It Is Medicare Open Enrollment Time Again

Medicare Open Enrollment

It is Medicare Open Enrollment time again and that means time for another refresher on what that expression means. If you are age 65 or over you are probably by now being bombarded with mail urging you to purchase a plan. It is important to know the facts behind the glossy brochures and whether you need to act at all.

By the way, do not get Medicare Open Enrollment confused with Open Enrollment for the Healthcare Marketplace. The Marketplace is for younger folks who are also not on Social Security Disability for two years and it probably deserves a separate column. The two “Open Enrollment” dates are different.

Here are FAQ’s for Medicare Open Enrollment.

  1. I have an employer plan that covers me for everything. Do I need to sign up under Open Enrollment. If you are 65 or over and have a qualified employer health insurance plan especially working for a larger employer, you probably do not need to be concerned. If not certain of your status, check with your HR Department at work.
  2. When is Medicare Open Enrollment for 2018 Coverage? Medicare Open Enrollment for 2018 runs from October 15, 2017 to December 7, 2017 to begin coverage January 1, 2018. Note, if you have a Medicare Supplement Plan, these dates do not apply. Also, if you are just becoming eligible for Medicare (such as just turning age 65), you can sign up as soon as you become eligible regardless of the month and can choose whether you want a Medicare Supplement or a Medicare Advantage plan.
  3. What Is a Medicare Advantage Plan. Medicare Advantage includes Medicare HMO and Medicare PPO, PFFS and others. Each year, if you are in a Medicare Advantage plan or Medicare D prescription drug plan, you can change your enrollment to another Medicare Advantage or Medicare D plan between October 15 to December 7 effective the following year if you think that another Medicare Advantage or Medicare D plan might work better for you. If you have a Medicare Supplement plan, you do not need to be concerned about Open Enrollment unless you want to change to a Medicare Advantage or change or add your Medicare D (prescription drug) coverage.
  4. Do I Need To Do Anything During Open Enrollment? Not necessarily. If you have coverage and are content with what you have, you can just ride out the period until next year. Open Enrollment just gives you a chance to review your coverages and decide whether you want to change.
  5. Is there anything I need to know about changing plans? When you are first enrolling in Medicare, you have the right and the ability to choose to enroll for a Medicare Supplement plan without regard to health. Medicare Supplement plans are typically more expensive and sometimes, to save money, enrollees might initially sign up for a Medicare Advantage plan. If they do and later experience poor health they can be denied the ability to switch to a Medicare Supplement for better coverage because medical underwriting is involved for the change. If you are already in a Medicare Advantage plan, you can switch to another Medicare Advantage plan without medical underwriting. If you are already in a Medicare Advantage plan and want to switch to a Medicare Supplement you would need to undergo medical underwriting with the insurance company to be approved.
  6. What kinds of Medicare Advantage Plans Are There? Not all Medicare Advantage plans are the same. A Medicare Advantage HMO might or might not limit your providers. It is less likely to be “portable” that is to provide coverage if you move to another coverage area, another state or another part of the country than, for instance, a PPO. Medicare Supplement plans (not Medicare Advantage) are accepted wherever Medicare is accepted.
  7. Is it important to know how prescription drugs and medical coverage work and the differences between Medicare Supplement and Medicare Advantage? Medicare Supplement plans do not themselves have prescription drug coverage but rather are often marketed with a separate PDP or prescription drug plan (look for PDP or Rx on the card). Medicare Advantage plans usually come with prescription coverage.

If you are confused, get help. The Chester County APPRISE program staffed by volunteers, is excellent. It can be contacted at 610-344-6035.

About the Author Janet Colliton

Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.

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