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Medicare Enrollment Periods

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What are the 3 Enrollment Periods set by Medicare?

1. Initial Enrollment period

A person first becomes eligible for Medicare, either because of turning 65 or qualifying for Medicare due to disability, or is late in enrolling in Part B and does so during the General Enrollment period from January 1st to March 31st for coverage to begin July 1.

2. Open Enrollment Period

October 15th to December 7th– During this time, changes can be made to Prescription Drug Coverage, you may join a Prescription Drug Plan if not already enrolled, or change a Medicare Advantage Plan, either with a drug plan or a Medical only Medicare Advantage.

3. Special Enrollment Period

Certain qualifying events allow you to obtain coverage during a Special Election period, such as losing group health coverage, moving out of your current plans service area, qualifying for Medicaid or qualifying for extra help paying for your premium through a Low Income Subsidy.

Common Medicare Enrollment Questions

Why is your Initial Enrollment Period to Medicare so important? What are the penalties for late enrollment in Part D (Medicare Prescription Drug Plan)?

Once a person is eligible for a Prescription drug plan it is very important for them to enroll in a plan. If a person chooses not to enroll in a plan then for each month that they are not enrolled a 1% (of the average drug plan cost) penalty will occur, for example if a person is eligible for Prescription drug coverage in January and does not enroll until June; once they enroll in a plan, their premium will be 6% higher than it would have been had they enrolled in January.

What are the qualifications to receive extra help paying for Part D premiums and prescription drug costs?

To qualify for the Medicare Low-Income Subsidy, a person would need to make less than $12,510 if they are single or a married couple must make less than $25,010 a year gross income.

What is the Difference between Entry Age vs. Attained Age Medicare Supplement Plans (Medigap)?

Medicare Supplement plans are divided into two categories: Entry age plans and Attained age plans. Entry Age Plans “lock” you into an age bracket. If you enroll in a plan at 65, when you are no longer 65 you will pay the same rate that new enrollees will pay that year. Attained Age plans are not locked into an age bracket, therefore the initial rate may be lower, but the rate will increase more noticeable as a beneficiary ages.

Due to the Medicare Modernization Act effective 06-01-10, what are the changes to Medicare Supplement Plans?

The most significant changes to Medicare Supplement plans beginning June 1, 2010 are, the elimination of the at home recovery benefit from all Medicare Supplement Plans, the addition of Hospice benefits to each Medicare Supplement Plan. Preventative Care benefits have also been added to all Supplement plans, due to Medicare coverage for most preventative measures. Several plans we also eliminated, these plans are E, H, I, and J. Plans K, M, N were added as new plan options.

Medicare Supplements (Medigap) vs. Medicare Advantage Plans (Part C)?

Medicare Supplement policies are designed to work with the benefits a member receives from Traditional Medicare. Depending on which plan a member is enrolled in there may be little or no out of pocket cost for medical care. If a person chooses to enroll in a Medicare Supplement policy they must additionally purchase a stand alone drug plan. Medicare Advantage plans are designed to take the place of traditional Medicare. A member of these plans still has traditional Medicare, rather than use their Medicare card, a member simply uses their Medicare Advantage card. These plans can have a built in drug plan or as a Medical only plan.

*There are many options available to you, it’s more important than ever to seek advice from someone local who deals in these types of plans on a daily basis.

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