December 3, 2012 | Back to: Local News

Analysis: Medicare annual enrollment ends Friday


All good things come to an end. This it true of my Medicare columns and true of making changes to your Medicare plan.

The annual enrollment period (or open enrollment period) started Oct. 15 and ends this Friday. What does this mean? Whom does it affect? And … whom does it not?

What does it mean?

This enrollment period is a guaranteed issue time to join or switch to a Medicare Advantage plan from a supplement (no preexisting conditions are an issue except End Stage Renal Disease). If you miss this opportunity you will not be able to switch again until the end of 2013 for an effective date of Jan. 1, 2014. Yes, that is a one year delay if you miss this opportunity.

Who does it affect?

Anyone who is already on Medicare and wishes to change to a Medicare Advantage plan or a Medicare Part D (Drug) plan can do so during the annual enrollment period. It does not matter if you are disabled and under 65 or if you are 65 and over — but you need to have both Part A and B of Medicare. Your new plan will start on Jan. 1, 2013.

Who does it not affect?

If you are turning 65 in the future you will have a window of time to join a plan around your birth month when you turn 65. This is called your initial enrollment period and starts three months before you turn 65, your birth month, and three months after (a total seven month window of time). I advise people I help to call social security four months before you turn 65 and confirm your Medicare part A and B will start on your birth month. Then I have them call me three months before their birth month to set up the rest of their coverage.

So if you are: turning 65 in the next year, losing a retiree plan, move out of Nevada County or qualify for a low income subsidy, you will be able to join a plan during other times throughout the year. The key is to be sure you will qualify, and no hiccups cause a disconnect with Social Security.

Delay in Part B?

This time of year is when many who have delayed starting their part B coverage find out they may have to wait to get it. If you are 65 or older and don’t have Medicare part B on your Medicare card and you don’t have an employer group plan or retiree plan then you may be one who has to wait to join Part B.

If this is you, you will have a delayed effective date of July 1 of next year. You will not be able to join an Advantage plan, a Part D (drug plan) or a Medicare Supplement without Medicare Part B. There is also a permanent 10 percent penalty added to your Part B premium for each year you delay in joining Medicare Part B. I advise people to let me know about this far in advance to be sure the deadline for applying for Part B is not missed and we get everything prepared ahead of time.

Switching supplement companies

The annual enrollment period does not affect switching from one supplement (Medi-gap) company to another. If you have not been an inpatient for the past 90 days and have no major issues or operations that have not be dealt with, then you may have the ability to switch companies anytime. Some companies have more strict underwriting requirements.

In California, “the birthday rule” does give you a guaranteed issue time (no underwriting for pre-existing conditions) to switch supplements companies when you birth month comes along.

Conclusion

Medicare is confusing. I have been honored to write several articles to bring clarity. Many of you have called to thank me for taking the time to do so. If you need help or know someone who is confused and does not have a knowledgeable adviser, please have them call me. They do not pay for my help. Insurance companies want you to have a knowledgeable adviser, so after I help someone and complete their application, I am compensated by the company.

God speed and blessings to you and yours during this season of Christmas and have a healthy New Year!

Bill Anderson lives in Nevada County and is licensed, certified and authorized to present, provide and bring clarity to Medicare plan choices. Bill conducts individual and community meetings throughout Nevada and Placer counties. He can be reached by email at Bill@MedicareDoneRight.com or by calling (530) 432-7988. For a list of Nevada County Medicare Community Meetings go to www.MedicareDoneRight.com.

Bill Anderson
Special to The Union


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The Union Updated Mar 29, 2013 09:18PM Published Dec 6, 2012 08:24AM Copyright 2012 The Union. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.