Medicare Open Enrollment Period: How to Find the Right Coverage
If you’re a senior, you can apply for Medicare during a 7-month Initial Enrollment Period which begins 3 months before you turn 65 and ends 3 months after the month you turn 65. Remember that Original Medicare is Part A or Part A & B. If you fail to sign up in time for Medicare Part B, you may get a late enrollment fee, which you’ll have to pay for the duration of your coverage. If you wait to apply for Medicare until the month you turn 65 or in the 3 months after you turn 65, you may have a gap in health insurance due to a delay.
Open Enrollment (October 15 - December 7) applies to seniors who have Medicare and want to switch to private Medicare (Medicare Advantage) or if they want to buy Medigap to help pay towards copays and prescription drugs.
The annual Medicare Advantage Open Enrollment period (MA OEP) is from January 1 to March 31 and coverage begins in July. This individual Medicare Advantage Open Enrollment period is limited to new Medicare beneficiaries with both Medicare Part A and B, who enroll in a Medicare Advantage plan during their initial coverage period.
From October 15 - December 7, anyone with Medicare Parts A & B can switch to Medicare Part C (Medicare Advantage); anyone with Medicare Part C can switch back to Medicare A & B; anyone with Medicare Parts A or B can join, drop or switch a Part D prescription drug plan; and anyone with Medicare Part C can switch to a new Part C plan.
Do I Sign Up for Medicare During Open Enrollment? What’s an SEP?
As mentioned above, you should not wait for open enrollment to enroll in Medicare. Do it as soon as you are eligible. However, if you didn’t sign up when you first became eligible or if you aren’t eligible for a special enrollment period, you can sign up during the general enrollment period (GEP), which runs from January 1 to March 31 each year, and your coverage doesn't begin until the following July 1. You may be hit with late penalties that are added to your monthly Part B premiums for all future years.
You can sign up for Medicare under special circumstances, during Special Enrollment Periods (SEP), which depend on your circumstances, if you or your spouse (or any family member, if you’re disabled) is working. Or if you’re covered by a group health plan through your employer. You also have an 8-month Special Enrollment Period (SEP) that starts the month after you/your spouse’s employment ends along with its group health insurance.
You won’t be charged a late enrollment penalty if you sign up during a Special Enrollment Period.
Cobra and retiree health plans are considered eligible coverage. Only coverages based on employment are eligible as Special Enrollment Periods.
When Is Medigap Open Enrollment?
Your Medigap Open Enrollment begins the month you turn 65 and enrolled in Medicare Part B (Medical Insurance). If you haven’t yet bought Medicare, visit here. No matter what health you’re in, good or bad, you will pay the same as someone in perfect health, but only if you buy Medigap within your Open Enrollment period. If you try to buy Medigap after the Open Enrollment period, you will pay more, especially if you are in poor health. To find you the best rates, SmartFinancial compares Medigap quotes for if you fill out a form here.
In some cases, if you miss your Open Enrollment period for Medigap, you may be turned down by all insurers. In some states, you can buy Medicare SELECT. After your 12 months on that plan, you can switch to a standard Medigap plan.
How Do I Buy a Medigap Policy
You can begin a Medigap policy application by filling out a brief form here. A reliable agent will then help you fill out the official form and compare rates for you. Make sure you check over that agent’s work so all the information is correct. If you are within your Medigap period, there’s no worry about your answers being used to hike up the price.
Always pay the insurance company your Medigap payment, not the insurance agent. Some companies allow electronic funds transfers, but it’s also possible to pay by check or money order. Make the check out to the insurance company.
You can decide your effective coverage date, so keep that in mind when you speak with your agent and be sure to have that date entered for you. Otherwise, your Medigap policy becomes effective the month after you apply.
If your policy does not go into effect 30 days after you paid, call the insurance company.
If it’s been 60 days and you didn’t get your Medigap policy call your State Insurance Department.
Can I Switch Medigap Policies?
You have a 30-day period to see if you like your Medigap policy, no questions asked. However, if you go beyond that 30-day period, you cannot switch to a different Medigap policy unless you’re eligible under a specific circumstance that is relevant to the switch. You may also switch if you have guaranteed issue rights or you’re still within your 6-month Medigap Open Enrollment period. You also don’t have to wait after buying the first Medigap policy before switching to a new one.
If you decide to change insurance companies, you can have an agent help you after you fill out a form here. Once your application is accepted, you can call your current insurance company and end the coverage. Do not submit a request to end coverage until you’re sure you’ve been accepted with another policy.
You cannot have two Medigap policies at the same time. You will be asked to promise to cancel your first policy when you sign on for another one.
Can I Cancel My Medigap Policy?
You can cancel your Medigap policy any time. Just call your insurance company to cancel.
Can I Get Dropped by Medigap?
Usually, a Medigap company can’t drop you because it’s guaranteed unless you stop paying your monthly premiums or if you lied on your Medigap application. Of course, there’s the chance too, that your insurance company goes bankrupt or becomes insolvent. That’s why it’s important to buy Medigap from a trusted source.
If you bought your Medigap policy before 1992, it may not be guaranteed renewable. That means your Medigap insurance company can refuse to renew your policy, but only with state approval. If this happens, you can buy another Medigap insurance policy.
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According to a 2015 study, called Medical Spending of the U.S. Elderly, on average, people aged 65 and up spend over $18,000 a year on medical expenses. Yes, your parents may qualify for Medicare, but did you know that there are many areas they won’t have coverage?
Don’t miss Open Enrollment (Nov 1-Dec 15) because you may be stuck waiting another year to buy health insurance if you do. Do you want to be exposed to accidents and illnesses?
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A 65-year-old retiring in 2019 will spend about $135,000 to $150,000 in out-of-pocket medical costs during their retirement. This astronomical figure has gone up about $2500 since last year. Of course, these costs would be higher if you have an existing condition or if you live longer than the average American.
Like auto and homeowners insurance healthcare insurance also has a deductible which needs to be paid before insurance begins to cover expenses. However, healthcare deductibles work a little differently. For instance, your healthcare insurance will pay for some services even before you meet your deductible.
You may be shopping for health insurance because you got a new job, which doesn’t offer health insurance. Some people even prefer to have a health plan separate from their jobs. It’s usually a more expensive option to buy an individual health insurance policy when an employer offers to pay a portion of your premiums each month. However, some people prefer to choose their own insurance company and a plan that fits their needs.