Medicare Open Enrollment

Medicare features a roughly six-week period each year where you can make changes to your plan, leave your plan entirely in favor of one you believe is better, or if you are satisfied with your current coverage, leave your plan exactly as it is.  Known as the Open Enrollment Period (OEP), this six week window will begin this year on October 15th, and run until December 7th.  All changes made during this time will become effective on January 1st, 2014.

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First Time Enrollment

Medicare coverage is provided by the government and has four components. Part A is hospital insurance paid by the government for most beneficiaries. Part B is voluntary medical insurance. Part C is Medicare Advantage; regulated private insurance that substitutes for Parts A and B, and often D. Part D is voluntary prescription drug coverage. Most people will benefit from enrolling in Parts B and D, or by enrolling in Part C and taking out a private Medicare Advantage plan, during their Initial Enrollment Period.

Open Enrollment allows the Medicare customer to research, find, and subscribe to new plans, return to an original Medicare plan of his or her choosing, or not make any changes at all.  With over 50 million Medicare-eligible citizens in the United States, insurance companies are working to make combinations of Medicare Part A and Part B (known as Medicare Advantage) both more attractive and affordable.  Since its creation, more than 14.1 million Medicare customers have now become subscribers to a Medicare Advantage plan of some type, with new plans and policy choices being offered each year to fit a wide variety of needs.

Benefits of Medicare and Program Changes for 2013

Many Medicare procedures and examinations are free of co-payments, deductibles, and expenses.  Preventative “wellness examinations” and certain health screenings fall under this category.  Consult with your physician about these no-cost services, and schedule them during this current calendar year while they still present the medical bargain that they are.

While many Medicare procedures are very low cost or even free, there is a gap in the amount of medical coverage enrollees can receive.  Once a certain limit is reached, enrollees will be required to pay for the medical services they receive out of pocket, until they pay a certain amount.  Once this amount is reached, Medicare will again pay for medical services.  This gap in coverage is commonly called the “Doughnut Hole.”

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Beginning in 2013, the “Doughnut Hole” will slowly start to be removed from coverage, and will be completely eliminated by calendar year 2020.  This year, however, will not provide much relief in that area, other than to note that the changes are not substantial in terms of actual dollars.  While the initial amount of prescription drug coverage limit you have under Part D will increase slightly ($2930 to $2970 this year), the deductible has only increased by $5 ($320 to $325).  The total coverage under Part D Drug Spending before “catastrophic coverage” kicks in has increased from $6657.50 to $6733.75.

Don’t Miss Your Opportunity to Change Your Medigap Plan

If you do not make any changes to your Medicare coverage during Open Enrollment 2013, your current coverage will remain in effect through 2014, subject to any changes in the coverage itself. In most cases, you will not be able to drop or make changes to your coverage until the next open enrollment period; however, there are several exceptions:

  • If you don’t have Medicare Part A coverage and you enroll in Medicare Part B during General Enrollment (January 1 – March 31), you can add a Medicare prescription drug plan between the dates of April 1 – June 30.
  • If you have Medicare Part A coverage and you enroll in Medicare Part B during General Enrollment (January 1 – March 31), you can sign up for a Medicare Advantage or Medigap plan between the dates of April 1 – June 30.
  • You can switch to a 5-star rated Medicare Advantage plan at any time.  You can only do this once per year, however.
  • You may be able to switch or drop your Medicare Advantage plan if you encounter special circumstances (ex: moving out of your plan’s coverage area).  You will need to check with your plan provider before any of the changes occur to make sure this is possible.

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Plan for Medicare Open Enrollment

Medicare-eligible members of the American population now exceed 50 million.  With approximately 10,000 members of the “Baby Boomer Generation” reaching retirement age each day, there are already a large number of new subscribers coming on board as their birthdays arrive.  These new retirees are just now getting used to this new reality of insurance for hospitalization, medical care, and prescription drug coverage.

While Open Enrollment may seem a long time off, it will quickly be upon us.  Before Open Enrollment starts, here are a few things you should do to prepare and educate yourself on the changes you may or may not need to make to your Medicare Supplemental Insurance plan this year.

  • Call your doctor and schedule some of the preventative, no-cost health screenings and tests that are available for Medicare beneficiaries
  • Take an inventory of your current prescription regimen and decide if your coverage is sufficient for the medicines you need
  • Use our site to review plans and policies that are available in your area and decide if changing plans will save you money

We strive to keep you informed of any changes well enough in advance for you to make the necessary preparations and adjustments during Open Enrollment.

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