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Medicare / Health Insurance Enrollment: Important Dates and Finding the Best Coverage

October 10, 2017

Now is the time of year to review your health care needs and consider your available health insurance plan options for 2018. Many plans change cost and benefit options, so you may end up paying more in your current plan or significantly less if you choose another plan. In this article, I will cover some Medicare enrollment details, including key dates, and then provide a step-by-step checklist of health care items for you to review annually.

For 2018 Medicare coverage, the Annual Open Enrollment Period runs from October 15 to December 7. During this period, you'll have the opportunity to review your existing Medicare coverage and, if you see the need to, change to a different plan for the following year. These changes to your coverage may include: 

1. Enrolling in Medicare Part D (prescription drug) plan, if you didn't enroll when first eligible. A late enrollment penalty may apply.

2. Returning to traditional Medicare (Parts A and B) from a Medicare Advantage (Part C, managed care) plan, or vice versa.

3. Switching from one Medicare Advantaged plan to another, or from one Medicare Part D plan to another.

Medicare Revisited:

When you turn 65, Medicare becomes your health insurance primary payer. Anyone who is currently covered by a retiree health plan, an individual policy, or a small employer group plan, must enroll in Medicare when they turn 65. If you don't enroll in Medicare during the appropriate enrollment period, you may have to pay a late-enrollment penalty. The only people who are exempt from enrolling in Medicare at 65 are workers and spouses who are covered by an employer group plan that covers 20 or more employees.

Medicare enrollment is only automatic if you are receiving Social Security when you turn 65.

Other Medicare Enrollment Periods:

1. If you are not receiving Social Security, the Initial Enrollment Period for Medicare Parts A and B starts three months before you turn 65 and extends for a full seven months. But, you will want to enroll during the first three months in order to have Medicare coverage on the first day of the month you turn 65. You can do this through the Social Security Administration, by calling (800) 772-1213 or online at 

2. If you are covered by an employer group plan that covers 20 or more employees when you turn 65, you have a Special Enrollment Period (SEP) for Medicare Parts B and D that entitle you to sign up later. To help avoid any late enrollment penalties, you should plan to enroll in Medicare by the end of the seventh month after your group coverage ends. It is important to note that Part D drug coverage has different rules than Part B. 

Additionally, there are other minor (SEPs) for Medicare Advantage and stand-alone drug plans that apply in specific circumstances.

3. If you didn't sign up for Medicare Parts A and B when you were first eligible (i.e. during the Initial or Special Enrollment Period), you have a chance to do so during the General Annual Enrollment Period, which runs from January 1 to March 31, with Medicare coverage effective on July 1. You may have to pay a late-enrollment penalty. For Medicare Part B, the penalty is an additional 10 percent of the premium for each 12-month period that you were eligible, but not enrolled. You'll have to pay this penalty for as long as you have Part B. 

4. The Medicare Annual Disenrollment Period (MADP) is specifically for people enrolled in a Medicare Advantage health plan who want to change to traditional Medicare (Parts A and B). This period runs from January 1 to February 14. This period provides an opportunity to change your mind and switch to the traditional Medicare program, regardless of how long you’ve been in the Medicare Advantage plan. You can also enroll in a stand-alone Part D prescription drug plan at this time. In both cases, your new coverage begins the first day of the month after you make the change. A late-enrollment penalty may apply.

Additional Information about Medicare:

For more information on Medicare, please click Health Care Quick Reference Guide.

Health Care Checklist for Finding the Best Coverage:

To help find the best health care coverage for you, please click Health Care Check List for Finding the Best Coverage

Information contained herein has been compiled from sources deemed reliable as of October 13, 2017, but is subject to legislative changes and is not intended to be legal or tax advice. This material is furnished “as is” without warranty of any kind. Its accuracy and completeness are not guaranteed and all warranties, expressed or implied, are hereby excluded.