Enrollment Periods For Medicare Supplements
Just like Medicare has special enrollment periods throughout the year, Medicare Supplements have a special window where you need to purchase a plan.There is really only one Enrollment period for Medicare Supplements. It is referred to as the Initial Enrollment Period. This window is from 3 months prior to your 65th birthday and 3 months after.
During this period you can enroll in a Medicare Supplement without being subject to medical underwriting and policies are guaranteed issues
If You Enroll In Drug Coverage Thats Equivalent To Medicare Part D
If you enroll in TRICARE, VA coverage, or another plan that offers comprehensive prescription drug benefits and you have a Medicare Advantage plan that includes prescription drug coverage then you can leave your Medicare Advantage plan and return to Original Medicare.
- Youll want to check with your prescription drug plan to make sure that it provides you with credible drug coverage.
- You can do this at any time, but your ability to enroll in the alternative creditable drug coverage may be limited by that plans rules.
How To Change Medicare Plans
Be aware that if you want to disenroll from a Medicare Advantage plan and dont want to enroll in another Medicare Advantage plan, you have to notify your plan in writing. However, if you want to change from one Medicare Advantage plan to another or from one Medicare prescription drug plan to another, all you have to do is join the new plan, and you will automatically be disenrolled from the old one.
Also understand that you can generally only change Medicare plans during the Medicare Advantage Open Enrollment Period, Annual Election Period, or a Special Election Period .
Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.
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Changing From Medicare Advantage To Original Medicare
Changing from Medicare Advantage to Original Medicare is a very simple process once youre ready and eligible to switch. There are three ways you can make the change:
You Lost Your Medicaid Coverage
Suppose you get notified that you no longer qualify for Medicaid. In that case, youll have three full months following the date your eligibility ends or notified, whichever is later. During that time, you can join, switch or drop your Medicare Advantage Plan or Drug Plan, or switch back to Original Medicare.
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How To Switch Medicare Advantage Plans
- You have several opportunities to switch your Medicare Advantage plan throughout the year.
- You can switch your plan for Medicare Advantage and Medicare prescription drug coverage during the Medicare open enrollment period or the Medicare Advantage open enrollment period.
- You can also switch your Medicare Advantage plan during a special enrollment period thats triggered by a major change in your life.
Medicare Advantage plans are offered by private insurance companies. If you have a Medicare Advantage plan, you can:
- switch to a different Medicare Advantage plan that offers drug coverage
- switch to a different Medicare Advantage plan that doesnt offer drug coverage
- switch to original Medicare plus a Part D plan
- switch to original Medicare without adding a Part D plan
To switch plans, contact the insurance provider of the plan you like and apply for coverage. If youre not sure how to contact the provider, Medicares plan finder tool may be useful. You will be disenrolled from your previous plan as soon as your new plan takes effect.
If you are switching from a Medicare Advantage plan to original Medicare, you can either call your former plan or enroll through Medicare by calling 800-MEDICARE.
The short answer is no. You may switch Medicare Advantage plans during set enrollment periods each year and within a specified period of time following certain life events.
Well discuss these enrollment periods in the next section.
Medicare Advantage Vs Medicare Supplement Insurance
In a nutshell, Medicare Advantage provides a way to get your Medicare Part A and Part B benefits through a private, Medicare-approved insurance company. Some plans offer additional benefits, such as routine vision care. Medicare Supplement plans are designed to work alongside your Original Medicare benefits Medicare Supplement plans dont provide those benefits, but instead, they may help pay your Part A and Part B out-of-pocket costs.
You cant use Medicare Supplement plans to pay your out-of-pocket costs from Medicare Advantage plans. In fact, if youre already enrolled in Medicare Advantage, its against the law for someone to sell you a Medicare Supplement plan . However, the reverse is not true. If you already have a Medicare Supplement plan and you decide to change to Medicare Advantage, youre allowed to keep your Medicare Supplement plan if you want to, even though it wont help you pay for Medicare Advantage out-of-pocket expenses.
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The Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period is for current Medicare Advantage plan members. It runs from January 1 to March 31. During this time, Medicare Advantage plan members can revisit their plan choices and choose to make coverage changes.
You can do the following during the Medicare Advantage Open Enrollment Period:
- Switch to a different Medicare Advantage plan.
- Drop your Medicare Advantage plan and go back to Original Medicare .
- Enroll in a stand-alone Medicare prescription drug plan , if you go back to Original Medicare.
And similar to the Medicare Annual Enrollment Period, if you choose to return to Original Medicare, you are now able to enroll in a Medicare supplement insurance plan, though you are not guaranteed coverage and could face higher costs.
If You Lose Your Medicaid Eligibility:
If youre covered by both Medicare and Medicaid and then you lose eligibility for Medicaid, you can switch from Medicare Advantage to Original Medicare up to three months from the date you lose Medicaid eligibility, or the date youre notified, whichever is later.
- If youre told in advance that youll lose your Medicaid coverage for the following year, you can switch to Original Medicare between January 1March 31.
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Can You Change My Medicare Advantage Plan After Open Enrollment
Once the open enrollment ends, in general you will not be able to make changes until the next enrollment period, says Joe Boden, vice president and partner at EP Wealth Advisors in Seattle. However, there are a few exceptions when you can make a change or disenroll from your plan outside of the enrollment periods.
Certain events may make you eligible for a Special Enrollment Period . For instance, if this is the first time youve ever enrolled in a Medicare Advantage Plan and you dropped a Medigap policy to enroll, you have a 12 month trial period after enrolling in the MA Plan in which you can drop your MA Plan and go back to Original Medicare.
Another exception is if your Advantage plan drops your healthcare provider, Boden says. Also, if you move and your plan does not have coverage in your new location, you can change plans. Even if your new address is within your current plans coverage area, you can switch to a different plan if your move made you eligible for new options that werent available at your old address. You have from one month before your move until 2 months after your move to switch plans.
Special Enrollment Period If Youre In An Area Affected By Certain Natural Disasters
The federal government allows a special enrollment period, after the end of the general enrollment period, Medicare Advantage open enrollment period, or other individual special enrollment period , for people who live in an area thats experienced a FEMA-declared major disaster or emergency.
In general, if, because of the disaster, you were unable to complete your enrollment during the window that was originally available to you , youll have additional time to complete your enrollment. Your disaster-related enrollment window will continue for four months after the start of the FEMA-declared emergency period.
For 2021 coverage, there were several states and several partial states where this special enrollment period was available after the fall enrollment window ended in December 2020.
Hurricane season overlaps with the Medicare general enrollment window in the fall, which often leads to some areas having additional time to enroll after December 7. There are also FEMA-declared disaster areas due to other situations each year, such as wildfires, tornadoes, and floods.
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How To Disenroll Or Switch Medicare Advantage Plans
Once youve decided to drop or change your Medicare Advantage plan, the first step is to enroll in the new plan youve chosen. Do this by filing out an enrollment request with the new plan during an open or special enrollment period to avoid penalties. After youve signed up with a new plan and your coverage begins, you will automatically be disenrolled from your previous plan.
If youre leaving Medicare Advantage to return to original Medicare, you can call 800-MEDICARE to resume original Medicare services.
General Medicare Enrollment For Those Who Didnt Sign Up When First Eligible
From January 1 to March 31 each year, people who are eligible for Medicare Parts A and B but not yet enrolled can sign up for coverage. Coverage will take effect on July 1 of that year. If you didnt sign up for Part B when you were first eligible and you havent had creditable coverage from an employer plan in the meantime, youll have to pay an additional premium for your Part B plan, as a late enrollment penalty.
If you sign up for Medicare during the general enrollment period, you have three additional months during which you can select a Part D plan or a Medicare Advantage plan. And once youre enrolled in Medicare Part B , youll have a one-time enrollment window during which Medigap plans in your area are guaranteed-issue. In most states, Medigap plans will then be medically underwritten if you apply after that six-month window ends.
Although the fall enrollment window for 2022 coverage is approaching, people who arent enrolled in Part B cannot sign up for it during the fall window. Instead, theyll need to wait until January 1, and enroll in Part B during the general enrollment period.
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Change Medicare Plans During Special Election Period
Medicare has certain provisions to help you deal with unexpected happenings. If you go through certain special circumstances, you may be able to change Medicare plans during Special Election Periods. These events may include, but arent limited to:
moving to a new address losing your current coverage qualifying for other coverage such as Medicaid, Employer Group Coverage and State Pharmaceutical Assistance Program becoming qualified for Extra Help to pay for Medicare Part D coverage through the Social Security Administration
The dates and types of changes you can make vary according to the Special Election Period.
The Cares Act Of 2020
On March 27, 2020, President Trump signed a $2 trillion coronavirus emergency stimulus package, called the CARES Act, into law. It expands Medicare’s ability to cover treatment and services for those affected by COVID-19. The CARES Act also:
- Increases flexibility for Medicare to cover telehealth services.
- Increases Medicare payments for COVID-19-related hospital stays and durable medical equipment.
For Medicaid, the CARES Act clarifies that non-expansion states can use the Medicaid program to cover COVID-19-related services for uninsured adults who would have qualified for Medicaid if the state had chosen to expand. Other populations with limited Medicaid coverage are also eligible for coverage under this state option.
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How Can I Get The Medicare Advantage Coverage I Need In My New Area Of Residence
The first step in making changes to your Medicare Advantage plan as a result of a move is to determine what plan options will be available to you in your new area of residence. You can start researching and comparing plan benefits, pricing, and networks today when you contact the licensed insurance agents at MedicareInsurance.com by phone at 950-0608.
If you need more information concerning your eligibility for Medicare coverage in your new area, our friendly insurance experts are more than willing to help. We look forward to hearing from you!
The Medicare Special Enrollment Period For Qualifying Life Events
You may also change Medicare plans during a special 2-month Medicare Special Enrollment Period, if you have a qualifying life event. During this Special Enrollment Period, you usually can join, switch or drop a Medicare Advantage plan or a Part D prescription drug plan.
You may be granted a Special Enrollment Period in select situations such as:
- You move out of your current Medicare plans service area.
- You move within the current plans service area and have new plan choices.
- You move into or out of an institution.
- Your Medicare plan stops serving your area or loses its contract with Medicare.
- You lose creditable drug coverage through no fault of your own.
- You lose retiree, union or COBRA coverage.
Changing your Medicare plan is possible during the above periods so be sure to keep these in mind.
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Medicare Part D Prescription Drug Coverage
2021 Part D premiums:
- The average premium for Medicare Part D coverage is about $38/month in 2021. There continue to be a wide range of Part D plan options available. Premiums for Part D plans start as low as about $7/month in 2021, down from a low of about $13/month in 2020. On the higher end, plans can have premiums of up to $100/month or more, so there is a great deal of variation in price and benefits across the available plans.
- High-income enrollees pay a higher Part D premium. The threshold for high-income began to be indexed as of 2020. The income threshold for 2021 is $88,000 for a single person and $176,000 for a couple. Its expected to increase to $91,000 and $182,000 as of 2022 .
Part D deductible:
- Maximum of $480 in 2022, up from $445 in 2021. .
Part D out-of-pocket costs after deductible:
- Not to exceed 25% of the cost of brand-name and generic costs.
- There is no longer a donut hole in terms of the maximum amount that enrollees can be charged when they fill prescriptions. But the donut hole still exists in terms of how insurers design their coverage , how total drug costs are counted, and who covers the bulk of the cost of the drugs .
- After a beneficiarys costs reach the catastrophic coverage threshold , additional out-of-pocket costs are capped at the greater of 5% of the cost of the drug or a copay of $3.95 for generics and $9.85 for brand-name drugs.
Learn more about Medicare Part D.
How To Change Medicare Advantage Plans
Evaluating your Medicare Advantage plan options can be overwhelming because there are so many plans to choose from. Our Medicare Plan Identifier Tool can help you get a head start on reviewing your options.
You can also get additional help from one of our licensed health insurance agents. At no cost to you, they show all available Medicare Advantage plans in your area and help you compare them to your current plan.
After you sign up for a Medicare Advantage plan, you are automatically disenrolled from your old plan when your new plan starts. Your health needs can change every year so the plan that worked this year might not be the plan you need next year. Factors range from a different financial status and needing a cheaper plan to an increase in prescription drug use or doctor visits. Get the coverage you need when you need it.
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Is Supplemental Medicare Insurance A Waste Of Money
Is supplemental Medicare insurance a waste of money? Having only Medicare may not be enough to protect you from large medical bills, and there are services with no coverage. Medicare covers only 80% of your medical costs. Thus, leaving you with 20% of the bill, in addition to any unmet deductibles or copayments.
How Do I Change Medicare Plans During Open Enrollment
The costs you pay and the coverage you get from your Medicare setup may no longer suit you. If so, switching may save you money.
Changing your Medicare plan can be challenging, so its wise to seek out help.
Youll need to schedule your switch to take place during the appropriate enrollment period.
Switching Medicare plans during the open enrollment period can be a smart move if your needs or costs have changed. For example, changes in your income or financial situation could have affected your monthly premium. Your Part D prescription drug plan or Medicare Advantage plan might have raised premiums, deductibles, or changed its cost-sharing percentages.
Whether youre unsatisfied with your current Medicare plan, your needs have shifted, or you just want to find out if theres a plan thats better suited or more affordable for you, its always wise to re-evaluate your coverage during open enrollment. If you dont know where to start, the counselors at your local State Health Insurance Assistance Program can help you sort through your choices for free.
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