If you are close to turning 65, you surely know that you will soon be able to apply for Medicare. It is likely that, from now on, you will constantly hear advertisements that speak of open enrollment in this federal health insurance program.
Medicare Open Enrollment
What is it about exactly? The Medicare Open Enrollment begins on October 15 and ends on December 7. At this time of year, health plans that supplement Medicare change their medical benefits. Many of them add benefits, while others do not, hence the importance of talking with an expert agent on the subject so that they can inform you about the changes these health plans will implement to this date.
During this time, you can also switch to or join a Medicare Advantage Prescription Drug Plan (MAPD), a Prescription Drug Plan (PDP), or return to your original Medicare. Changes made in this period will take effect on January 1 of the following year. Usually, everyone about to turn 65 must apply for the benefits Social Security Administration (SSA) offers seven months before reaching that age.
Suppose you have just become eligible for Medicare due to age or disability. In that case, you can generally apply for Medicare Advantage plan coverage close to the date your Medicare Part A and B coverage begins.
Please note that your Medicare Advantage plan cannot start before Part A and Part B coverage begins. However, a seven-month window to apply for coverage in a Medicare Advantage plan exists.
Also, consider that the SSA imposes lifetime penalties on anyone who turns 65 and does not subs-cribe to a medical or prescription plan when appropriate, according to their age. So please don’t waste time and call us to explain how to receive all the benefits that apply to you.
How to know if you need to change your Medicare plan
Refrain from settling for the current benefits you receive. You may have the opportunity to review your current plan and decide if it is the one that offers you the best help for the coming year. As we said, all plans update their benefits; some even reduce them. Your health insurance agent can help you compare your options for 2024.
Be ambitious and choose the plan that will bring you the most benefits for the coming year, and make sure all your specialists participate in the plan you like before making a final decision.
Of course, when you go to choose a plan, consider the following aspects:
- Prescription drugs: Does your plan cover all your drugs?
- Late enrollment penalties: In some situations, Medicare beneficiaries must pay a late enrollment penalty because they did not enroll in the drug plan when they became eligible. Or because they had a gap in coverage for a continuous period of 63 days or more when they didn’t have what Medicare defines as creditable prescription drug coverage.
- Effective dates: Coverage is generally effective on the first day of the month after you apply. However, if you enroll in a plan during the annual enrollment period (AEP), from October 15 to December 7, your coverage will be effective on January 1 of the following year.
Most Medicare Advantage plans require members to use network providers, except in emergency or urgent care situations (or if a plan has a Point-of-Service [POS] option).
Emergency or urgently needed services are always available inside and outside the service area and provided by the closest provider. You must use plan providers for immediate care when you are within the service area. Also, outside the service area, you can receive dialysis treatment from any qualified provider.
For more information on this topic, don’t hesitate to contact our medical benefits advisors. We work seven days a week and are ready to answer all your questions. Call us at (786) 290-5050. Don’t miss the opportunity to learn how to receive your Medicare benefits.