Medicare


The annual Medicare Open Enrollment period begins on October 15 and continues until December 7
For 2020 coverage, open enrollment will run from October 15, 2019, to December 7, 2019.

During the annual enrollment period (AEP)  you can make changes to various aspects of your coverage.

You can switch from Original Medicare to Medicare Advantage, or vice versa.  (ESRD patients are not able to switch from Original Medicare to a Medicare Advantage Plan for 2020.) You can also switch from one Medicare Advantage plan to another, or from one Medicare Part D (prescription drug) plan to another.
And if you didn’t enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

  • You must be enrolled in Medicare Part A and B.
  • You must live in the plan’s service area.
  • You cannot have End-Stage Renal Disease (some exceptions apply; ESRD patients will be able to enroll in Medicare Advantage plans as of 2021, under the terms of the 21st Century Cures Act).

Sources:
Open Enrollment Period - MedicareResources.org
Medicare Enrollment Plans - Medicare.gov 

Medicare is a federal health coverage program paid for through employment taxes and premiums. There are several parts to Medicare. You will be most familiar with the following:

Part A

Medicare Part A is hospital insurance for the aged, disabled and individuals who have ESRD. Part A helps pay for care in a hospital and skilled nursing facility and for home health and hospice care. There is no cost for Part A for individuals who meet the work requirement or who are the dependent(s) of an individual who meets the work requirement. Individuals age 65 or older who do not meet the work requirement may purchase Part A by paying monthly premiums.

Part B

Medicare Part B is medical insurance which helps pay for doctor bills, outpatient hospital care (including dialysis), and various other services not covered by Part A. To qualify for Part B, a person must be entitled to Part A. Part B is optional and requires the payment of monthly premiums.

Part D

Medicare Part D is a prescription drug plan for people with Medicare. Part D is optional. It requires selection of a plan. Depending on the plan, there may be a monthly premium, co-payments, or deductables.

Here are some resources that can help providers and patients better understand the prescription drug plans:

Medigap Plans (Medicare Supplemental Plans)


By a different federal law, those who are 65 can purchase a Medigap plan during the first 6 months they have Medicare. A number of states have regulations that allow those younger than 65 to purchase at least one Medigap plan during the first 6 months they have Medicare. You can see which ones at http://www.medicare.gov/find-a-plan/questions/medigap-home.aspx .

More information about Medigap coverage can be found at http://www.cms.gov/Medigap/.