simpsontruckdriver
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It's time to sit down with an agent. AEP starts on October 15, but you can talk to an agent beforehand to go over what is new and such. You can enroll in a plan then, then if you change your mind find another, repeating if needed, but the plan you're "stuck with" is the one that you're enrolled in on December 7th at 23:59:59. Unlike Group and ACA ("ObamaCare") plans, all Medicare plans are Guaranteed Renewable. What that means is, unless your insurer says they are cancelling the plan, you will stay on it. And in many locations, you have a choice of MAPDs, you can get an HMO (restricted) or a PPO. Some MAPD HMOs like United and Humana allow you to go to in-network providers in another region, but only temporarily. ER, hospitalization, and dialysis are always covered out of region. Definitely ask if you plan on traveling next year! Some have an HMO POS network, meaning you must choose in-network doctors BUT there are no referrals.
For Medicare Supplements, your enrollment window (Guaranteed Issue) is 2 months before your birthday, birth month, and 2 months after, as well as Annual Enrollment. You can leave your MAPD and switch to a MediGap plan and PDP during Annual Enrollment or Open Enrollment (01/01-03/31). On the other hand, if you decide to switch MediGap plans during the year, you're subject to underwriting, which usually means no pre-existing conditions are covered. Now, if you are under 65, disabled, and you have a MediGap plan, switching to an MAPD means you won't be able to get another MediGap plan until you hit 65 (very few states allow disabled MAPD members to switch to a MediGap plan). Unlike MAPDs which are regulated by the federal government, supplements are regulated by the state. Many states have either Issue Age (your premium is based on the age when you sign up) or Attained Age (premiums go up every year).
Then, there is the matter of Prescription Drugs (Part-D). No matter what, you MUST have either a MAPD or a Part-D plan once you get Medicare, you have 63 days from your first eligible month to sign up or else you will be charged 1% per month every month you do not have creditable Rx coverage. For example, if you did not have an Rx for 102 months, you're essentially paying $40-ish Late Enrollment Penalty + premiums for life. If you are disabled and don't take Part-D, everything resets at 65.
There are plenty of Special Enrollment Periods (SEP) throughout the year, and if there is a natural disaster in your area, Medicare may add one. The disaster ones extend your current enrollment period. So, let's say your birthday enrollment period ends this month and your area gets hit with a hurricane. CMS ("Medicare") would specify how long you have. But, if you don't qualify for an SEP when the disaster declaration is issued, that does not give you one.
If you currently make less than $19000 per year, you may qualify for Social Security Extra Help. They will eliminate any late enrollment penalties, erase the "Coverage Gap" (you pay the same for each tier of drugs until reaching the Catastrophic Phase), and possibly erase Part-B and/or Part-D premiums. Agents like myself suggest anyone having $$$ issues go ahead and apply, there may be state assistance available.
I think I covered it, definitely ask for more information! We can pretty much stop adding to my original post, that is last year's news!
TS
For Medicare Supplements, your enrollment window (Guaranteed Issue) is 2 months before your birthday, birth month, and 2 months after, as well as Annual Enrollment. You can leave your MAPD and switch to a MediGap plan and PDP during Annual Enrollment or Open Enrollment (01/01-03/31). On the other hand, if you decide to switch MediGap plans during the year, you're subject to underwriting, which usually means no pre-existing conditions are covered. Now, if you are under 65, disabled, and you have a MediGap plan, switching to an MAPD means you won't be able to get another MediGap plan until you hit 65 (very few states allow disabled MAPD members to switch to a MediGap plan). Unlike MAPDs which are regulated by the federal government, supplements are regulated by the state. Many states have either Issue Age (your premium is based on the age when you sign up) or Attained Age (premiums go up every year).
Then, there is the matter of Prescription Drugs (Part-D). No matter what, you MUST have either a MAPD or a Part-D plan once you get Medicare, you have 63 days from your first eligible month to sign up or else you will be charged 1% per month every month you do not have creditable Rx coverage. For example, if you did not have an Rx for 102 months, you're essentially paying $40-ish Late Enrollment Penalty + premiums for life. If you are disabled and don't take Part-D, everything resets at 65.
There are plenty of Special Enrollment Periods (SEP) throughout the year, and if there is a natural disaster in your area, Medicare may add one. The disaster ones extend your current enrollment period. So, let's say your birthday enrollment period ends this month and your area gets hit with a hurricane. CMS ("Medicare") would specify how long you have. But, if you don't qualify for an SEP when the disaster declaration is issued, that does not give you one.
If you currently make less than $19000 per year, you may qualify for Social Security Extra Help. They will eliminate any late enrollment penalties, erase the "Coverage Gap" (you pay the same for each tier of drugs until reaching the Catastrophic Phase), and possibly erase Part-B and/or Part-D premiums. Agents like myself suggest anyone having $$$ issues go ahead and apply, there may be state assistance available.
I think I covered it, definitely ask for more information! We can pretty much stop adding to my original post, that is last year's news!
TS
