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 planThe 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.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

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.

Compare Medicare Supplement Plans in 3 Easy Steps

  • Let us help you find the right Medicare Supplement coverage for you

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.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

Medicare Annual Enrollment (AEP) Guide

Medicare Annual Enrollment (AEP) Guide text overlaying image of a senior couple walking together in a fieldMedicare’s Annual Enrollment Period (AEP) is here, so don’t worry if you missed your initial enrollment period, you’ve got time! You’ve probably seen all the ads urging anyone eligible to enroll or make changes, but what is the AEP, and how can you make sure you’re enrolling in the right plan? Well, you’re in the right place for those answers. This guide will show you how, when, and what changes you can make to your current Medicare health plan or prescription drug plan for 2024. You’ll get answers to all the important Medicare AEP questions so you can make the best choices.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

What Is The Annual Enrollment Period?

For Medicare, this happens every year from October 15 to December 7. People might also call AEP “Open Enrollment” or “Fall Enrollment Period.” All people who are eligible for Medicare can sign up or make changes during this time, and your new coverage will start on January 1 of the next year.

What Can I Do During The Annual Enrollment Period?

You can use the AEP to initially enroll in Medicare. You can also use the AEP to sign up for a Medicare Supplement Plan or Advantage Plan if you already have Medicare Parts A and B. On the other hand, you can also drop your current Medicare Supplement Plan or drop your Medicare Advantage Plan and go back to Original Medicare if you choose. 

Enrolling in Medicare

Medicare is a government program that helps pay for health care for people 65 and older or younger people with certain disabilities or health problems. The 4 Different parts of Medicare cover different kinds of medical treatments.

 

  • Medicare Part A – Medicare Part A pays for short-term inpatient care in a hospital, skilled nursing center, or nursing home, as well as hospice care and some home healthcare.
  • Medicare Part B – Medicare Part B pays for doctor visits and other outpatient services, as well as mental health care, ambulance transfers, durable medical equipment, lab tests, and preventive screenings. Parts A and B are sometimes called “original Medicare” to set them apart from Medicare Advantage plans that are run by private companies.
  • Medicare Advantage (Part C) – Medicare Advantage plans are an option to replace original Medicare. They are offered by private insurance companies in accordance with Medicare rules. Participants usually pay less out of pocket, but service is usually limited to providers in the network.
  • Medicare Part D – Coverage for prescription drugs. To sign up for Medicare Part D, you need to have either standard Medicare or a Medicare Advantage plan.
  • Medicare Supplement – Medicare Supplement Insurance is sold by private companies. It pays for some of the costs that original Medicare doesn’t cover, like deductibles, coinsurance, and copays.

Comparing

During the Annual Enrollment Period, one of your biggest decisions is whether it’s better to go with Original Medicare with a Medicare Supplement plan or a Medicare Advantage plan. Knowing the different types of coverage can help you decide which one makes the most sense for you. Here’s a look at how they compare.

Original Medicare

  • Allows you to use any doctor, hospital, or other health care provider who accepts Medicare and is taking on new patients.
  • Coverage for Parts A and B of Medicare.
  • There’s no need to pick a primary care doctor, and most of the time, you don’t need a referral to see a specialist.
  • Most of the time, you pay a deductible, co-pays or co-insurance, and Part B premiums.
  • Medicare Part D is not included.

Most people who have Medicare Part A benefits do not have to pay a premium. In 2024, the standard monthly premium for Medicare Part B is $179.80, but if you make more, your payment may be higher. The Part B deductible in 2023 was $226 and should be close to the same for 2024. There are deductibles and charges for both Parts A and B. The 2024 prices have not been announced yet but they should be close to the 2023 amounts. Part A charges in 2023:

 

  • Benefit period deductible was $1,600.
  • Hospital stay days 1-60 had no coinsurance per benefit period.
  • Days 61-90 has a $400 per day coinsurance per benefit period.
  • Days 91 and over had $800 coinsurance per lifetime reserve day used (up to 60)
  • Once you’ve used all of your lifetime reserve days the patient pays all costs

Medicare Supplement

  • Fills in the coverage gaps left by Original Medicare
  • Medicare is billed first for health care services, and the Supplement Plan is billed second.
  • Out-of-pocket costs will be based on what’s left after Medicare and the Supplement Plan pay their share.

Medicare Supplement plans vary based on the insurer and the plan you choose and where you live. To find out more about Medicare Supplement costs click here for our state-by-state Medicare Supplement Guide.

Medicare Advantage

  • Usually, you have to use doctors, hospitals, or other health care workers that are part of the plan’s network. There may be a fee if you go to a service that is not in your network.
  • Required to cover the same essential services Original Medicare does.
  • Depending on plan and provider, you may need a referral for specialists.
  • Plans have different out-of-pocket costs, but some may limit how much you have to pay each year.
  • Most plans cover medications through Medicare Part D.

How much you pay for a Medicare Advantage plan (Medicare Part C) depends on the plan you choose. Members of Medicare Advantage are still responsible for paying their Medicare Part B payments, but some plans may pay some or all of them on their behalf. This is called a “Medicare giveback benefit” in the insurance world. Some Medicare Advantage plans may have a monthly fee on top of what you already pay, but most don’t. Deductibles, copayments, and coinsurance costs can also be different.

Compare Medicare Supplement Plans in 3 Easy Steps

  • Let us help you find the right Medicare Supplement coverage for you

AEP Tips

Your Medicare plan will automatically continue at the start of each year unless you change it, but you might not get the same benefits. Every year, insurance companies look at the perks of their Medicare plans and make changes. Instead of just letting your plan keep going, you should make sure it still meets your wants. During the Medicare Annual Enrollment Period (AEP), you can change your plan if you want. Here are some tips to help you make decisions about your Medicare coverage during AEP that are based on accurate information.

Check Your Current Plan Changes

Each year, your Medicare Advantage plan (Part C) or Medicare prescription drug plan (Part D) may change how much it covers or how much it costs. Changes go into action on January 1, so you need to be aware of them when making decisions during AEP. Changes to a plan may include adding new benefits, taking away benefits that were previously offered, updating the list of drugs that are covered, and lowering or raising prices. Plans will send you a letter called an Annual Notice of Change (ANOC) that explains any changes to your benefits or costs for the next year. Plan members usually get ANOC letters in September. Read it carefully and get in touch with your plan provider if you don’t get one.

Review Your Handbook

“Medicare & You” is the government’s official guide to Medicare. It covers coverage, costs, enrollment, and more. Every year, it’s changed. The guide shows what’s new with Medicare and what, if any, big changes are coming in the next year. Changes to Medicare rules or policies could affect your benefits, costs, or other parts of your health care, so it’s important to stay up to date.

Review Your Plan

Now that you’ve looked at plan changes and gone over what your plan covers it’s time to look at your present plan more closely. Start by figuring out how well your current Medicare plan will work for you in the coming year. If your plan still seems like the right choice, you don’t have to do anything during AEP to keep it. You’ll stay on the plan as long as you keep paying your fees and other costs.

Shop Around

If you think your plan won’t meet your requirements anymore, you should look for one that will. Even if you think your current plan will still meet your needs, you may want to look around to see if you can find one with better features or lower costs. Every year, on October 1, insurance companies release new information about their Medicare plans. They are competing for your business, so don’t be afraid to look at all of your choices.

What If I Miss The Annual Enrollment Period?

During the Medicare Annual Enrollment, you can change your Medicare Parts A or B coverage. From October 15 to December 7, anyone can sign up. People who have private Medicare Advantage plans have their own open enrollment time, which runs from January 1 to March 31. If you miss your open enrollment time, you usually have to wait until the next year to make changes. However, there are some cases where you can make changes before the next year. Special Enrollment Periods (SEPs) are times when you can make changes to your benefits. You might be able to get an SEP if you:

 

  • Move to a place that isn’t in the service area of your present plan.
  • Move to a new area that gives your current plan new coverage choices
  • Are let out of prison
  • Move into or out of a nursing home with skilled care
  • Move back to the United States after living abroad
  • Leave coverage through a company or COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage
  • Stop being covered by the Program of All-Inclusive Care for the Elderly.
  • Used to be able to get Medicaid, but now you’re not.
  • Are registered in a Medicare Advantage plan or Part D plan that hasn’t been renewed
  • Both Medicaid and Medicare are available to you.

These are just some of the times when you might be able to change your Medicare plan outside of the Annual Enrollment Period. On the Medicare page, you can find out more about these times.

Getting Medicare With EZ

EZ can assist you in enrolling in Medicare, purchasing a Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. They can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs and help you find a plan that meets your needs. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

Most Common Medicare Mistakes

Most Common Medicare Mistakes text overlaying image of a older man worried Medicare is the nation’s health insurance program for seniors 65 and older. It also provides coverage for younger people who meet specific eligibility criteria. Medicare Parts A, B, C, and D cover a large variety of your major medical expenses. It’s a great program but it can be difficult to read through all of the plans, options, and rules. This can make it difficult to choose the right plan on time. Below we’ve outlined some of the most common Medicare mistakes so you know what to avoid and not wind up with penalties, coverage delays or gaps.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

Signing Up Late

Medicare has specific deadlines to enroll. Your Initial Enrollment Period (IEP) happens when you first become eligible for Medicare. It starts 3 months before your 65th birthday, including your birth month, and then ends 3 months after you turn 65. This gives you 7 months to enroll. If you’re receiving Social Security benefits then you will be automatically enrolled and you don’t have to do anything or worry about the deadlines, Social Security handles enrollment for you. However, if you are not automatically enrolled you have to apply yourself during your IEP. If you miss the IEP you do have another opportunity between January 1st and March 31st called the General Enrollment Period (GEP).

 

Missing these enrollment periods is one of the most common and costly mistakes people make. If you miss both enrollment periods you can face late enrollment penalties for Medicare Parts A, B, and D. It’s important to note that there is a way to avoid these penalties. If you qualify for a Special Enrollment Period (SEP) then you will be able to enroll in Medicare penalty free with all the same benefits as when others enroll during the IEP. 

SEP Types

  • Qualifying life event – If you have a qualifying life event then you qualify for a 2-month SEP where you have 2 months to enroll in Medicare. The most common qualifying events are:
    • You moved out of your current plan’s service area
    • Your plan no longer serves the area you are in
    • If you decide to switch from Medicare Advantage to Original Medicare within 12 months of enrolling in the Medicare Advantage plan.
    • You move into or out of a facility such as a nursing home
    • If you’ve lost Medicaid eligibility 
  • Working past 65 – If you decide to continue working past 65 and have creditable coverage through your or your spouse’s employer’s health plan then once you leave your job you will open an 8-month SEP. This SEP does have a stipulation, if you want Part D you have to enroll in it within the first 2 months of your 8 month SEP, otherwise you still face penalties. Your 8 months begin the day you no longer have credible health coverage.

Medicare Part A Penalty

Some people qualify for Part A premium-free. If you’ve worked and paid into Social Security and Medicare taxes for at least 40 calendar quarters, then you are eligible for Railroad Retirement benefits (RRB), or have a spouse that qualifies for premium-free Part A then you will get Part A for free. However, if you don’t and have to pay for Part A, then you can face a 10% increase on your premium for missing the IEP. This penalty stays with you for twice the number of years that you were eligible and didn’t sign up. For instance, if you were eligible for Part A for 3 years and did not enroll, you’ll have the penalty for 6 years.

Medicare Part B Penalty

If you miss your enrollment period and don’t qualify for an SEP, you will face a Part B penalty. This penalty is a 10% increase for every year you did not sign up. For example, say you waited 2 years to enroll. You’re looking at a 20% increase in your premium, 10% for each of the 2 years you delayed. The standard Part B premium for 2023 is $164.90, plus adding the 20% will bring your premium up to $197.88 which will be rounded up to the nearest $.10, making it $197.90 for part B. That’s $32.98 extra every month that you could have saved by enrolling on time. Now that might not seem like a lot, but if you look at it on a yearly basis that is $395.76 a year!

Medicare Part D Penalty

The amount of the penalty depends on the length of time that you did not have Part D or a creditable prescription drug plan. Medicare determines the penalty amount by multiplying 1% of the national base beneficiary premium ($32.74 in 2023) by the number of full months you went without drug coverage. The penalty amount is then rounded to the nearest $.10 and added to your monthly premium. The national base beneficiary premium can vary from year to year, so your penalty will change with it.

 

For example, say you waited 14 months to enroll in Part D and didn’t have creditable drug coverage for any of that time. You’ll have to pay a 14% penalty. For 2023 that would be $4.58 rounded up is $4.60 extra on your premium.

 

Compare Medicare Supplement Plans in 3 Easy Steps

  • Let us help you find the right Medicare Supplement coverage for you

 

Assuming Spouse Coverage

Assuming your spouse is covered by Medicare because you have it or vice versa is a big mistake. It could leave you or your spouse without insurance. Medicare doesn’t work the same as an employer group plan. Meaning it won’t cover your family, it only applies to the individual who enrolls. If you worked and paid your Medicare taxes for the last ten years then at most your spouse who is 65 will be eligible for premium-free Part A. If your spouse is under 65, they need to find their own coverage elsewhere, such as a plan from the Health Insurance Marketplace, their own group plan, or COBRA. Additionally, if your spouse is under 65 they still may be eligible under certain conditions. Medicare is available to anyone who receives Social Security Benefits for at least 24 months, has End-Stage Renal Disease (ESRD), or Amyotrophic Lateral Sclerosis (ALS).

Not Weighing Your Options

There are many options to choose from with Medicare. There’s Original Medicare, Medicare Advantage, and Medicare Supplement Plans. It’s important that you know the differences and their benefits. If you make the mistake of not weighing your options you can leave yourself with large gaps in your coverage or end up paying far more than you need. Below we’ve outlined these plans to give you a starting point.

Original Medicare

Original Medicare, also known as traditional Medicare, consists of only Parts A and B. Medicare Part A is hospital insurance, and it covers hospital inpatient care and skilled nursing facility care. Part A coverage typically includes the following:

 

  • Semi-private hospital rooms
  • Hospital meals
  • Inpatient lab tests and X-rays
  • Operating room and recovery room services
  • Drugs and medical equipment used while in the hospital or skilled nursing facility
  • ICU care
  • Skilled nursing services
  • Hospice care

Part B of Medicare covers your general medical expenses. Such as doctor’s visits, urgent care, and specialists. Typically Part B covers:

 

  • Doctor visits and services
  • Some preventative screenings and services
  • Ambulance services
  • Outpatient surgery services
  • Mental health care
  • Some durable medical equipment
  • Some medically necessary tests such as X-rays, MRIs, CT scans, and EKGs

Medicare Advantage

Medicare Advantage, commonly known as Part C, is a type of Medicare plan that is offered by private insurance companies. These companies have a contract with the Medicare program that ensures the plans they offer comply with Medicare’s regulations. Medicare pays a set amount to the insurers for each participant enrolled in the plan. Additionally, you will pay your medical bills directly to your insurance company while your insurance provider must follow Medicare’s regulations. They are allowed to set their own rules for out-of-pocket expenses as well as decide if you need a referral to see specialists.

Medicare Supplement Plans

Medicare Supplement Plans are plans that you can buy to supplement your Original Medicare. These plans fill in any gaps in coverage, ensuring you get the most coverage for all the medical needs you specifically have. You do have to pay a monthly premium for these plans, and you must enroll in both Part A and Part B to be eligible for a Medicare Supplement Plan. However you may end up paying less than you would overall with your Original Medicare because Medicare Supplement Plans all have benefits that cover a lot of the out-of-pocket costs for Part A and B. One of the biggest advantages with Medicare Supplement is the variety. There are 10 plans to choose from and all of them cover different benefits at different amounts. It’s important you look through these plans and compare to tailor your coverage specifically to what you need.

Working With EZ

In order to save as much as possible during your Medicare journey, it’s important to keep all of these mistakes in mind. You can rely on EZ if you have any questions or need help choosing your plans. Whether you’re looking for help enrolling, or just need some information. Give us a call today at 877-670-3608 to speak to your own Medicare Agent or you can get free instant quotes by entering your zip code in the box below.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

Medicare Myths Debunked

medicare myths debunked text overlaying image of wooden blocks spelling out the words myths and factsYour Initial Enrollment Period (IEP) is an important time if you’re considering your Medicare options. It’s natural that everyone has their own opinions regarding Medicare and the best coverage. While advice from family and friends can be helpful, when it comes to Medicare, there are a lot of myths passed around. Maybe you’ve come across information on social media or in conversation and wondered “Is that really true?”. You deserve accurate information about your coverage options so we’ve compiled a list of 10 common myths that we’d like to debunk for you.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

Medicare Myths

1.Medicare is free.

There’s a misconception that since Medicare is a government benefit, seniors don’t have to pay for it because it has already come out of their taxes. While that would be great, it’s unfortunately not entirely true. Medicare Part A, or hospital coverage, doesn’t have any premiums. That is as long as you have paid your Medicare taxes for at least 40 calendar quarters. Even so, you still have a deductible and copays. So that part of the myth is kind of true. 

 

However, Part A is the only Medicare product with no premium. Part B, medical coverage, has a monthly premium of $164.90 as of 2023. It’s important to note that the premiums are adjusted annually, meaning some years they increase and some years they’ll decrease. These premiums might also be higher for enrollees with higher income. The good news is that if you’re on Social Security, your Part B premium can be paid directly from those benefits, so while you may not be paying directly out of pocket, you are still paying for it. Additionally, if you choose the Medicare Advantage route you may also have to pay a monthly premium.

2. Medicare covers all healthcare costs.

Medicare does cover a large portion of your healthcare but not everything. Between Part A and Part B most of your hospital and basic medical expenses are covered. 

This includes:

 

  • Hospital care
  • Skilled nursing facilities 
  • Hospice
  • Lab tests
  • Surgeries
  • Home health care
  • Doctor visits
  • Outpatient care
  • Durable medical equipment
  • Some preventative services

 Even with the services it does cover you are still responsible for deductibles, coinsurance, and copays. As you can see there are still several services that you may need that aren’t covered. Such as hearing, vision, and dental care. There is also no prescription drug coverage in Original Medicare (Part A and B). Typically to get those things covered most people will enroll in Medicare Advantage, Medicare Part D (prescription drug coverage), or a Medicare Supplement Plan. Any of those options do provide coverage for the gaps in your Medicare coverage.

3. You are automatically enrolled in Medicare.

This is another myth that is only partially true. If you have been receiving Social Security benefits or Railroad Retirement Board Benefits (RRB) for at least 24 months after you turn 65, then you will automatically be enrolled in Medicare Part A and B. Be aware that even after automatic enrollment, you are responsible for enrolling yourself in either Medicare Advantage, Medicare Part D or any Medicare Supplement Plans. 

 

Now, if you’re not receiving Social Security or RRB, then enrolling is entirely up to you. The best thing to do is to enroll during your IEP, which will begin 3 months before you turn 65 and will end 6 months after your 65th birthday. 

4. I can enroll in Medicare at any time.

This is completely false and can be one of the most detrimental myths to believe. If you don’t enroll during your IEP, you can face enrollment restrictions as well as a penalty. You will then have to wait for the next eligible enrollment period, which is known as the General Enrollment Period (GEP). The GEP lasts from October 15th to December 7th every year. The penalty for waiting is a premium increase of 10% for twice as many years that you were eligible and did not enroll. To make that simpler, If you did not enroll in Part A for 2 years after your IEP then the penalty would apply to your premium for the next 4 years. For Part B, the increase only lasts for the amount of time you did not enroll, so it would only apply for those first 2 years.

 

Now having said that, another way that you can avoid these penalties, aside from applying on time, is if you qualify for a Special Enrollment Period (SEP). To trigger an SEP you would have had to still be working and have credible health coverage through your employer or through your spouse’s employer during your IEP. Once you leave your job or lose the group plan coverage, you then have 8 months to enroll without penalty. Another way you can get an SEP is if you are under 65 and eligible for Medicare due to illness or disability, but have health insurance through a caregiver or spouse’s employer-sponsored health insurance. However, this only applies if their company has at least 100 employees.

 

Compare Medicare Supplement Plans in 3 Easy Steps

  • Let us help you find the right Medicare Supplement coverage for you

 

5. Medicare costs the same for everyone.

While Medicare offers the same benefits to everyone, the cost is not universal. How long you worked and paid Medicare taxes, as well as your gross income determine your premiums and deductibles. The more you make, the more you will end up paying just like with regular health insurance. Additionally enrolling in Medicare Advantage, or Part D, or any Medicare Supplement Plans will change how much you pay for Medicare. So it varies greatly from person to person depending on their specific circumstances.

6. I can only enroll if I’m healthy.

This is a huge myth, Original Medicare cannot deny your coverage due to illness or a pre-existing condition due to implementation of the Affordable Care Act. If you have certain medical conditions like End-Stage Renal Disease (ESRD) or ALS, you are eligible for Medicare even if you aren’t 65 yet. Once you turn 65 or retire you are eligible for Medicare Parts A and B, period. Also,there are no penalties or premium increases for pre-existing conditions. If you have certain medical conditions like End-Stage Renal Disease (ESRD) or ALS, you are eligible for Medicare even if you aren’t 65 yet. 

7. Medicare Advantage and Medicare Supplement Plans are the same thing.

This is not true at all. They are similar in that private companies offer them but they are entirely different. Medicare Advantage is an alternative to Original Medicare. It may include prescription drug coverage. Medicare Supplement Plans are additional coverage you can buy to fill in the gaps left by your Original Medicare. Additionally, you can buy one or the other but not both. 

8. Medicare doesn’t have as many options.

You may believe that Medicare is a one-size-fits-all program because it’s a government program. However, this is another one of those pesky Medicare myths. Medicare typically provides significantly more health insurance options than your employer’s group coverage. Whereas you may have had only a few plan options to choose from when enrolling in employer coverage, Medicare provides you with dozens of options. Medicare allows you to tailor your coverage to your specific needs.

9. Medicare will notify me when it’s time to enroll.

Obviously you don’t want to be late enrolling in Medicare. Nobody wants to have a penalty added to their premium. Unfortunately, Medicare does not give you an enrollment reminder when it’s time for you to enroll. The good news is that if you have Social Security Benefits or RRB before you’re 65, you will automatically enroll in Medicare Parts A and B. On the other hand, if you don’t have those benefits you have to remember to enroll on your own. So, it’s important that you note the specific times when you can enroll. 

10. I am on COBRA so I don’t need to sign up for Medicare Part B.

COBRA does not count as active employment. To delay Part B enrollment without incurring a penalty, you or your spouse must be actively employed and covered by a group health plan. Additionally, if you are already on COBRA and your Medicare begins, your COBRA status will change when you turn 65. Meaning your COBRA coverage will end. You won’t be eligible to delay Part B without incurring a penalty. You may even experience a delay in the start of your Part B coverage, which could result in a serious coverage gap.

EZ Can Help

Now that you have all the facts it’s time to enroll with the help of EZ. EZ is able to help you enroll in Medicare, purchase a Medicare Supplement Plan, or just help you weigh your options. Our insurance agents collaborate with some of the most reputable insurance providers in the country. They are able to provide you with a free analysis that compares all of the plans that are available in your region. We will discuss your medical and financial needs and then assist you in locating a plan that is tailored to meet those requirements. To start, enter your zip code into the box below. Or give one of our licensed agents a call at 877-670-3602 and we’ll get the ball rolling for you.

Compare Medicare Supplement Plans Online

  • Let us help you find the right Medicare Supplement coverage for you

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.

Are Medicare Parts A & B Enough?

If you’re enrolled in Medicare, you have the ability to change your plan once a year during the Medicare Annual Enrollment Period (AEP). The AEP is less than 2 months long, lasting from October 15 to December 7, and is the time to review your Medicare options and find ways to save money on medical expenses: for example, if you only have Medicare Parts A and B, you could be missing out on hundreds of dollars of savings. EZ can help you save money by assessing your financial and medical needs during the AEP.

Medicare Parts A & B Coverage

stethoscope
Medicare Parts A & B will cover hospital and medical insurance, but will not cover anything.

If you’ve been enrolled in Medicare for a while, you probably have a good understanding of how it works, but it’s always helpful to have a refresher, because Medicare can get complicated. So, Medicare Part A is hospital insurance, and Part B covers other medical expenses; both allow you to use almost any hospital or doctor within the United States that accepts Medicare assignment. 

As far as out-of-pocket costs go, generally there is no monthly premium for Part A, but there is a deductible for each benefit period. Part B has an annual deductible, a monthly premium based on your income, and a 20% coinsurance, meaning you will have to pay 20% of your medical expenses, which can add up to quite a lot, especially if you have a chronic condition or illness.

What You Can Do To Save More

During the AEP, you have the option to make changes to your Medicare coverage: for example, you can change from Original Medicare to a Medicare Advantage Plan, switch Medicare Advantage Plans, enroll in a Part D plan, or change prescription drug plans. But what if you’re not interested in  switching to a Medicare Advantage Plan and want to stick with Original Medicare, but want to save money on your out-of-pocket expenses? Well, what a lot of Medicare beneficiaries do not know is that they can buy a Medicare Supplement Plan during the AEP. These plans help fill the gaps in Original Medicare and can save you hundreds of dollars each year because they cover some or all of your:

  • Part B coinsurance
  • First three pints of blood
  • Part A hospice coinsurance

Some plans will offer additional benefits, including covering your:

  • Part A deductible
  • Part B excess charges
  • Skilled nursing facility coinsurance
  • Foreign travel emergencies that do not qualify for Medicare reimbursement from Medicare Parts A or  B

These plans are a great way to save on medical expenses, but be aware that if you are signing up for a Medicare Supplement Plan outside of your Open Enrollment window (the month you turn 65 and the 5 months after that), you might be subject to underwriting, meaning that the insurer might ask you some health questions in order to determine the price of your premiums.

Work With An Agentillustration of a woman pointing towards money and statistics next to her

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 them and figure out which one you should choose. To make the process easier for you, work with a licensed EZ agent. Our agents are highly trained, and work with the top-rated insurance companies in the nation; your dedicated agent will assess your medical needs and help you find a plan that will save you as much money as possible, which is important if you are living on a fixed income. 

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.