Medicare Annual Election Period is Around the Corner
Medicare’s annual election period for the 2017 plan year is from October 15th through December 7th. This is the one time a year you can change your Medicare health or prescription drug coverage, which would be effective January 1st. So if you aren’t happy with your current coverage or want to see what else is available, now is the time to do so.
The annual election period is for anyone age 65 or older, that has Part A and B of Medicare (Original Medicare) and/or is enrolled in a Medicare Advantage plan, a Medigap plan or stand-alone prescription plan and wishes to make plan changes. Like with any insurance coverage, there are always exceptions to the rule. If you are under 65 but have end stage renal disease, are disabled or perhaps have another qualifying factor, you too may be eligible for coverage.
When you turn 65 you are automatically enrolled in Medicare part A and B, as long as you are receiving social security or the railroad retirement board. If you turn 65 and are not yet receiving social security or railroad retirement board benefits, Medicare enrollment may work differently. You will not be automatically enrolled in Medicare Part A and B, and would need to sign up.
Original Medicare covers Part A (hospital insurance) and B (medical insurance) services which you are automatically enrolled in if you collect social security. You usually don’t pay for Part A coverage, if you or your spouse paid Medicare taxes while working. For Part B most people will pay a standard premium ($121.80 for 2016), however if your modified adjusted gross income is above $85,000 filing single tax return or $170,000 filing a joint return your premium may be adjusted.
Medicare Advantage is the alternative way to receive coverage and these benefits are offered through local carriers (in our region, carriers like UPMC or Highmark). These plans must at a minimum offer the same services the original Medicare offers, but, these plans often offer more benefits with lower copays. Unlike original Medicare, there is a monthly premium with an annual limit on out-of-pocket costs. In addition, by choosing this type of plan, your coverage will act more like a group-sponsored health plan which may be something you are more comfortable with.
Medigap plans are different from Medicare Advantage plans. A Medigap plan, supplements your original Medicare (Part A & B) benefits. This type of plan is medical coverage only there is no coverage for prescription drugs, vision or dental. Original Medicare pays claim first, then Medigap plan benefits are applied. These plans are offered by many different carriers however the government dictates that benefits are exactly the same regardless of carrier, only the premiums can change.
If you need to sign up for Part A and/or Part B, you can sign up during the following times:
- Annual Election Period — Each year you can elect a plan change from October 15 through December 7, for a January 1st effective date.
- Initial Enrollment Period — When you are first eligible for Medicare, you have a seven-month period to sign up. This seven-month period begins three months before your 65th birthday, includes the month you turn 65, and ends three months after you turn 65.
- Special Enrollment Period — If you or your spouse (or family member if you are disabled) is currently working and you are covered by a health insurance through an employer or union, you will have a Special Enrollment Period when your coverage ends.
Medicare is confusing. With so many criteria and choices it can be hard to navigate through so reach out to our KFG Medicare experts for helping understanding what is available to you.