The Medicare Open Enrollment season runs from October 15th through to December 7th every year.
According to most recent data published by the Centers for Medicare and Medicaid Services (CMS), 9 out of 10 Americans aged 65 years and above are currently enrolled in Medicare. This makes the Open Enrollment Period a very important time for senior adults.
Frequently asked questions about Medicare Open Enrollment Period
Navigating Medicare can be tricky. Some of the most commonly asked questions about Medicare Open Enrollment Period are:
Question: Is Medicare Open Enrollment Period the same as Initial Enrollment Period?
No. The Initial Enrollment Period (IEP) is a 7-month stretch of time with your date of birth at its midpoint. Your individual IEP starts 3 months before your 65th birthday, runs through the birthday month, and continues for 3 months more. For the majority of senior Americans, IEP is when you enroll in Medicare for the very first time.
Medicare Open Enrollment Period is for senior adults who are already enrolled in an Original Medicare or Medicare Advantage plan. The Open Enrollment Period is a 54-day window in which you get the opportunity to change your Medicare coverage.
Question: Why should I care about Medicare Open Enrollment Period?
After you have been in a Medicare plan for some time, you may notice that your current coverage does not quite fit your needs. Your reasons for concern could be:
- The premiums, copayments, coinsurance, or deductibles of your current plan are too high.
- You are not covered for new conditions that have recently surfaced, such as worsening eyesight.
- Now that you’re retired, you’ve decided to travel and explore other countries and want your healthcare covered no matter where you go.
- You want to join a health club or gym and would like assistance with membership fees.
For these and many other possible reasons, you may feel that your present health coverage is not enough. Medicare Open Enrollment Period is your chance to modify your coverage, switch to a Medicare Advantage (also known as Medicare Part C) plan, or switch back to Original Medicare if you have Part C at the moment.
Question: What is the difference between Medicare and Medicare Advantage?
When used in context of the senior community, ‘Medicare’ generally refers to Original Medicare coverage as offered by the CMS. This has two parts, A and B. Every senior adult qualifies for Part A as mandated by the US federal government, but you must separately buy Part B and Part D (prescription drug) coverage.
Medicare Advantage, or Part C, is health coverage plans offered by private insurance companies in collaboration with government-run Medicare. The largest Part C insurance company in the US is UnitedHealthcare, followed by Humana and Blue Cross Blue Shield.
Medicare Advantage plans are rising in popularity because they are more holistic. Any Medicare Advantage plan you purchase will have Part A built in (it is a federal requirement), will include most aspects of Parts B and D, and will include additional services not covered by Original Medicare, such as meal deliveries or acupuncture.
Question: I changed my health coverage during Medicare Open Enrollment season; when will my new plan kick in?
If you modify your healthcare coverage during the Medicare Open Enrollment Period, your new coverage will become effective from January 1st of the following year.
Question: Where can I get more useful guidance and advice about Medicare?
You can start by browsing Medicare’s website, or call their helpline at 1-800-633-4227. This number is operational 24/7 except on federal holidays.
Additionally, you can call our Patient Relations Team at (800) 941-1106. This is IntraCare’s department dedicated to helping senior patients get the most out of Medicare benefits and programs.
Question: What is a benefits review? Why should I do a benefits review before the Medicare Open Enrollment Period?
Medicare regularly revises its benefits offered, eligibility criteria, and programs. This year, especially, major overhauls are expected that may impact large numbers of Medicare beneficiaries.
A benefits review is simply looking at, or reviewing, the benefits you receive from your Medicare coverage to see if they are enough. Much like Medicare Annual Wellness Visits that keep you informed of changes happening to your health, a Medicare benefits review keeps you updated about useful changes taking place in Medicare.
As Medicare can’t inform its millions of beneficiaries individually, it is imperative that you conduct your own benefits review every year, ideally before or during Medicare Open Enrollment season. This will help you figure out if you need to make any changes between Oct 15th and Dec 7th.
IntraCare’s Patient Relations Team is your biggest support when doing a benefits review. We monitor all updates to Medicare and provide answers to your questions, as well as guidance on Medicare benefits and programs relevant to you, such as:
- Reductions on premiums and deductibles
- Prescription drug assistance
- Transportation assistance
- Diet and nutritional programs
- Resources to help with chronic health conditions
You can reach out to the Patient Relations Team by asking at your nearest IntraCare Health Center, or calling (800) 941-1106.