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Medicare Open Enrollment Is Upon Us

Generally, Medicare coverage starts when you turn 65. This is called your Initial Enrollment Period. It lasts for seven months, starting three months before you turn 65, and ending three months after the month you turn 65.

Medicare open enrollment for 2022 coverage starts on October 15, 2021, and continues through December 7. During regular open enrollment through December, Medicare plan enrollees can:

  • Do nothing, as existing policies remain in force
  • Make changes to an existing policy or purchase a new policy
  • Move 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
  • Move from Medicare Advantage to Original Medicare, plus a Medicare Part D plan, and possibly a Medigap plan
  • Move from one Medicare Advantage plan to another
  • Move 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 initially eligible for Medicare. Just know that if you haven’t maintained other creditable coverage, a late-enrollment penalty may apply.

According to www.medicareresources.org, the annual Medicare open enrollment period does not apply to Medicare Supplement insurance – Medigap plans – due to their guaranteed-issue status in most states during the initial enrollment period, and during limited special enrollment periods. Medigap policies, however, are easy to get and available in every state.

A Few Good Reasons to Change

Your needs are personal to you, so consider them carefully and think about the available coverage as part of your overall evaluation of Medicare plans. You always want to get the most from your plans, which means look deeper into the coverages you are currently getting.

The reality is, sooner or later, you might have to make a switch.

While this next reason to change plans might seem to be the most popular, it’s really not. Medicare Advantage and Part D benefits change each year causing your premiums to change with them. Understandably, no one wants to pay more. Some do, avoiding making a switch.

However, what most recipients do complain about is the doctor, dentist or specialist they’ve come to know and trust over time is no longer in the plan. The second complaint is medications may change within the drug formulary and some prescriptions are no longer covered.

Each September, an Annual Notice of Change is sent to all recipients specifying the upcoming changes. This leaves a bit of time to think about whether or not to make changes during the Annual Enrollment Period.   

Also note that Medicare doesn’t cover routine dental, vision, and hearing services, but some Medicare Advantage plans do. You can buy dental, vision, and hearing coverage separately.

A Quick Look at Parts A and B

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

January 1 to March 31. If you enroll during the general enrollment period, your coverage will take effect July 1.

Basically, Medicare’s general enrollment period is for people who did not 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 is also for people who have to pay a premium for Medicare Part A (hospital coverage) and didn’t enroll in Part A – which is free and considered premium-free coverage for most people – when they were first eligible. You can see how important this first step is.

Part A is available to citizens and legal immigrants with at least five years of residency. Most U.S citizens are eligible for Part A upon turning 65. If you can get Part A, you qualify for Part B.

Medicare Part B is the medical portion of Original Medicare. This includes coverage for services provided by your doctors that are preventive and medically necessary, medicarefaq.com reports.

However, Part B does not provide dental or vision benefits, anything not considered medically necessary or preventative, or prescriptions taken at home. It does not provide long-term care.

From 2020 to 2021, the base Medicare Part B premium increased only $3.90 to $148.50 per month. Without the cap imposed by Congress, the base premium would have been $160.20. In 2022, the temporary cap will be lifted. The normal 2021 increase will be reinstated, plus whatever 2022 increase is calculated on top of that.

In addition, and as an aside, Social Security and Supplemental Security Income (SSI) recipients will see a raise in payments in 2022 — the highest increase in almost four decades, according to the latest estimate from The Senior Citizens League––which is certainly good news to seniors.

If you have questions about Medicare enrollment, Hefren-Tillotson can help. Contact us today.

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