Are you eligible for Medicare Open Enrollment?

The Annual Medicare Open Enrollment period takes place from October 15 through December 7. During the open enrollment period, those with Medicare can make changes and updates to their current Medicare coverage—Original Medicare, or Medicare Advantage—and enroll in new policies if they wish to do so.

Changes that are made to your Medicare plans will go into effect on January 1 of the following year. For instance, if you choose to change or update your plan on November 22, 2021, those changes will go into effect January 1, 2022.

Who is eligible?

Most Americans become eligible for Medicare when they turn 65. You qualify for Medicare if:

  • You are a United States citizen or a permanent legal resident who has lived in the United Stated for at least five years and;
  • You receive Social Security or railroad retirement benefits or have worked long enough to be eligible for those benefits but are not yet collecting them.
  • You or your spouse is a government employee or retiree who has not paid into Social Security but has paid Medicare payroll taxes while working.

While most Medicare recipients are over the age of 65 14% of all Medicare beneficiaries are under the age of 65. These recipients have become eligible after receiving Social Security disability benefits for two years or being diagnosed with ALS or end-stage renal disease.

You may be eligible to buy Part A if you did not pay Medicare taxes while you worked and you are 65 or older and a citizen or permanent resident of the United States. If you are under age 65, you can get Part A without having to pay premiums if:

  • You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You are a kidney dialysis or kidney transplant patient.

Which Medicare coverage is right for me?

After determining your eligibility, you should now determine which Medicare coverage you should enroll in.

  • To enroll in Medicare Advantage, you must be enrolled in both Medicare Part A and Part B. Your Medicare Advantage plan will take the place of both parts and will likely also include Medicare Part D prescription drug coverage.
  • You are eligible to enroll in Medicare Part D if you have Medicare Part A and/or Part B.
  • If you are enrolled in both Medicare Part A and Part B (but not Medicare Advantage or Medicaid), you are eligible to enroll in a Medigap plan to supplement your Medicare coverage.

o   You  have a six-month guaranteed-issue window during which you can sign up for any Medigap plan available in your area. if you decide to apply for a Medigap plan after that window ends, you’ll likely have to go through medical underwriting.

For more information on the Medicare coverage options check out Everything you need know for Medicare Open Enrollment

During Open Enrollment

What changes can be made to your current Medicare plan during open enrollment?

  • During the open enrollment period (October 15- December 7 every year), you can make a variety of changes to your current Medicare coverage—none of which involve medical underwriting.
  •  You have the ability to switch from Medicare Advantage to original Medicare or vice versa.
  •  You can switch from one Medicare Advantage plan to another Medicare Advantage plan.
  • You can join a Medicare Part D plan—late enrollment penalty may apply if you did not have credible coverage.
  • Change your Medicare Part D prescription plan to another.

o   It is recommended that beneficiaries utilize the Medicare’s plan finder tool every year to compare the available plans, instead of letting an existing drug plan auto renew to ensure your plan still fits your needs.

  • You can discontinue your Medicare Part D plan

o   Keep in mind that if you re-enroll in the future, you may incur a late-enrollment penalty if you are not maintaining other creditable drug coverage.

To find out if you are eligible for Medicare and which option would be the best healthcare coverage for you, contact our office to discuss with Julie Hasselbach.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
how can we help you?

Contact us at the Sprouse office nearest to you or submit a contact form.

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