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Medicare Open Enrollment Is Here. Do You Need To Make Changes?

Medicare open enrollment 2019 is here! The annual Medicare enrollment period is October 15 – December 7 and includes Medicare, Medicare Advantage, Medicare Part D plans, and Medigap (Medicare Supplement).

Medicare Open Enrollment 2019

Medicare Open Enrollment Period

This is important because it allows people with Medicare coverage to make changes to their medical and prescription drug plans for 2019, which will go into effect on January 1, 2019.

This is your chance to make changes to your medical and prescription plans to improve coverage and save money. After December 7th you’ll have to wait until the following year to make changes.

You may want to make changes because Medicare health and prescription plans change on an annual basis. Coverage, costs, service areas, and which providers and pharmacies are in the network are subject to change.

These changes could cause healthcare costs to increase, but switching plans could get you the coverage you need without having your premium or out of pocket costs go up. Plus, a lower premium could provide what you need.

Look For Your Annual Notice of Change (ANOC)

Medicare open enrollment includes your annual change noticeEvery year at the beginning of October you will receive some important Medicare documents to review, including the Annual Notice of Change (ANOC). It will most likely be in the same packet as the Evidence of Coverage (EOC) for the upcoming benefit year. It will highlight all of the changes that have been made along with descriptions of all benefits (not only the ones that were changed). 

This information may arrive in the mail on its own or with the Summary of Benefits, Low Income Subsidy (LIS) rider if you’re eligible, and provider and pharmacy directories.

What Should I Do With My ANOC? 

Carefully review it and compare your plan to others. You want to compare 3 key areas:

  1. Costs 

Is your premium going up? Is a plan with a lower cost and similar coverage available?

Look at your current deductibles and copays. Are they increasing next year?

  1. Prescription Drug Coverage

Medication is expensive, especially when it’s not covered. Checking drug tiers and premiums could save tons of money. Look up each of your prescription medicines to see if they’re covered and remember to see if your preferred pharmacy is in your network.

  1. Care

With Medicare part C, Medicare, or Managed Care contact your current doctors, specialists, and any other providers are still in your network.

What Exactly Can I Change?

  • You can enroll in Medicare Advantage from Original Medicare and vice versa.
  • You can switch from one Medicare Advantage plan to another.
  • You can switch from one Medicare Part D plan (prescription drug) to another.
  • You can enroll in a Medicare Part D plan if you didn’t when you were first eligible.

If you don’t want to make any changes to your plan it will automatically renew as long as it’s still available. Receiving a nonrenewal notice in the mail means that your plan has been discontinued and you’ll need to choose a new one. If you don’t receive a nonrenewal notice, your plan has not be discontinued and you don’t have to make a change.

How Do I Enroll In Medicare?

The open enrollment period is only for people already enrolled in Medicare. If you are turning 65, open enrollment is not the time to apply for Medicare. Each enrollment period has certain rules that determine when coverage will begin, so it’s crucial to pay attention to the dates.

Medicare Initial Enrollment Period Timeline

Your Initial Enrollment Period

Your Initial Enrollment Period (IEP) is when you can sign up for Medicare the first time. You can enroll in Medicare Plans A, B, C, and D during this period:

  • 3 months before your 65th birthday
  • The month of your 65th birthday
  • 3 months after your 65th birthday

Part B coverage begins based on your sign up date:

  • If you sign up during the 3 months before your birthday coverage begins on the first day of your birthday month. Your initial medicare enrollment period is around your 65th birthday
  • When you sign up during your birthday month your coverage will begin the first day after your birthday month.
  • If you sign up the month after your birthday month coverage will begin 3 months after your birthday month.
  • Signing up the 2nd month after your birthday month results in coverage beginning 5 months after your birthday month.
  • Signing up the 3rd month after your birthday month results in coverage beginning 6 months after your birthday month.

Part D coverage also begins based on when you sign up during your IEP:

  • If you sign up during the 3 months before your birthday coverage will begin the 1st day of your birthday month.
  • Signing up during your birthday month results in coverage beginning the 1st day after your birthday month.
  • If you sign up during the 2nd or 3rd month after your birthday month coverage will begin the 1st day of the month following enrollment.

NOTE: If you miss your initial enrollment period, you will get another chance to apply, but you may face late penalties:

Special Enrollment Period (SEP) – Special enrollment periods that apply when you’re able to delay enrolling in plans A, B, C, and D due to special circumstances such as:

  • While you have coverage from an employer
  • The 8 months your coverage ends for parts A & B
  • The 63 days after your coverage ends for parts C & D

General Enrollment Period – This is your chance to enroll if you miss your initial enrollment period and special enrollment period. The general enrollment period is from January 1st until March 31st and if you enroll during this period coverage will begin July 1st.

Medigap Open Enrollment – During your 6 month Medigap enrollment period you can purchase any Medigap policy sold in your state. These are extra insurance policies to help cover costs not covered by original Medicare. You must meet specific medical underwriting requirements to be approved for a Medigap policy. There is no guarantee that you’ll be accepted. The Medigap open enrollment period is 6 months after your Part B becomes effective.

 

DME Supply Coverage And Possible Laspes

If you’re wondering if your Medicare coverage would cover supplies from your durable medical equipment (DME) supplier, Lindsay Engle, Medicare Specliast at Medicare FAQ,  explained, “The only concern would be cost. Generally, you pay 20% of the Medicare-approved amount after you pay your Medicare Part B deductible for the year, which is $183 as of 2018 but could change for 2019. Medicare pays the other 80%.

To get the remaining 20% and other out of pocket expenses covered, the beneficiary would need to enroll in a Medicare Supplement plan. With that said, the amount you pay may vary because Medicare pays for different kinds of DME in different ways. So they might cover a steady supply of replacement stuff 100%, it just depends on the DME.  Their best bet is to contact their Medicare agent or Medicare directly to make sure their supplies is coved by that DME supplier.”

Lindsey also covered reasons why you may experience a lapse in coverage, “That would depend on their current healthcare coverage. If they have coverage and are still paying their premiums, there shouldn’t be any lapse in coverage. They should be aware of the Part B late enrollment penalty when you don’t enroll as soon as your eligible at 65. There are Special Enrollment Periods for Part B too.

If their company offers COBRA, they will have 18-36 months to enroll without any lapse in coverage. If they’re on group health insurance through their employer and still working, they can have both insurances. One will be primary and one will be secondary, depending on the size of the company.”

When it comes to lapses in coverage, it depends on your individual policy and situation. However, an Aeroflow representative can help you qualify to receive medical equipment through insurance. Simply fill out our quick qualification form and we will contact you with your options. We will also take the hassle out of the process by contacting your doctor and Medicare for you to make sure your items are shipped directly to your home.

If You Need Assistance…

Medicare can be a little confusing to navigate, but you’re not on your own. Contact the Medicare office at 1-800-MEDICARE (1-800-633-4227) to ask questions. Contacting your local Agency on Aging may provide you with faster results. Also, you can view available plans here.

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