Medicare Annual Enrollment Period
Submitted to The Union
Medicare is confusing. Add a great amount of incomplete information and you will find many who miss important deadlines and are exposed to growing lifetime penalties.
The goal of this article is to bring some clarity to the confusion around the Medicare Annual Enrollment Period (AEP). This period happens once a year (Oct. 15 – Dec. 7) and can affect anyone on Medicare considering adding or changing plans for 2018.
What is Original Medicare?
Original Medicare has two parts: Part A covers part of Hospital care and Part B covers Doctor Care and outpatient services. In order to qualify for Original Medicare you need to be at least 65 or permanently disabled for 2 years.
Is Medicare A & B enough?
Under Original Medicare (Part A & B) you would be exposed to deductibles and a percentage of hospital and doctor costs. That means you would have no limit to the amount you can be charged for care.
Plus, most outpatient drugs are not covered under Original Medicare. To fill these gaps there are plans you can join when you are first eligible for Medicare.
If you miss or pass on joining some of these plans, you may have a growing lifetime penalty. But you can add or change plans during the … Medicare Annual Enrollment Period (AEP).
During AEP anyone who has Original Medicare may add or change a Drug Plan, or Advantage plan. There is only one pre-existing condition question: “Do you have end stage renal disease?” If so, there are special government programs to help.
What happens if you miss this timely opportunity? No plan changes can be made until 2019. (See Special Enrollment Period Exceptions below).
Wish to change Medi-Gap (supplement) companies?
Medi-Gap plans work differently than other Medicare plan options.
For one, the government standardizes plan medical benefits (benefits by plan are the same regardless of company choice). But there are 11, cost saving, company differences.
Without knowing these, you could eventually pay $1,500 more per year than your neighbor. Same plan, same doctors, but a different company.
Changing Medi-Gap companies is different as well. You can make these changes outside of AEP but you will need to qualify medically. However, there is a special “birthday rule” that allows you to change companies around your birthday — no medical questions asked.
What are Special Enrollment Periods?
Following is a partial list of Special Enrollment Periods that may allow changes to Medicare plans outside of AEP: Relocation, loss of employer group health plan, plan ends, major plan change, you qualify for Extra Help or Medi-CAL.
What are the 2018 plan choices?
One way to learn about plans is to attend a Free Medicare Community meeting. You will learn plan choices, how they work, changes and how to enroll in plans available for 2018.
Here is the list of the Nevada County Medicare Community Meetings in October:
2 p.m. Wednesday at Gold Miners Inn, 121 Bank St. Grass Valley.
2 p.m. Friday at Round Table Pizza, 10894 Combie Rd. Lake of the Pines.
2 p.m. Tuesday, Oct. 24, at Players Pizza, 10161 Commercial Ave. Penn Valley.
Contributing Writer — Nevada County resident Bill Anderson who recently authored the book: “How to Navigate Medicare, Start-To-Finish.” He is licensed and certified to provide and present Medicare Supplements, Medicare Advantage and Part D — Drug plans. Anderson is advisor and agent to over 1,000 Medicare recipients at no-added charge. He can be contacted by calling 530-432-7988 or 916-409-6819. Or by e-mail at: Bill@MedicareDoneRight.com.
Support Local Journalism
Support Local Journalism
Readers around Grass Valley and Nevada County make The Union’s work possible. Your financial contribution supports our efforts to deliver quality, locally relevant journalism.
Now more than ever, your support is critical to help us keep our community informed about the evolving coronavirus pandemic and the impact it is having locally. Every contribution, however large or small, will make a difference.
Your donation will help us continue to cover COVID-19 and our other vital local news.
Start a dialogue, stay on topic and be civil.
If you don't follow the rules, your comment may be deleted.
User Legend: Moderator Trusted User