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When is Medicare Open Enrollment?

Medicare open enrollment – also known as Medicare’s annual election period – runs from October 15 through December 7 each year.

During this annual window, Medicare plan enrollees can reevaluate their coverage 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 (as long as you’re enrolled in both Medicare Part A and Part B, and you live in the Medicare Advantage plan’s service area).

  • Switch from Medicare Advantage to Original Medicare (plus a Medicare Part D plan, and possibly a Medigap plan).

  • 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 didn’t enroll when you were first eligible for Medicare. If you haven’t maintained other creditable coverage, 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 is changing for 2021, under the terms of the 21st Century Cures Act. People with ESRD have the option to enroll in Medicare Advantage for 2021, and CMS expects more than 40,000 to do so.

This could be particularly advantageous for beneficiaries with ESRD who are under age 65 and living in states that don’t guarantee access to Medigap plans for people under the age of 65.

Medicare open enrollment: What you can’t do

The annual Medicare open enrollment period does not apply to Medigap plans, which are only guaranteed-issue in most states during a beneficiary’s initial enrollment period, and during limited special enrollment periods.

If you didn’t enroll in Medicare when you were first eligible, you cannot use the fall open enrollment period to enroll. Instead, you’ll use the Medicare general enrollment period, which runs from January 1 to March 31.

Medicare’s general enrollment period is for people who didn’t sign up for Medicare Part B when they were first eligible, and who don’t have access to a Medicare Part B special enrollment period. It’s also for people who have to pay a premium for Medicare Part A and didn’t enroll in Part A when they were first eligible.

If you enroll during the general enrollment period, your coverage will take effect July 1.

Learn more about Medicare’s general enrollment period.

How to change Medicare plans

Once you’re enrolled in Medicare, you’ll have various opportunities to change certain aspects of your coverage. Here’s an overview:

  • During the Annual Election Period (October 15 – December 7), you can make a variety of changes, none of which involve medical underwriting. (Prior to 2021, people with end-stage renal disease were not able to switch to Medicare Advantage during the open enrollment period, but that’s no longer the case as of 2021.):

  • Switch from Medicare Advantage to Original Medicare or vice versa.

  • Switch from one Medicare Advantage plan to another.

  • Switch from one Part D prescription plan to another. It’s highly recommended that all beneficiaries use Medicare’s plan finder tool each year to compare the available Part D plans, as opposed to simply letting an existing drug plan auto-renew.

  • Join a Medicare Part D plan. (Late-enrollment penalty might apply.)

  • Drop your Part D coverage altogether. (Re-enrolling in a later year will include a late-enrollment penalty if you’re not maintaining other creditable drug coverage.)

Medicare eligibility

For most Americans, Medicare eligibility goes hand in hand with turning 65, but some people become eligible for Medicare earlier.

Most Medicare beneficiaries receive Medicare Part A without a monthly premium, but some have to pay for it. And some beneficiaries have to pay more than the standard amount for their Medicare Part B and Part D coverage.

Here’s our detailed overview of eligibility for all parts of Medicare coverage. In summary:

  • Most Americans become eligible for Medicare when they turn 65.

  • But 15 percent of all Medicare beneficiaries are under 65, and became eligible after receiving Social Security disability benefits for two years or being diagnosed with ALS or end-stage renal disease.

  • In order to enroll in Medicare Advantage, you must enroll in both Medicare Part A and Part B. Your Medicare Advantage plan will take the place of both parts, and will likely also include Part D prescription drug coverage.

  • In order to get Medicare Part A without having to pay a monthly premium, you or your spouse must have worked for at least 10 years in the United States, paying Medicare taxes during that time.

  • If your income is high (currently defined as more than $87,000 for a single person or $174,000 for a couple), you’ll pay more than other people for your Part B coverage and your Part D coverage.

  • You’re eligible to enroll in Medicare Part D as long as you have either Medicare Part A or Part B.

  • If you’re enrolled in both Medicare Part A and Part B (but not Medicare Advantage or Medicaid), you’re eligible to enroll in a Medigap plan to supplement your Medicare coverage. You’ll have a six-month guaranteed-issue window during which you can sign up for any Medigap plan available in your area. In most states and most circumstances, you’ll have to go through medical underwriting if you decide to apply for a Medigap plan after that window ends.

Most eligable folks are not aware that using an agent such as our team at RCB & Associates, LLC is free to them. Using an agent will help you avoid mistakes & penalties, saving you time & giving you peace of mind that your enrollment is accurate to your needs and opportunities. Give us a call today, 616-233-9050.

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