National Medicare Education Week

Every fall, Medicare resources and information become readily available for Americans to make the best health care decisions for themselves or their loved ones. National Medicare Education Week conveniently starts one month before Medicare’s Annual Enrollment Period. We’re here to tell you how to make the most of this valuable window to increase your awareness of how Medicare works.

The purpose of the Annual Enrollment Period is to give beneficiaries a chance to change their Medicare coverage for the coming year.

Enroll in Original Medicare First

You must already have Original Medicare (Part A and Part B) before making any coverage changes during the Annual Enrollment Period. You become eligible for Medicare once you turn 65, or earlier due to disability.

At this time, you can enroll in Original Medicare during your Initial Enrollment Period, which lasts seven months. This window starts three months before you turn 65 and ends three months after your 65th birthday.

If you miss your Initial Enrollment Period, you have another opportunity to enroll during the General Enrollment Period that runs every year from January 1 through March 31. Once you have Original Medicare, you’ve taken the first step toward being ready for the Annual Enrollment Period!

Keep in mind that if you have creditable coverage, you can delay enrolling in Medicare without paying any late enrollment penalties. You’re allowed to delay Part B and Part D as long as you meet certain requirements. It’s important to note that TRICARE, CHAMPVA, Veterans benefits, and Federal Employee Health Benefits (FEHB) are all not creditable coverage for Part B.

However, if you’re already collecting Social Security benefits, you’ll enroll in Original Medicare automatically. Medicare and Social Security are two different programs, but both work together.

Signing Up for Parts A and B

Become Familiar with the Parts of Medicare

Now that you understand the importance of Original Medicare regarding the Annual Enrollment Period, let’s break down the four parts of Medicare.

Part A covers inpatient hospital care, including services at skilled nursing facilities, medically necessary home health care, and much more. You’re entitled to premium-free coverage if you’ve worked at least 40 quarters (ten years) and have paid Medicare tax.

Medicare Part B pays for medical services, which include doctor visits, annual lab work, ambulance services, and some durable medical equipment. Like with Medicare Part A, Medicare Part B covers 80% of your out-of-pocket costs after you meet your yearly deductible.

While you need Original Medicare to participate in the Annual Enrollment Period, it doesn’t involve your Part A or B coverage. You’re only allowed to add, change or drop your Medicare Part D or Advantage plan for the following year.

Part C is Medicare Advantage. These plans, through private insurance companies, cover all services under Part A and Part B. Some plans also cover dental, over-the-counter medications, vision services, and more. An Advantage plan may also come with a zero-dollar premium. If you’re enrolled in a Private-Fee for Service (PFFS) plan that doesn’t include prescription drug coverage, you can sign up for a Part D plan.

Speaking of drug coverage, let’s explore Medicare Part D. These plans are also offered through private insurance companies. They help lower costs for prescription drugs to make them more affordable. With Part D plans, beneficiaries are responsible for copayments versus the full price.

Part D has four phases because drug costs may change throughout the year. While Part D isn’t mandatory, you’re subject to late penalties if you delay coverage.

With Original Medicare, beneficiaries who don’t have drug coverage can purchase a Medigap policy. As we mentioned above, the Annual Enrollment Period centers around Medicare Advantage and Part D. However, if you decide to enroll in a Medigap plan, you may need to undergo medical underwriting if you aren’t eligible for guaranteed issue rights.

Breaking Down the Parts of Medicare

Prepare for Fall Open Enrollment

The Annual Enrollment Period is also known as Fall Open Enrollment. Any changes made during this time take effect on January 1 of the following year. Each September, beneficiaries receive an Annual Notice of Change (ANoC) letter, which outlines changes to your Medicare plan’s coverage or costs for the next year.

If you don’t receive a letter by the end of September, contact your plan provider. Individuals enrolled in a Medicare Supplement (Medigap) policy won’t receive an ANoC since the plan’s benefits don’t change annually. Once your letter comes in the mail, please review it and decide if any of the changes will still meet your needs. Ask yourself the following questions:

• Will the costs be any different for the upcoming year?
• Will my prescriptions and dosages still be on the drug formulary of my Part C or Part D plan?
• Are my doctors still within my Advantage plan’s network?

It’s important to understand any changes to your plan leading up to the Annual Enrollment Period. If you have any questions once you obtain your letter, contact your plan’s provider.

What You Need to Know Before the Fall Annual Enrollment Period

Understand How Advantage Plans Work

Medicare Advantage plans and Original Medicare have many similarities regarding coverage, but they’re ultimately different. While both plans offer the same benefits for Part A and Part B, Original Medicare has no copays. Additionally, these plans may be easier to enroll in compared to Medigap since beneficiaries with pre-existing health issues can still enroll.

Another difference between the two is how they’re managed. Original Medicare is a federal program, while private insurance companies run Medicare Advantage. Advantage plans replace Medicare as these plans are referred to as Medicare replacement plans. These plans provide benefits that must be used within the plan’s network of providers.

If you miss your opportunity to sign up for Medicare Advantage during the Annual Enrollment Period, you’ll need to wait until AEP the following year. Those who aren’t happy with the Advantage plan that they picked up during AEP can use the Medicare Advantage Open Enrollment Period to drop their plan or switch to another Advantage plan.

Make sure you know what you want from an Advantage plan before starting to shop for one.

How Medicare Advantage is Different from Original Medicare

Enlist a Licensed Agent During National Medicare Education Week

Consulting with a licensed Medicare agent comes with a lot of perks. Licensed agents want all of their clients to have the best health care coverage. With access to the most up-to-date Medicare information, you’ll be sure to enroll in a plan tailored to your needs. Here are a few reasons you should work with a licensed agent:

• Access to multiple Medicare Supplement insurance carriers
• Guarantee you’ll receive the best health care coverage
• Saving time spent researching plans/providers
• Saving money by speaking to a licensed agent, as this service is typically free
• Discovering Medicare resources you may not have known about

Questions to Ask Your Medicare Agent

How to Learn About Medicare During National Medicare Education Week

This year, turn to MedicareFAQ with your coverage questions during National Medicare Education Week. When you sign up with us, we’re here for you year-round. MedicareFAQ is a community that cares. Our team of experts can help you understand the options available to you during the Annual Enrollment Period. We’ll walk with you through everything, including enrollment, switching plans, and handling claims and appeals.

If you want to stay up-to-date about Medicare basics, policies, and changes, join our Facebook Community Group. We answer all your questions and give you the knowledge to make the best enrollment decisions. To discover the best rates available in your area, contact us at the phone number above. We also have an online rate form you can use now to see the best Part C and Part D plans available to you.