Medicare 103 – Enrolling and Changing Medicare Plans

This is the 3rd of 3 basic Medicare educational modules.————————————-


Go Back to Medicare 102

Off the Starting Line

Let’s start with those of you who are new to Medicare this year. Maybe you know you’re in your Initial Enrollment Period (IEP) but maybe not. Either way we can look at the (pretty simple) process.

Initial Enrollment Period

IEP depends on your birthday and starts three months before your birth month and continues until three months after for a total of 7 months. 3 before + birth month+ 3 after = 7 total. Since it’s easy to do, my opinion is to get it done the first week you can.

There are just two steps to get you setup in Medicare for the plan year you turn 65:

  1. Enroll in Original Medicare
  2. Select a Medicare Advantage Prescription Drug (MADP) plan OR

    2a. You could choose to stay with Original Medicare only, purchase a standalone Prescription Drug plan, and perhaps purchase Medicare Supplement Insurance (Medigap). Medigap is a good choice for those who travel often and will need to get routine care in another part of the country.

The goal is to prepare so both steps to be easily completed in a morning. There are three Medicare “Parts” to consider as you enroll:

Part A: Hospital Insurance. Most everyone should enroll in Part A as quickly as possible. A hospital stay can be a savings buster. Medicare doesn’t coordinate with employer or union insurance; it is your primary coverage after age 65.

Part B: Medical Insurance. This means doctor visits and similar. If you are still covered under an employer or union plan, speak with your benefits administrator. It’s possible to delay Part B (and its premiums) till your employer coverage ends.

Part D: Prescription Drug Plan. Unless you have “creditable” coverage with some other plan, you’ll want to enroll in a plan. There are penalties if you wait. Most will bundle the prescription plan with Medicare Advantage, but standalone plans are available.

Social Security integration

If you already receive Social Security benefits, your enrollment in both Parts A and B is automatic. You should receive a packet near or before the beginning of your IEP.

The Enrollment Steps

Best bet is to enroll online. Social Security website provides a fairly clear checklist document. Medicare is a program of the Social Security Administration, so you’ll need a “my Social Security” account to get it done online. For the youngsters reading, it’s a good idea to create your online Social Security account at the earliest opportunity. It’s handy for retirement planning.

Here’s the link to create the my Social Security account: https://secure.ssa.gov/RIL/SiView.action. You’ll need (surprise) your Social Security number to create the account, plus an email address or mobile phone for security purposes. Security is tight; every single time you login, you will be required to receive and then enter a code to gain access.

Once the account is created, the checklist for the online Medicare application:

  • Date and place of birth.
  • Medicaid Number (if applicable)
  • Current Health Insurance info: Start and end dates of employment and start and end dates of the group insurance plan you’re in

This document at SSA.gov explains the process as well.

That’s it! You’ll be assigned a Medicare number and sent a card. Since it’s the 21st century, you’ll then want to create an online account at https://www.mymedicare.gov/

Shop for a Medicare Advantage plan

With your fresh new Medicare number, you’re free to shop online for a perfect Medicare Advantage plan. This site and many others are available that contract with many, if not all, of each state’s Medicare Part C companies. Humana, Aetna, Anthem, and UnitedHealthCare are among the biggest plan providers in the country. There are other choices and most of the others are regional.

Changing Plans for Ongoing Medicare Enrollees

Open Enrollment Period (OEP)

October 15, 2020 to December 7, 2020 will be Medicare Open enrollment period for 2021 plans. These six weeks are the most active period of the year when Medicare enrollees can shop for new plans. Coverage doesn’t begin till January 1, so it’s allowed to go in and out and make as many changes as necessary. Medicare Advantage plans renew automatically, so for those content with their coverage, they can watch the scramble from the sidelines. But…plans incrementally improve, so it makes sense to at least browse once, especially since it’s so easy to do by yourself online.

Medicare Advantage Open Enrollment Period

This period runs from January 1 to March 31 and applies to people on Medicare Advantage plans only (not Original Medicare). During this window, you’re allowed to make one change only, either to Original Medicare (rare) or to switch MA plans.

Special Enrollment Period

Throughout the year, certain circumstances affect plan enrollment and enrollees are allowed to make changes. The most common are moving to a new Medicare service area or going on (or off) Medicaid.

What’s Next?

If you feel comfortable enough with your knowledge of the possibilities, use this link (which will take you to another site) to shop for 2020 plans or just take a look at the system to prepare for 2021 enrollment.

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