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Last Chance For AEP

Last Chance For AEP text overlaying image of an hourglass Every year, from October 15 to December 7, the Medicare Annual Enrollment Period takes place. This is a good time to look over your present Medicare coverage. Does it cover the medicines you need? Are you able to pay for the plan? Are you able to see your favorite doctor through the plan? The Medicare AEP is not the same as the other times you can sign up for a Medicare plan. You can add, change, or get rid of Medicare Advantage plans or stand-alone Medicare Prescription Drug Plans during the Medicare AEP. After that, you can also make the following changes:

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Medicare Options

There is a time every year when people who already have Medicare can switch from Original Medicare (Parts A and B) to Medicare Advantage (Part C). Or the other way around. However, if you want to change, you might have to do some other things too. Changes to and from different types of plans will require you to make different choices.

Switching to Medicare Advantage

In this scenario, you are currently enrolled in Traditional Medicare and are considering switching to a Medicare Advantage plan. In addition to that, you can also have a separate Part D plan for your prescription medication. The majority of Medicare Advantage plans offer comprehensive coverage that encompasses all of your needs. They will pay for your Medicare Part A and Part B benefits. As well as your Medicare Part D prescription medicines and most other health services or items that are not covered by Original Medicare. A few of these additional things are dental, eye, and hearing care, in addition to memberships at fitness centers. To prevent you from spending an excessive amount each year, Medicare Advantage plans come with a cap on the amount of money you are responsible for paying out of pocket.

 

You have the ability to switch from Original Medicare to a Medicare Advantage plan if you do so during the Annual Enrollment Period. If you already have Medicare Part D coverage, but decide to enroll in a Medicare Advantage plan, you may find that you no longer require a separate Part D plan. If you decide to enroll in a Medicare Advantage plan instead of Original Medicare, the plan will coordinate the transfer of your benefits with Medicare. There is no requirement for you to initiate contact with Medicare on your own. Your new plan will begin covering you as of the first of the year. 

Switching to Original Medicare

Only Part A (covering for hospital stays) and Part B (coverage for medical services) are included in Traditional Medicare. It doesn’t cover prescription drugs, dental care, vision care, or fitness programs like some Medicare Advantage plans offer. Because there is no yearly out-of-pocket maximum with Original Medicare, there is also no built-in financial security for beneficiaries.

 

You will need to get additional coverage if you still intend to have these things. For instance, if you want coverage for prescription drugs. You will have to search for a stand-alone Part D plan and sign up for it. Previously, this was not the case. In the event that you determine you require additional coverage, you will be required to select a Medicare Supplement Plan and register for it directly with the issuer of that plan. In order to make the transition back to Original Medicare, you will need to contact either the provider of your Medicare Advantage plan or Medicare itself.

What If I Miss The AEP?

A number of different things might happen, and it all depends on the coverage that is being given right now. What transpires next will be determined by the type of coverage you currently have in place. The majority of people who are enrolled in Medicare have either Original Medicare with a Part D prescription medication coverage or Medicare Advantage together with a Medicare Supplement insurance policy.

Missing The AEP With a Medicare Advantage Plan

During the AEP, beneficiaries who are enrolled in Medicare Advantage plans have the opportunity to make modifications to their coverage. If you do not enroll in the new plan during the Annual Enrollment Period, your existing plan will be transferred to the new plan automatically. One possible exception to this rule is if your existing Medicare Advantage plan moves out of the area it serves or is terminated. In the event that this takes place, you will be eligible for a Special Enrollment Period. The SEP will extend for two months after the Part C program has concluded.

 

You have the ability to make modifications to the Medicare Advantage Open Enrollment Period if you are enrolled in a Medicare Advantage plan and you are currently enrolled in the plan. Every year, the MAOEP begins on the first of the year and continues until the end of March. You have the opportunity to make changes to your Medicare Advantage plan during this period of enrollment. If you do not enroll during the AEP or MAOEP, you will not be able to change your plan until you have a Special Enrollment Period that meets the requirements.

 

Imagine you are only eligible for Original Medicare, and you fail to enroll during the Annual Enrollment Period. If this is the case, the only way for you to add a Medicare Advantage plan or a Medicare Part D plan is if you have a Special Enrollment period during which you are eligible to do so.

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Missing The AEP With a Part D Plan

If you miss the AEP, your existing plan will carry over into the following year. Just like it would with a Medicare Advantage plan, unless the program is discontinued. If you miss the enrollment period for a program and then decide you want to switch to a different one, you won’t be able to make the switch unless there is a special enrollment period. An SEP is triggered by particular occurrences in a person’s life as well as unusual conditions. 

Options After Missing The AEP

Even if you miss the Annual Enrollment Period for Medicare, you still have choices available to you to obtain health insurance.

Special Enrollment Period

You may be able to make changes to your Medicare coverage outside of the Medicare Annual Enrollment Period if you meet the requirements to qualify for a Special Enrollment Period (SEP). There are numerous instances in which you may be eligible for a SEP. Some of these circumstances could result in you losing your health insurance coverage, either temporarily or permanently. The following are some instances of circumstances that may qualify you for a Special Enrollment Period, which allows you to join up for a Medicare Advantage plan or a stand-alone Medicare Part D prescription drug plan, or alter your current plan, without having to wait for regular enrollment periods.

 

  • You moved out of your plan’s service area.
  • You moved into, out of, or still live in a skilled nursing facility. Or another institution such as a long-term care hospital.
  • You left your employer-based or union-based health insurance.
  • You used to be eligible for Medicaid, but now you’re not.
  • You just got out of jail.
  • You’re moving back to the United States after living outside the country.
  • Your plan is losing or ending its contract with Medicare.

Keep in mind that these are only some examples. If you suffer significant changes to your plan, your coverage, or even your health, it may be worthwhile to check with Medicare to see if you may qualify for a Special Enrollment Period to change your coverage. This can be done if you contact Medicare after you have experienced any of the aforementioned changes. There is a possibility that various SEPs will have varying durations. Your specific circumstances will determine how much time you have to make the adjustment. But in most cases, you will have at least two months to do so.

COBRA Coverage

After certain qualifying events, such as the loss of a job or a reduction in the number of hours worked, individuals who are eligible are able to continue their employer-sponsored health insurance coverage for a limited amount of time through COBRA coverage, which is an abbreviation for the Consolidated Omnibus Budget Reconciliation Act. It can provide temporary coverage and assist you in bridging the gap until you find alternative options for health insurance.

 

If you are qualified, you have the opportunity to continue receiving health insurance coverage from your employer even after you have left your position there. This enables you to keep your present health benefits after becoming eligible for Medicare, which is a significant advantage. It is crucial to check with your employer to understand the precise rules and requirements for remaining on your company’s plan while still being eligible for Medicare. This information can be obtained by checking with your employer.

Wait For The Next AEP

In the event that you don’t qualify for any SEPs or any other special enrollment choices, you will have to wait until the subsequent open enrollment period in order to make any modifications to your Medicare coverage. Both the AEP and the IEP are considered to be the most important enrollment periods. You have the ability to make modifications to your current Medicare plan. Or enroll in a new plan for the following calendar year during these enrollment periods. It is essential to be aware of these enrollment times. And to make appropriate preparations in order to guarantee that you will have the necessary coverage.

Help From EZ

If you miss the Medicare Annual Enrollment Period, you can find yourself in a stressful situation. Agents located in your area are available through EZ.Insure to provide assistance and answer any questions you might have. Our sales representatives have received extensive training to assist you in selecting the solution that is most suited to meet your requirements. Estimates for Medicare Supplement Plans will be sent to you by our agent. Who will also assist you in signing up for coverage at no additional cost. These estimates will come from the leading insurance companies in your area. Simply enter your zip code in the box below to get free immediate quotes. If you would like to speak to a local licensed representative, you can call us at 877-670-3602.

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Medicare Annual Enrollment Period (AEP) FAQ

Medicare Annual Enrollment Period (AEP) FAQ text overlaying image of building blocks with faq written on them. If this is your first year participating in the Medicare Annual Enrollment Period (AEP), you may be confused about what you need to do. Getting the information you need is crucial if you want to make sure your Medicare plan is ready for the upcoming year. You could lose hundreds of dollars if you don’t fully understand the AEP and don’t take advantage of it. We have compiled and addressed some of the most commonly asked questions we receive this time of year in an effort to better prepare you for the AEP. 

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What Is The AEP?

A specified window of time known as the Annual Enrollment Period (AEP) allows people to modify their Medicare coverage. It enables Medicare enrollees to change their plan selections to better meet their medical needs. The AEP can be used by eligible people to switch, enroll in, or disenroll from any Medicare plan. Including Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare prescription drug coverage (Part D). Including the options to enroll in or modify Medicare prescription medication coverage, move between Medicare Advantage plans, and convert from Original Medicare to Medicare Advantage. 

When Is The AEP?

Every year, the AEP takes place from October 15 to December 7. Unless you are eligible for a Special Election Period (SEP), the AEP is usually your opportunity to make these adjustments if, during your initial enrollment period, you did not enroll in a Medicare Advantage or Medicare prescription drug plan. Any modifications you make during the AEP take effect on January 1st of the following year.

Why Is The AEP So Important?

There are several reasons you might think about changing your Medicare coverage since your healthcare needs change over time. All Medicare beneficiaries should be aware of the costs associated with premiums, deductibles, and copayments. If your current plan is too costly, moving to a more affordable alternative can help you control your medical spending. When you undergo specific health changes, switching Medicare plans can also be helpful. Some people have pre-existing ailments that get worse with time, or they develop chronic conditions. In these situations, you might want to think about moving to a Medicare plan that provides better coverage along with condition-specific care management services. By doing this, you can make sure that you have access to the care, drugs, and assistance you need to maintain your health.

What’s The Difference Between Original Medicare and Medicare Advantage?

Original Medicare consists of two portions that are provided by the federal government: Part A and Part B. Hospital insurance, or Part A, is typically premium-free and includes skilled nursing facility care, inpatient hospital treatment, lab testing, surgery, and home health care. As long as you worked 10 years and paid Medicare taxes. Part B medical insurance has a monthly payment that is determined by your income and covers physician services, outpatient treatment, medical equipment, home health care, and certain preventive services. Under a contract with the federal government, private insurance firms offer Medicare Advantage Plans, often known as Medicare Part C. In addition to other benefits like dental, hearing, vision, and/or prescription medication coverage, they cover the same benefits as Medicare Parts A and B.

Do I Have To Change My Coverage?

No, if you are happy with your current Medicare plan, you don’t need to change it. However, you should be aware of any impending changes for the future year and shop around to make sure you are getting the features you need at a reasonable cost.

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What Are The New Medicare Changes In 2024? 

Every year, the Medicare program in the United States may alter somewhat or significantly. Before AEP, every year the Centers for Medicare and Medicaid Services (CMS) announces these changes in September and October. Increases in Part B and Part A cost-sharing, higher Part B premiums (but flat or slightly lower Part A premiums), modified income-related premium surcharges for Part B and Part D, the removal of Medicare Part D coinsurance once an enrollee reaches the catastrophic coverage level, and expanded availability of the full Low-Income Subsidy (Extra Help) for Part D prescription drug coverage are some of the changes to 2024 Medicare coverage.

Medicare Part A Changes

Certain home healthcare services, skilled nursing facilities, and inpatient hospitals are covered by Medicare Part A. For those who have worked for 40 quarters or more who are insured by Medicare, there is no premium for Medicare Part A. CMS estimates that 99% of Medicare enrollees do not pay a Medicare Part A premium. CMS said that the monthly Part A payment, which is paid by beneficiaries with less than 30 quarters of Medicare-covered employment and some individuals with disabilities, will drop to $505 in 2024 by $1. Your premiums stay at $278 if you or your spouse have worked 30 to 39 quarters. The Medicare Part A deductible for inpatient hospital services will rise to $1,632 by an additional $32. The daily coinsurance payments for Part A will be as follows:

 

  • $408 for days 61–90 of hospitalization during a benefit period
  • $816 for lifetime reserve days
  • $204 for days 21–100 of extended care services in a skilled nursing facility during a benefit period

Medicare Part B Changes

Medicare Part B is medical insurance, which pays for doctor visits along with other services and supplies that are required for medical care. It also includes ambulance services and preventive treatment to avoid illness. In addition, several kinds of outpatient prescription medication, mental health coverage, and durable medical equipment are included. Medicare Part B is going to get more expensive in 2024. In 2024, the average monthly premium for Medicare Part B will be $174.70, representing a nearly 6% increase over the 2023 payment. The Medicare Part B premium was $164.90 in 2023. Additionally, the yearly Medicare Part B deductible will rise from $226 in 2023 to $240 in 2024. Increases in spending are the main cause of cost changes.

Medicare Advantage Changes

Under a contract with Medicare, private businesses provide Medicare Advantage plans (Part C). Medicare Advantage plans, which offer Part A, B, and occasionally D (drug) benefits, are enrolled by around 50% of Medicare beneficiaries. Lower rates and appealing extras like gym memberships, dental, vision, and hearing coverage are features found in most policies. 

 

Selecting “in-network” providers is a requirement of MA plans. You might have to pay extra or not receive coverage at all if you travel outside the network or coverage area of the plan. According to CMS reports, it expects Medicare Advantage premiums to remain relatively unchanged in 2024 compared to 2023. Medicare Advantage monthly premium averages should be $18.50 in 2024 as opposed to $17.86 in 2023. For over 73% of beneficiaries, there will be no rise at all.

Medicare Part D Changes

CMS anticipates a decrease in Part D premiums in 2024 to $55.50 in 2024 from $56.49 in 2023. The Inflation Reduction Act of 2022 caused multiple policy adjustments, which is why there has been a drop. In 2024, new cost-sharing restrictions take effect. There is a temporary cap on the amount of coverage provided by Medicare prescription drug plans, known as a coverage gap. This coverage gap is called the “donut hole.”

 

The donut hole begins when your insurer and you spend $5,030 on covered pharmaceuticals, which is more than the $4,660 in 2023. Following $5,030, you will have to pay a part of your prescription medications out of pocket, up to the amount specified by your plan. Upon reaching this threshold, whether you purchase your prescriptions from a pharmacy or online, you won’t be required to pay more than 25% of the total cost of the medication (brand-name and generic). Once you cross that threshold, your coverage resumes. 

 

You get into the catastrophic coverage phase once you’ve spent the maximum amount of money you can for covered medications ($8,000 in 2024). This stage results in the elimination of cost-sharing for approved medications in 2024. More individuals will also be eligible for expansion of Extra Help in 2024. This will allow Medicare beneficiaries who meet certain requirements can receive fixed lower copayments instead of a premium and deductible. Participants can save roughly $300 a year on average.

Can I Change My Medicare Plan Outside of The AEP?

It depends on the situation. You will have the opportunity to make adjustments during your Special Enrollment Period, for instance, if you move outside of the coverage area of your plan or if you no longer qualify for coverage for any other reason. Of course, you can always leave a Medicare Advantage Plan, prescription drug plan, or Supplemental Plan whenever you choose, but you can’t join or modify them unless you are eligible for a Special Enrollment Period (AEP). 

How Do I Enroll During The AEP?

It is possible to enroll in a Medicare plan through assessing your options and selecting one on your own, but working with a qualified Medicare agent is recommended to avoid missing out on a fantastic, cost-effective plan. The Medicare representatives at EZ can help you every step of the way and compare all of your Medicare options. As well as help you find a Medicare Supplement Plan from the best insurance providers in the nation. 

Working With EZ

If you have any additional questions about medicare & medicare supplement plans feel free to reach out to an EZ agent. Our local agents are here to help you compare plans, find plans that fit in your budget, go over your coverage, and keep you up to date with everything you need to know about your plan. To get a medicare supplement quote online you can enter your zip code in the bar below. To speak to a live agent you can give us a call at 877-670-3602.

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How ESRD and ALS Affect Medicare

How ESRD and ALS Affect Medicare text overlaying image of a senior and younger persons hands holding When you think of Medicare you likely think of the health insurance system designed for people over 65, but there are some cases where younger people are also on Medicare. Some people with disabilities who are younger than 65 can get Medicare. These people must have been getting disability payments from Social Security for at least 24 months or have End Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s disease). So, if you have one of these conditions, it’s important to not only look into and compare all of your plan choices, but also make sure you sign up for Medicare at the right time.

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ESRD

End-stage renal failure, also called end-stage renal disease (ESRD), is the last and final stage of chronic kidney disease. In this stage, the kidneys’ function has gotten so deficient that they can’t function on their own anymore. A person with end-stage renal failure needs dialysis or a kidney donation to live longer than a few weeks. As kidney failure worsens, patients may feel a wide range of symptoms. Some of these are tiredness, drowsiness, less urination or not being able to pee, dry skin, itchy skin, headache, weight loss, nausea, bone pain, changes in skin and nails, and being easy to bruise.

 

If you have been told you have end-stage renal disease and need a kidney donation or are getting dialysis, you can sign up for Medicare on the first day of your fourth month of dialysis. If you are taking part in a program to help you do your own dialysis, you will be qualified for Medicare right away. However, if you stop doing self-dialysis and start going to a dialysis center, your Medicare benefits will stop and you will have to go through 4 months of dialysis before you can start getting them again. 

ESRD Medicare Coverage

A doctor must tell you that you have ESRD before you can get ESRD Medicare. Also, you must have enough work history to qualify for Social Security Disability Insurance (SSDI) or Social Security retirement benefits. You can also apply based on your spouse’s or parent’s work history. Depending on your treatment plan, Medicare for ESRD will start when:

 

  • If you start a training program for home dialysis, which is sometimes called “self-dialysis,” you can get Medicare as of the first day of the first month of the program. Before your third month of dialysis, you must start the program. Your doctor must also say that they think you can finish the program and that you will keep doing home dialysis after the program is over.
  • If you get dialysis at a center for inpatients or outpatients, you can get Medicare starting on the first day of the fourth month you get dialysis. For instance, if you start dialysis on May 10, your ESRD Medicare coverage can begin on August 1.
  • If you need a kidney transplant, you can get Medicare starting the month you are admitted to a Medicare-approved hospital for the transplant or for health services you need before the transplant. If you need a kidney transplant, you can get Medicare starting the month you are admitted to a Medicare-approved hospital for the transplant or for health services you need before the transplant.

What’s Covered?

As long as you meet the requirements, you won’t have to pay a premium for Medicare Part A, but you will have to pay a monthly premium and meet a yearly deductible for Medicare Part B coverage, just like everyone else who has Medicare. Parts A and B of Medicare will pay for:

 

  • Dialysis
  • Kidney transplant
  • Transplant drugs after a covered transplant
  • Dialysis-related drugs

Part B covers outpatient dialysis, which is why you should sign up for Medicare as soon as possible so that this expensive treatment is covered. Immunosuppressant drugs used after a kidney donation are now covered by Medicare, thanks to a law passed in 2019. Before this law was passed, many Medicare recipients couldn’t afford to pay for these drugs out of pocket. 

ALS

Amyotrophic lateral sclerosis is a motor neuron illness that kills people. It is defined by the loss of nerve cells in the brain and spinal cord over time. It is often called Lou Gehrig’s disease after the famous baseball player who died from it. ALS is one of the most debilitating diseases that affect how nerves and muscles work. ALS does not affect the brain or the senses, like being able to see or hear. It is also not infectious. There is no cure for this sickness right now. People of any race or ethnicity are most likely to get ALS between the ages of 40 and 70, though it can happen at a younger age. 

ALS Medicare Coverage

If you have been identified with ALS, you will automatically be enrolled in Medicare the month you start getting disability payments from Social Security. If you have Amyotrophic Lateral Sclerosis (ALS), you are automatically enrolled in Medicare the first month you get Social Security Disability Insurance (SSDI) or a train disability annuity.

 

Once you know you have ALS, you should fill out an application for SSDI or a railroad disability annuity and send it to Social Security or the Railroad Retirement Board. Before you can start getting disability payments, you will have to wait five months. Make sure to say that you have ALS in a clear way on your application for disability payments. Once you’ve waited five months, your Medicare will start the same month as your unemployment payments. Coverage includes services like:

 

  • Physical and occupational therapy
  • Speech-language therapy
  • Medicines used in intravenous infusions

After you sign up for Parts A and B, you can choose between a Medicare Supplement Plan and a Medicare Advantage plan. You can save money on Part B out-of-pocket costs with a Medicare Supplement Plan.

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Medicare Costs Under 65

Original Medicare (Parts A and B) costs the same for both people over 65 and people under 65 who are disabled, but the prices of Medicare Supplement plans are very different in big ways. Most of the time, Medicare supplement plans cost a lot more for disabled Medicare recipients under 65 than for Medicare recipients over 65. Many people with Original Medicare buy Medicare Supplement insurance to cover care that isn’t covered by Medicare Parts A (hospitalization and inpatient care) and B (outpatient care). Parts A and B cover about 80% of the costs, so you need extra insurance.

 

Most states do not offer Medicare Supplement insurance to Medicare recipients under the age of 65, or they are too expensive for this age group. For example, a Medicare Supplement Plan G insurance costs $179 a month for a 65-year-old woman who doesn’t smoke and lives in the Tampa, Florida, area. However, if she were under 65, that same plan would cost $479 a month.

 

There are no federal laws that say insurance companies have to sell Medicare Supplement policies to people under 65, and most states do not have laws about how much the plans can charge Medicare recipients under 65. Insurance companies don’t want to sell these plans to people with disabilities because they are high-risk customers. Because of this, Medicare Supplement Plans for Medicare recipients under 65 can be hard to find and can cost a lot more than in other states.

States with guaranteed issue and pricing regulations

In these states, Medicare Supplement policies must be sold to Medicare users under 65 with disabilities. These states also require insurance companies to keep policy costs low.

States with some Medicare Supplement availability

In these states, insurers must offer at least one Medicare Supplement insurance to people under 65 who are already on Medicare.

 

States where all 10 plans are available but cost more

In these states, insurance companies are required to offer all Medicare Supplement Plans to people under 65, but the states let insurance companies charge high rates.

 

States with variable availability and alternatives

In these places, Medicare enrollees who are under 65 and have a disability and don’t qualify for a full Medicare plan are not required to get a supplemental policy. However, these states have other kinds of insurance, like high-risk insurance pools, that can cover them.

 

States with no requirements

These states are not required to offer Medicare Supplement Plans to Medicare recipients under 65.

 

 

Finding the Right Medicare Option

Knowing that having ESRD or ALS won’t stop you from joining Medicare or getting coverage for your treatment should put your mind at ease. Depending on your condition, you may have to wait for coverage, but once you are ready for Medicare, you will have choices for more help. For example, you can sign up for a Part D plan to cover your prescriptions, and you can buy a Medicare Supplement Plan to help pay for your Part B out-of-pocket costs, since Part B only covers 80% of your medical bills.

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What Changes Can I Make During The AEP?

What Changes Can I Make During The AEP? text overlaying image of a street sign that say change of plan The Medicare Annual Enrollment Period (AEP) is a set period of time where you can change your Medicare benefits. Every year, the AEP lasts from October 15 to December 7. If you didn’t sign up for a Medicare Advantage plan or a Medicare prescription drug plan when you first became eligible for Medicare (during your Initial Enrollment Period), the AEP is usually your chance to do so, unless you apply for a Special Election Period (SEP). It also allows you to make any changes you need to tailor your Medicare coverage to your specific needs.

 

If you are eligible or already enrolled in any Medicare product you can use the AEP to move to a different Medicare plan, sign up for an entirely new plan, or drop out of a plan. This includes the ability to move from Original Medicare to Medicare Advantage, switch between different Medicare Advantage plans, and sign up for or change Medicare prescription drug coverage.

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Your AEP Options

During the Medicare AEP, you can move from Original Medicare (Parts A and B) to Medicare Advantage (Part C), or vice versa, if you already have Medicare. However, if you want to switch, you may also have to make some other choices. Depending on what kind of plan you’re switching to and from, you’ll have to make different decisions.

Original Medicare to Medicare Advantage

In this case, you have Original Medicare and want to move to a Medicare Advantage plan. You may also have a separate Part D plan for prescription drugs. Most Medicare Advantage plans include everything that you need. They pay for your Medicare Part A and Part B benefits, as well as Part D prescription drugs and other health services and things that Original Medicare doesn’t cover. Some of these other things are dental, vision, and hearing care, as well as gym memberships. There is also an annual out-of-pocket limit on Medicare Advantage plans to keep you from paying too much.

 

During the AEP you can move from Original Medicare to a Medicare Advantage plan. Depending on the Medicare Advantage plan you choose, you may no longer need a separate Part D plan if you already have one. With Medicare Advantage, you usually don’t need a separate Part D prescription drug plan because drug coverage is built in.

 

If you switch to a Medicare Advantage plan, the plan will work with Medicare to move your benefits over. You don’t have to get in touch with Medicare on your own. On January 1, your new plan will start to cover you. If you have a stand-alone Part D prescription drug plan or another private Medicare plan, you’ll need to call the plan provider directly to drop out. Just call the number on the back of your member ID card. During the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31, you can choose a different Medicare Advantage plan or switch back to Original Medicare.

Medicare Advantage To Original Medicare

Original Medicare only has Part A (coverage for hospital stays) and Part B (coverage for medical care). It doesn’t give you some of the things your Medicare Advantage plan might have, like coverage for prescription drugs, dental, vision, or fitness. Original Medicare also doesn’t have an annual out-of-pocket cap, so there is no built-in financial protection.

 

If you still want these things, you will need to buy extra coverage. For example, if you want coverage for prescription drugs, you will now have to find a stand-alone Part D plan and sign up for it. If you decide you need more coverage, you will need to choose a Medicare Supplement Plan and sign up directly with the plan provider. To make the switch to Original Medicare, you will need to call your Medicare Advantage plan provider or Medicare directly.

Switching Medicare Advantage Plans

Medicare advantage plans are pretty comprehensive, but there are still times you may want to switch to a different plan. Such as:

 

 

 

  • Moving to a plan that offers drug coverage
  • Moving to a plan without drug coverage
  • Switching to a plan that has dental or vision coverage

Aside from the AEP there are other times you can change your Medicare Advantage plan. During the Medicare Advantage open enrollment period, which runs from January 1 to March 31 every year, you can make changes to your plan at any time. The changes you make will go into action on the first of the month after you make them. You can also change your Medicare Advantage plan during a Special Enrollment Period if you have a big change in your life. Medicare may give you a special enrollment period if you move to a new place, if your coverage choices change, or if certain other things happen in your life.

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Enroll in a Medicare Supplement Plan

You can apply for a Medicare Supplement Plan at any time of the year, not just during the AEP. However, unlike Part D and Medicare Advantage plans, Medicare Supplement Plans don’t have to offer a yearly enrollment period like Part D and Medicare Advantage plans do. If you apply for a Medicare Supplement Plan after your six-month initial enrollment time has ended, the insurer is likely to use a process called “medical underwriting” to decide if you are eligible and how much you will have to pay. Some states have passed laws that make it easier for seniors to switch from one Medicare Supplement Plan to another by applying birthday rules or guaranteed issue rights. Both allow a specific amount of time where you can change your Medicare Supplement Plan without going through underwriting. 

Guaranteed Issue Rights

 

  • New York and Connecticut – Medicare Supplement Plans are guaranteed issue all year. 
  • Massachusetts – There is a 2 month period every year between February and March where plans are guaranteed issue
  • Maine – Participants can move to a different Medicare Supplement plan with the same or less benefits at any time during the year, and all carriers must set aside one month each year when Medicare Supplement Plan A is guaranteed to be available to all participants.
  • Missouri – There is an Anniversary Guaranteed Issue Period. Anyone with a Medicare Supplement plan has 60 days around the anniversary of their plan each year to switch to the same plan from a different insurance company.

Birthday Rules

  • California – The rule goes into effect 30 days before their birthday and stays in place for 60 days after. During this time, customers in The Golden State can switch to any plan with the insurance company of their choice that has the same or less benefits.
  • Oregon – The birthday rule starts on your birthday and lasts for 30 days after that. This gives you 31 days to change plans. It works like California’s and lets customers switch to any insurance company or plan with the same or less benefits.
  • Idaho – This rule goes into effect on your birthday and lasts for 63 days. You will be able to sign up for any plan with the same or less benefits. Also, the plan could be with any provider.
  • Illinois – This birthday rule only applies to people who are 65 to 75 years old. During this time, you can switch plans with your current insurance company. But the benefits of your new plan can’t be better than those of your old plan. This open registration period starts on your birthday and goes on for 45 days.
  • Louisiana – The time for the birthday rule starts 30 days before your birthday and ends 63 days after it. So, you have 93 days to change the plan you have now. During this time, you can switch to a policy with the same or less benefits through your present provider.
  • Maryland – The birthday rule for Medicare Supplement starts on your birthday and ends 30 days after that. Giving residents 31 days to sign up for a plan with the same or less worth.
  • Nevada – For at least 61 days, you can make changes to your plan. This window opens on the first of your birthday month. You can switch carriers or plans during this time, but the benefits of the new plan must be the same or less than what you get from your present plan.
  • Oklahoma – The 60-day window for the birthday rule starts on your birthday. During the 60 days, you can change your plan or provider. However, you can only switch to a plan with the same or less value than the one you have now.

Need Help?

Medicare is great, but sometimes it can be hard to understand. Even after you sign up during the AEP, you’ll still have to make some decisions about your health care. Don’t worry about asking questions. Talk to an EZ person who can tell you what you need to do to sign up and explain everything to you. EZ can help you sign up, buy a Medicare Supplement Plan, or just think about your choices. Our insurance brokers work with the best firms in the country. You can get a free review of all the plans in your area from them. We’ll talk with you about your medical and financial needs and help you find a plan that meets them all. Call one of our certified agents at 877-670-3602 to get started.

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Missed the AEP? Find Out What You Can Do

If you’re a Medicare beneficiary, you have a few opportunities throughout the year to enroll in, change, or drop your Medicare plan. One of the opportunities to do so is the Medicare Annual Enrollment Period (AEP) which runs from October 15th to December 7th. Because this period is such a short amount of time, many people accidentally miss it. So what happens if you missed the Medicare Annual Enrollment Period, but would like to make changes to your current plan?

Research Other Medicare Enrollment Periods

Although you might have missed the AEP, there are other Medicare enrollment periods that you might qualify for, including:ipad with a calendar pulled up on it

  • Initial Enrollment Period – This is when you have just become or are about to become eligible for Medicare. It begins three months before your 65th birthday and continues through the three months following.
  • General Enrollment Period – This runs from January 1-March 31 each year, and is an opportunity for individuals who didn’t sign up for Original Medicare when they were first eligible to sign up. It’s important to note that you might have to pay a late enrollment fee if you enroll after your Initial Enrollment Period, and your coverage will not start until July 1 of that year.
  • Special Enrollment Period – Certain life events can make you eligible to enroll in Medicare, such as moving, losing employer coverage, being diagnosed with a qualifying chronic condition, or moving in or out of a skilled nursing facility or long-term hospital care.

Speak With Your Doctor

If you have missed this year’s AEP, and you don’t qualify to change your coverage or can’t wait for another enrollment period, there are still ways you can lessen the burden of healthcare costs. One of the best ways is to speak with your doctor. Talk to them about your medications, for example: they might be able to find a generic version that will help you save hundreds of dollars each year. 

In addition, ask your doctor if certain medical services are required, and how you can save on those, particularly when it comes to how they are coded for billing.

Work With An EZ Agentillustration of a person working on the laptop with a network around

Missing the Medicare Annual Enrollment Period can cause a lot of stress. EZ.Insure offers agents in your region to help you and answer any questions you may have. Our agents are highly trained to provide you with the best option for your needs. Our agent will provide you with Medicare Supplement Plan quotes from top carriers in your area, and even help you sign up at no cost. To get free instant quotes on plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a local licensed agent, call 888-753-7207.

The AEP Is Almost Over! Have You Done Everything You Need to Do?

The Medicare Annual Enrollment Period (AEP) is the time to review your current plan and ensure it will still work for you for the coming year. But the AEP ends December 7, leaving you with a little less than a week to make any changes to your Medicare plan. Before this time is over, it is imperative that you do all of the following to make sure that you are fully and financially prepared for next year!

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It is very important to review your plan before the AEP runs out to make sure it meets your needs next year.

Review Your Current Plan

This is one of the most important things that you need to do during the AEP! Oftentimes people will not read the letters they receive about upcoming changes to their plan, but it is very important to review any correspondence that you receive in order to make sure that your plan will cover your medical needs in the coming year, and that you will be able to afford it. 

Review Your Healthcare Habits & Needs

Gather all of your healthcare receipts, and think back to all your doctor visits, specialist appointments, and any other health-related expenses from the last year. Then make a list of everything health-related that you think you will need or healthcare expenses that you anticipate for the coming year. Will your current plan cover these needs for next year? Or do you need to start searching for a plan that will? 

Check Your Coverage for Medications

If you regularly take prescription medications, you will need to make sure that your plan’s drug formulary includes these necessary medications. Different Medicare plans have different formularies, meaning each plan covers medications differently. Some plans might have your prescription on a different tier, making it less expensive. Make a list of all the prescription medications that you take, and compare plan formularies and pricing to make sure that your medications will be covered at a reasonable price.

list with a pencil
Remember to make a list of your doctors and specialists!

Make A List of Your Doctors & Specialists

Write down all of the medical providers that you visit, including your primary care physician, your hospital of choice, and any specialists that you see regularly. If you want to continue seeing the same providers, make sure they will still be covered by your current plan next year.  If not, it’s time to search for a plan that will cover them.

Talk With An Agent

The best way to find the right plan for you is to get personalized assistance from an EZ agent. There are 10 different Medicare Supplement Plans to choose from, which means there’s sure to be a plan that’s right for you. But that also means it can be confusing and time-consuming to compare and choose between them. That’s where EZ comes in! And our services are free because we just want to help you find an affordable plan with the coverage you need – no obligation, just free quotes. To get free instant quotes on plans that cover your current doctors, simply enter your zip code in the bar on the side, or to speak to a local licensed agent, call 888-753-7207.

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