medicare

Medicare Open Enrollment

Admin Blog

For those counting on Medicare benefits, it’s important to understand the Medicare open enrollment process and what to expect in terms of enrollment dates, available plans, and premiums. Available plans may change from year to year, and this once-a-year opportunity to choose your plan can affect the doctors and care options you have available to you.

Medicare Defined

Initial and open enrollment are the periods in which you can enroll for Medicare Part A, B, C, D, or Medigap.

  • Medicare Part A covers hospitalization
  • Medicare Part B covers physicians and other benefits
  • Medicare Part D covers prescription drug coverage
  • Medicare Part C is also known as Medicare Advantage, and it is a combination of all traditional Medicare under one policy, allowing subscribers to pay one single premium for all of their Medicare benefits
  • Medigap is a Medicare supplement that helps cover co-payments, coinsurance, and deductibles

Initial Enrollment

Before open enrollment, Medicare participants must complete initial enrollment. This initial enrollment in Medicare Parts A and B will automatically qualify you for Parts C, D, and Medigap. But to qualify for Parts A and B, you must enroll between the 3 months prior to your 65th birthday month through the three months after your 65th birthday month (7 months total). When you turn 65, if you are receiving benefits from Social Security or the Railroad Retirement Board, you are automatically enrolled in Medicare Part A and B. If you are not receiving social security, you must sign up during this initial 7 month election period. Missing this enrollment period can require you to pay a higher premium for part B, for life.

Open Enrollment

Open enrollment is the time period in which you can change your elected plans. Medicare’s open enrollment period is October 15 through December 7 of each year. During this period you have the option to change your Part D (prescription drug coverage), or switch between or within Medicare and Medicare Advantage plans.  The coverage you choose during open enrollment begins on the first day of the following January.

Review the materials your plan sends you in their Evidence of Coverage and Annual Notice of Change to ensure that your current plan continues to include the cost, coverage, pharmacies, and providers that you prefer.

Continued Enrollment

Once you have enrolled in Medicare part A and B, you are not required to re-enroll each year. You must only re-enroll if you would like to switch your Medicare plan to Medicare Advantage, or switch your Medicare Part A or B enrollment. If you have missed your initial enrollment, you may sign up for Medicare between January 1 and March 31 of each subsequent year, resulting in coverage that will begin on the first day of the following July.

If you’re not sure what coverage you have, you can check your enrollment through Medicare.gov’s enrollment tool. From this website, you can also:

  • View open enrollment dates
  • Enroll in your desired plan for next year
  • Change your address
  • See what Medicare covers
  • Learn how to file a claim
  • See how Medicare works with in tandem with other insurance
  • Learn about cost saving programs
  • Find doctors and hospitals
  • Replace a lost Medicare card
  • Elect to get your Medicare Summary Notices electronically
  • And many other activities.

Open enrollment is a once-a-year opportunity to switch plans or transition to a Medicare Advantage plan. It’s important during open enrollment to review your plan and ensure that it covers your preferred doctors, drugs, and pharmacies at the most affordable price point for you. Each eligible individual should review their options and ensure that next year’s plan accommodates their preferences.

AdminMedicare Open Enrollment