enrollment Period ?
This is enrollment period you must qualify for to change your Medicare Advantage Plan or Medicare Part D prescription plan outside of the AEP window as outlined above. If you cannot qualify for an SEP, then you will not be permitted to change your Medicare Advantage Plan or Part D prescription drug plan outside of AEP.
Suppose You Do Want To Make Some Changes To Your Medicare Plans
You cant generally make changes anytime youd like you need to be aware of the enrollment and election periods for the various types of Medicare plans.
Two of the most popular and useful periods when you can make coverage changes are your Initial Enrollment Period and the Annual Election Period, also known as Fall Open Enrollment for Medicare.
- Your Initial Enrollment Period takes place when youre first eligible for Medicare, typically a seven-month period that starts three months before you turn 65 or the 25th month of disability benefits. During that time, you can decide what type of Medicare plan to enroll in.
- The Annual Election Period lets you:
- Sign up for a Medicare Advantage plan.
- Change from one Medicare Advantage plan to another.
- Leave a Medicare Advantage plan and return to Original Medicare.
- Sign up for a stand-alone Medicare Part D Prescription Drug Plan.
- Change from one Medicare Prescription Drug Plan to another.
- Drop your Medicare Prescription Drug Plan.
In some situations, often involving a change in or loss of coverage, you may qualify for a Special Election Period for enrolling in Medicare Advantage plans or Medicare Prescription Drug Plans. Learn more about Special Election Periods here.
If you want to drop your Medicare Advantage plan and return to Original Medicare, you can do so during the Medicare Advantage Open Enrollment Period . You can also add a stand-alone Medicare Prescription Drug Plan during this time.
New To Medicare?
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Do I Need To Do Anything With My Medicare Supplement Plan
Whether youâre entirely new to Medicare or youâve been a Medicare participant for a while, you may have questions about your Medicare Supplement plan, such as âWhat do I need to do with my Medicare Supplement plan this year?â
Medicare Supplements are handled very differently from Medicare Advantage plans, and many individuals donât know this!
Remember that our team of licensed agents is always willing to help you, so please feel free to contact us at any time for individualized help.
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When To Sign Up For Medicare Plans
When you sign up for the various Medicare coverages and when each one comes into effect varies with the different Plans. A general outline follows specific situations or health conditions touch off a number of different enrollment periods. For fuller details see the publications.
Enrolling in Medicare parts A & B:
Part A
For qualified individuals, you should sign up during the “Initial Enrollment Period” of seven months around the month you turn 65 . Note that this may be before you can or choose to file for Social Security benefits. If you enroll prior to the birthday month, you will start being covered as of your birthday month. If you enroll during the last four months of the period, coverage will start with an additional month’s delay.
If you didn’t sign up for Part A during your Initial Enrollment Period, you can sign up during the “General Enrollment Period” between January 1 and March 31 each year. Coverage will begin July 1. If you are a qualified individual, there may be a penalty premium for late sign-up, as mentioned above .
In certain cases, if you did not sign up for Plan A when initially eligible because you were covered under a group health plan based on current employment, you can sign up later during a “Special Enrollment Period”. See Publication 11219 for details.
Part B :
Part C and Part D :
Some addiitonal information on Medicare sign up can be found at the following non-US government links:
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