Annual Enrollment Period, AEP
**When: October 15th to December 7th each year.
**What: The time to make changes to your Medicare plans, such as switching between Medicare Advantage plans or adding/dropping a Part D prescription drug plan. This is your opportunity to review your current coverage and make adjustments to ensure it aligns with you changing needs and budget.
Open Enrollment Period, OEP
**When: January 1st to March 31st each year.
**What: A limited time to switch Medicare Advantage plans, but you can't return to the Original Medicare or change your Part D. This is a good time to compare plans and find one that offers better benefits or lower costs.
Initial Enrollment Period, IEP
**When: Three months before you turn 65, your birthday month, and three months after.
**What: The time to first enroll in Medicare Parts A & B, a Medicare Advantage plan, or a Part D plan. This is crucial because you may face late enrollment penalties if you don't enroll during your IEP.
Key Points:
**Timing is critical. Avoid late enrollment penalties by enrolling during your IEP.
**Consult with a professional. A Medicare specialist can help you understand your options and choose the best plan for your circumstances.
**Review your coverage regularly. Your health needs and Medicare plan may change over time. It's important to review your coverage annually to ensure it continues to meet your needs.
Additional Considerations:
**Medicare Advantage Plans: These plans combine Part A, B, and sometimes Part D into a single plan. They often offer additional benefits like prescription drug coverage, vision, dental and hearing aids.
**Part D Prescription Drug Plans: If you don't have a Medicare Advantage plan, you'll need a Part D plan to cover your prescription drug costs.
**Medigap plans: These plans can help fill in the gaps of original Medicare. They can cover deductibles, copayments, and coinsurance.
Medicare Questions
Quick Guide to Medicare Enrollment, Part 2
When choosing a Medicare plan, consider the following factors:
**Your health needs: Do you have chronic health conditions that require specialized care?
**Your budget: How much are you willing to spend on premiums, deductibles, and copays?
**Your lifestyle: Do you travel frequently or need extra benefits like vision or dental coverage?
**Your future plans: Are you planning to retire soon or move to a different location? Some
Medicare plans may have geographic restrictions or limitations on certain services.
Making the most of your enrollment periods:
**Research and compare plans. Use online tools or consult with a Medicare specialist to compare different plans and find the best option for you.
**Consider your future needs. Think about your long-term health goals and choose a plan that can accommodate your changing needs.
**Be proactive. Don't wait until the last minute to enroll. Plan ahead and take advantage of your enrollment periods.
**Stay informed. Stay up to date on changes to Medicare plans and enrollment rules. You can find information on the Medicare.gov website or by contacting a Medicare specialist.
Additional tips:
** Review your coverage annually. Even if you don't need to make changes to your plan, it's important to review your coverage regularly to ensure it continues to meet your needs.
**Consider a Medicare Advantage plan with a health maintenance organization, HMO, or preferred provider organization, PPO network. These plans ay offer lower premiums and copays, but they may also have more restrictions on the doctors and hospitals you can see.
**If you have a chronic health condition, look for a Medicare Advantage plan that specializes in that condition. These plans may offer additional benefits or services that can help you manage your condition.
Period When Is It? What You Can Do
Initial Enrollment Period 3 months before you turn 65 Enroll in Parts A and B
IEP the month of, and the 3 for the first time
months after
Annual Election Period October 15 to December Enroll in, change, or drop a Part
AEP 7 every year D or Medicare Advantage plan
General Enrollment Period January 1 to March 31 Enroll in Part A and/or Part B
GEP every year, coverage is if you missed your IEP and don't
delayed until July1 qualify for a SEP
Medicare Advantage Open January 1 to March 31 Switch to another Medicare
Enrollment Advantage plan or enroll in
MADEP Original Medicare with a
part D Drug plan
Special Enrollment Period Anytime you have a qualifying Apply for Parts A and B.
SEP event, ie delaying Medicare There are also SEPs for past 65, C and D plans. You have 2 months to enroll in either.
Medigap 6 months before and after 6 Purchase any Medigap plan
months after your part B without answering health effective date. questions.
**The AEP is for those who already have Original Medicare.
Rick Peterson
Independent Insurance Broker
CA License#0E52928
949-677-3864 cell
*****This is my friend, but you could not ask for a more honorable person with unequalled sincerity.
Please contact him if you have any questions.
**
Annual Enrollment Period (SEP)
**When: October 15th to December 7th each year
**What: The time to make changes to your Medicare plans, such as switching between Medicare Advantage plans or adding/dropping a Part D prescription plan. This is your opportunity to review your current coverage and make adjustments to ensure it aligns with your changing needs and budget.
Open Enrollment Period (OEP)
**When: January 1st to March 31st each year
**What: A limited time to switch Medicare Advantage plans, but you can't return to Original Medicare or change your Part D. This is a good time to compare plans and find one that offers better benefits or lower costs.
Initial Enrollment Period (IEP)
**When: Three months before you turn 65, your birthday month, and three months after.
**What: The time to first enroll in Medicare Parts A & B, a Medicare Advantage plan, or a Part D plan. This is crucial because you may face late enrollment penalties if you don't enroll during your IEP.
Key Points:
**Timing is critical. Avoid late enrollment penalties by enrolling during your IEP.
**Consult with a professional. A Medicare specialist can help you understand your options and choose the best plan for your circumstances.
**Review your coverage regularly. Your health needs and Medicare plans may change over time. It's important to review your coverage annually to ensure it continues to meet your needs.
Additional considerations:
**Medicare Advantage Plans: These plans combine Part A & B, and sometimes Part D into a single plan. They often offer additional benefits like prescription drug coverage, vision , dental and hearing aids.
**Part D prescription drug plans: If you don't have a Medicare Advantage Plan, you'll need a Part D plan to cover your prescription drug costs.
Medigap plans: These plans can help fill in the gaps of Original Medicare. They can cover deductibles, copayments, and coinsurance.
This is Part 1. Part 2 available on site Saturday, Sept. 28th.
Thanks to Rick Peterson, Independent Insurance Broker, rick@bilhartzinsurance.com, 949-677-3864
*It is never too early to prepare for open enrollment with Medicare. We are lucky to have a Licensed Broker contribute information so you don't have to approach "that time" without sound knowledge of what you are going to sign up for. Hope this helps.
In this blog you will get a general 30,000-foot view of the difference between the different Medicare enrollment periods.
1. What is the Medicare AEP?
*The Medicare Annual Enrollment Period (AEP)occurs between October 15 til December 7 each year.
*During this time, beneficiaries can make changes to their Medicare health or drug plans.
2. Changes You Can Make:
*Participants can switch, add, or drop plans during the AEP.
*Any changes made during this period take effect on January 1 of the following year.
3. *Initial Enrollment Period, (IEP):
* Most people sign up for Medicare Part A and Part B when they turn age 65
*No penalties apply during the IEP.
*If you're already covered by an employer group health plan, you might delay signing up for Part B.
4. Special Enrollment Period (SEP):
*If you've been covered by an employer group health plan, you have an SEP.
*Sign up for Part B within 8 months of stopping work or when the group health plan ends.
*Coverage begins the month after enrollment.
5. General Enrollment Period (GEP)
If you miss other enrollment periods, the GEP runs from January 1 to March 31.
There is typically a lifelong penalty for signing up during the GEP.
Thank you Rick Peterson, Independent Licensed Broker, Ca License #OE52928
949-677-3864 cell
The rules for getting care may change for a short time in areas where one of these has happened:
*The President has declared it an emergency or disaster. Visit the Federal Emergency Management Agency, FEMA, or call 1-800-621-FEMA (1-800-621-3362) to see if your area is affected (TTY 1-800-462-7585).
*A governor has declared it an emergency or disaster. Visit your state government's website to find out if your area is affected.
*The Secretary of the Dept. of Health and Human Services (HHS0 has declared a public health emergency. Visit the HHS Public Health Emergency website. Or call us at 1-800-MEDICARE) 1-800-633-4227 to find out if your are is affected.
Idea: Cut this out and put on the inside of a cabinet with easy access. Should something happen, you may not remember these numbers.
FOR THOSE OF US AT A CERTAIN AGE (OR FOR THOSE WHO ARE RAPIDLY APPROACHING THIS CERTAIN
AGE), THE TERM 'MEDICARE" CAN STRIKE FEAR OR, AT THE VERY LEAST, CONCERNS AND QUESTIONS.
WHAT ARE MY CHOICES?
WHICH CHOICE IS BEST FOR ME?
HOW ABOUT MY COVERAGE IF I SPEND TIME ABROAD?
BUT HOW CAN I MAXIMIZE MY MEDICARE BENEFITS?
WITH THE COST OF PRIVATE HEALTH INSURANCE PREMIUMS ON A STEADY RISE, MOST OF US LOOK
FORWARD TO BECOMING ELIGIBLE FOR MEDICARE. TODAY, LET'S START AT THE BEGINNING AND TAKE A
LOOK AT A 30,000 FOOT OVERVIEW OF MEDICARE CHOICES WITH A GOAL OF HELPING TO DE-MISTIFY THE
WORLD OF MEDICARE!
ORIGINAL MEDICARE OR STRAIGHT MEDICARE, IN IT'S MOST BASIC FORM INCLUDES MEDICARE PART A AND
MEDICARE PART B.
PART A COVERS INTPATIENT SERVICES SUCH AS DOCTOR SERVICES, SKILLED NURSING CARE, HOSPICE AND
SOME HOME HEALTH CARE.
PART B COVERS OUTPATIENT SERVICES SUCH AS DOCTOR SERVICES, .
ORIGINAL MEDICARE BENEFITS ARE SUBJECT TO AN ANNUAL DEDUCTIBLE AS WELL AS OTHER COST
SHARING.
MEDICARE PART B PREMIUMS ARE TYPICALLY DEDUCTED FROM YOUR SOCIAL SECURITY BENEFIT AND THE
AMOUNT VARIES DEPENDING ON INCOME. IF YOU ARE NOT COLLECTING SOCIAL SECURITY YOU WILL HAVE
TO PAY THE PART B PREMIUM DIRECTLY.
THINGS TO KNOW ABOUT ORIGINAL MEDICARE
1. MEDICARE IS PORTABLE ONLY IN THE US. ANY DOCTOR, MEDICAL CLINIC OR HOSPITAL THAT ACCEPTS
MEDICARE ASSIGNMENT WILL BILL MEDICARE DIRECTLY FOR THEIR SERVICES.
HOWEVER
A. MEDICARE IS ONLY VALID IN THE US AND US TERRITORIES. MEDICARE WILL NOT COVER ROUTINE
MEDICAL CARE INTERNATIONALLY.
B. MEDICARE PAYS 80% OF THE COVERED MEDICAL EXPENSES, YOU ARE RESPONSIBLE FOR 20%.
C. THERE IS AN ANNUAL DEDUCTIBLE THAT MUST BE SATISFIED.
D. MEDICARE LIMITS THE DAYS OF HOSPITAL STAYS AND SKILLED NURSING CARE.
E. PRESCRIPTION BENEFITS ARE AVAILABLE THROUGH MEDICARE PART D FOR AN EXTRA PREMIUM AND
OTHER COST SHARING BASED ON YOUR MEDICATION.
THINGS TO KNOW ABOUT MEDICARE SUPPLEMENTS (MEDIGAP PLANS)
1. MEDIGAP PLANS ARE DESIGNED TO "FILL THE GAP" BETWEEN WHAT MEDICARE PAYS AND WHAT YOU
WILL BE RESPONSIBLE FOR (ANNUAL DEDUCTIBLE AND COINSURANCE) IN OTHER WORDS, IF YOU ARE
HOSPITALIZED AND THE TOTAL COVERED BILL IS $100,000, MEDICARE WILL PAY $80,000, AND THE MEDIGAP
PLAN PICKS UP THE DIFFERENCE, USUALLY WITH A SMALLER, PRE-DETERMINED CO-PAYMENT. MEDIGAP
PLANS ARE PORTABLE IN THE US, LIKE MEDICARE.
HOWEVER
A. MOST MEDIGAP PLANS COVER FOREIGN TRAVEL EMERGENCY SERVICES BUT CAP THE LIFETIME
BENEFITSTO $50,OOO.
B. FOREIGN TRAVEL EMERGENCY SERVICES ARE PAID ON A REIMBURSEMENT BASIS.
C. MEDIGAP PLANS COSTS CAN BE FAIRLY EXPENSIVE.
THINGS TO KNOW ABOUT MEDICARE ADVANTAGE
1. MEDICARE ADVANTAGE (OR MEDICARE PART C) REPLACES ORIGINAL MEDICARE WITH A PRIVATE
INSURER, TYPICALLY AS AN HMO (MANAGED CARE) OR PPO PLAN.
2. MEDICARE ADVANTAGE HMO ALLOWS YOU TO ASSIGN A LOCAL PRIMARY CARE PHYSICIAN AS YOUR
"MEDICAL MANAGER" OR GATEKEEPER TO MEDICAL SERVICES. YOU CAN CHANGE YOUR PRIMARY CARE
PHYSICIAN MONTH TO MONTH.
3. BECAUSE MANAGED CARE INCLUDES MANY PATIENT WELLNESS BENEFITS, THE LONG-TERM COST OF
CARE IS REDUCED, SO THERE ARE MANY BENEFITS INCLUDED SUCH AS PRESCRIPTION BENEFITS, HEARING
AND DENTAL BENEFITS, WELLNESS PROGRAMS PROVIDED BY YOUR MEDICAL GROUP, ETC.
4. MANY MEDICARE ADVANTAGE PLANS ARE PROVIDED WITH NO ADDITIONAL PREMIUM ABOVE YOUR
MEDICARE PREMIUM.
5. UNLIKE MOST MEDIGAP PLANS, MEDICARE ADVANTAGE PLANS COVER FOREIGN TRAVEL EMERGENCY
SERVICES. THERE IS AN ANNUAL LIMIT, TYPICALLY NO LESS THAN TWENTY FIVE THOUSAND DOLLARS.
THERE IS NO LIFETIME CAP.
HOWEVER
A. BECAUSE MEDICARE ADVANTAGE PLANS REQUIRE ASSIGNMENT TO A LOCAL PHYSICIAN/MEDICAL
GROUP, YOU WILL BE REQUIRED TO HAVE ROUTINE DOCTOR VISITS DONE BY YOUR PRIMARY
PHYSICIAN. THEREFORE THESE PLANS ARE LESS PORTABLE IN THE US.
B. ANY COVERED INTERNATIONAL MEDICAL EXPENSE IS PAID ON A REIMBURSEMENT BASIS.
I SINCERELY HOPE THIS INFORMATION IS HELPFUL. WE WILL BE EXPLORING DIFFERENT ASPECTS OF MEDICARE IN THE COMING BLOGS. IN THE MEANTIME, FEEL FREE TO REACH OUT WITH SPECIFIC VEXING QUESTIONS.
COURTESY OF RICK PETERSON
INDEPENDENT INSURANCE BROKER
1-949-677-3864