When it comes to Medicare and getting the best plan options and costs, there are key dates to keep in mind. These apply to the 11,000 Americans turning 65 every day as well as the more than 61 million current Medicare beneficiaries.
Knowing the key Medicare dates is vital and so is avoiding last minute submission. With so many seniors now part of the Medicare system, missing a deadline could mean you'll end up having to wait another year or potentially face costly penalties.
While Medicare is a federal program, rules and important dates can vary by state. Working with an experienced and knowledgeable local Medicare insurance agent can help you take advantage of the following important and sometimes special Medicare dates.
First Time Medicare Enrollment: Turning 65
There is a 7-month window around your birthday month to enroll in Medicare. The window is open 3 months before your birthday month, 3 months following and, of course, during your birthday month.
This is generally the time when you'll have the greatest opportunity to compare options from Original Medicare to Medicare Advantage or Medigap and drug plans available.
See also: Best Medicare Advantage Plans
Medicare Advantage Open Enrollment: January 1 through March 31.
This is the enrollment period specifically for Medicare Advantage (MA) plan members. During these dates, you have a one-time opportunity to change to another MA plan. Or you have the option to cancel your MA plan and revert to Original Medicare. In addition, you may add Part D (prescription drug coverage) if it is not included with your coverage.
Medicare Annual Enrollment Period: October 15 through December 7
These are key dates when mailboxes are filled to the brim and television ads fill the cable airwaves. During the Annual Enrollment Period, or AEP, you are allowed to review your plan coverage and make switches to get better coverage or save money. AEP is especially important for those with Medicare Advantage and Part D drug plans. Potential savings can be significant. According to the American Association for Medicare Supplement Insurance, individuals with a stand-alone Medicare drug plan could save an average of $486 per year by switching to a different plan.
Special Opportunity Dates For Medicare Beneficiaries
Some states including California and Oregon have enacted a “Birthday Rule”. This provides a 30 or 60-day window for individuals to change their Medigap every year. The state-specific rules permit the opportunity to change plans without health underwriting as long as the policy benefits are equal to or less than the current plan.
In Connecticut, seniors have guaranteed issuance at any time. In addition, rates cannot be varied based on the applicant's age, gender or health status. Some rules regarding a gap in coverage do apply.
States including New York and Vermont permit residents to enroll in a Medigap plan without health underwriting throughout the year.
Special timing rules also exist for residents in Washington and Missouri that are worth asking about.
Local Medicare Insurance Experts Can Help You Capitalize
There are other special Medicare enrollment periods that you may qualify for. Here are a few key examples.
- Loss of your employer or retiree insurance coverage.
- You are moving out of your current plan's service area.
- Your Medicare eligibility is due to a disability and you are turning 65.
- You qualify for low-income prescription drug assistance.
The complexity of Medicare's ever changing rules as well the increasing competition among entities vying for your Medicare coverage make it beneficial to seek the best information for your particular area. When speaking to an agent, ask whether they offer both Medicare Advantage and Medigap options. Ask if they are willing to help you compare available drug plan options.
The online national directory listing Medicare agents by Zip Code can be a good place to start. Access it at www.medicaresupp.org and connect with one or two agents to see who can best help you review available plan options.
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