Medicare Services and Procedures

Medicare’s Annual Election Period, also known as the Open Enrollment Period happens each year from October 1 to December 7. It’s during this time that millions of beneficiaries will make changes to existing coverage or sign up for new plans. If you are a Medicare beneficiary, the Annual Election Period is an important time to pay close attention to changes in plans, including coverage and premiums, for the following year.

Must-know facts about open enrollment

When choosing your health coverage through Medicare, you should remember that Part A is hospital insurance and will protect you if you need to make a trip to the emergency room, or are admitted and must spend a few days under hospital care or in a nursing facility. Part B medical coverage and is what you need when making a trip to the doctor’s office.

Medicare Advantage plans, offered by private insurance companies, are another way to receive all of your Part A and Part B benefits, and it may also provide additional benefits, such as prescription drug coverage. If you have medications due to health conditions, you’ll want to make sure you have Part D coverage, either through a Medicare Advantage plan that offers it, or a stand-alone Medicare Prescription Drug Plan.

Each year, Medicare sends out an Annual Notice of Change to give you a list of changes that are taking place to your current plan, including information about copayments and premiums for next year. The notice also compares benefits for the next year, so it’s important to consider any changes in health conditions or needs. Insurers can change the drugs covered under Part D, procedures, rates, and even networks on a yearly basis.

Any beneficiaries who aren’t satisfied with their current plans offerings for the next year can switch now. You can join a Medicare Advantage or Part D plan for the first time, or unenroll from your current coverage and go back to Original Medicare.

Of course, anyone who is pleased with their current coverage, and wants to keep the same coverage for the following year, doesn’t need to make any changes during open enrollment for Medicare.

Warnings to beneficiaries

With this open enrollment season comes the chance that you may run into fraud. If someone comes to your door and offers to sell you anything to do with Medicare, don’t let them in. They aren’t allowed to solicit business at your home if they don’t have an appointment with you. You should also refrain from giving out personal information such as your Social Security number, Medicare ID, and bank account or credit card numbers.

Medicare tips for seniors

For seniors and other individuals looking to make changes during the Medicare Annual Election Period, here are some tips to ensure that they don’t get confused about insurance requirements:

  • The Annual Election Period opens October 15 and closes on December 7. If you choose to make plan alterations, your new coverage will begin on January 1 of the following year.
  • Seniors should know Medicare isn’t a part of the health insurance marketplace under the Affordable Care Act. If you have Medicare, then you’re covered under the new regulations and won’t be required to purchase a separate plan.
  • Review your Annual Notice of Change and Evidence of Coverage during open enrollment to make sure changes made to your current plans will not affect you negatively next year. If they do, you may want to go with a different plan, or if your health needs have changed and will no longer be met, you may need find one that will suffice.
  • Part B premiums generally change each year, with new premiums announced in the fall. This is the same for Part A premiums, if you are required to pay one, as well as deductibles and other costs associated with Original Medicare. Knowing all of your Medicare costs will help you make better decisions about any additional coverage you may need.
  • Beneficiaries with a Medicare Advantage plan may see changes in premiums, deductibles or copayments. There may also be changes in procedures, doctors and medical facilities that will be covered through your health insurance and some plans may even discontinue service. If this happens, you’ll want to be sure to shop around and find a plan that fits what you’re looking for in coverage. Understanding the details of each Medicare Advantage and determining which one will cover you the best is the most beneficial.
  • If you only have Original Medicare, you likely need to get prescription drug coverage if you don’t have any, else pay a late enrollment penalty. You may want to consider enrolling in a Part D Prescription Drug Plan for this coverage and comparing plans during this time to make sure you have the right plan for your medication needs.

Medicare has neither reviewed nor endorsed this information.