What to Know for Medicare Open Enrollment
Medicare open enrollment is from October 15 – December 7th. This is an important time to review and/or modify healthcare coverage whether you are new to Medicare or have been a recipient for many years. Here are a few things to know during this period:
You may or may not be enrolled in Medicare automatically.
If you’re over 65 and you’ve already enrolled in Social Security benefits, you are enrolled automatically in Original Medicare (Part A and Part B). Even if you are automatically enrolled, you should review your needs and consider if this plan will suit them. If you are happy, you do not have to take action.
If you’re not receiving benefits, you can enroll during your 7-month Initial Enrollment Period surrounding your 65th birthday, or you can enroll in the annual General Enrollment Period from January 1 to March 31st. Additionally, you can enroll in the Special Enrollment Period for eight months after your employer coverage ends. But you cannot use the Fall Open Enrollment Period if you missed your IEP.
You can read more about the timing and related penalties in our blog here.
You have many different coverage options.
Put simply, you can enroll in Original Medicare (Part A and B) or Medicare Advantage (Part C – the combination of Part A and B). If you select Original Medicare, you can add on Medigap (formerly Part G) and Part D (Prescription Drug Coverage). If you select Medicare Advantage, you can add on Part D.
You can read more about the coverage options and considerations in our blog “Medicare Timing and Penalties.” Remember that your situation is different from your friends’ and neighbors’ – your medical needs, your AGI, your timing will all affect your plan. Do your research and call your advisor for help.
Be mindful of annual changes.
Check your mail! You may receive Medicare or Social Security notices in an Annual Notice of Changes (ANOC). Review your 2022 “Medicare & You” booklet for changes in costs or benefits. Keep in mind, it’s common for plan provisions and coverage to change from year to year. Be on the lookout for modifications to:
Monthly premiums,
Out of pocket costs,
Network providers,
Network of pharmacies,
Drug coverage,
Annual deductibles,
Medication tiers,
Coinsurance,
Max-out-of-pocket limits,
and much more.
You would not want to be caught off guard with a significant change to your plan. You can compare your coverage options, health plans, and see prices on Medicare Plan Finder.
You can make some changes during Open Enrollment.
If you do decide to make a change, these are the adjustments you can make during open enrollment. Any changes you make will become effective January 1, 2022.
Enroll in or change your Medicare Part D prescription drug coverage.
Unenroll from Medicare Part D.
Change from Original Medicare to a Medicare Advantage plan, or vice versa.
Change to a new Advantage plan.
You should re-evaluate your needs annually.
Plans change and so do your needs. Be sure your plan is still appropriate for your situation. Some questions you should ask as you evaluate coverage information include:
Is my physician still available under my plan?
Are my medications covered?
Are there more cost-effective policies out there?
Do I have any upcoming major health procedures I need coverage for?
Will I want telehealth options to maintain social distancing during COVID?
Do I need any non-medical, health-adjacent benefits? (ex: meal delivery, doctor appointment transportation, etc.)
To make changes call 1-800-MEDICARE or visit Medicare.gov. Remember to be aware of Medicare fraud. Medicare will never call, email or visit you to ask for personal information.