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Understanding Medicare open enrollment can help you get the most out of this government-sponsored health coverage. Medicare's fall open enrollment period runs from Oct. 15 to Dec. 7 each year.
What is Medicare open enrollment?
People already enrolled in Medicare can make changes to their coverage each year during the annual Medicare open enrollment period from Oct. 15 to Dec. 7. It’s always a good idea to compare coverage and assess your health and prescription drug needs during this time “to make sure you have the Medicare coverage that’s best for you and your budget,” says David Lipschutz, associate director of the Center for Medicare Advocacy.
What can you do during Medicare open enrollment?
You can do the following during Medicare open enrollment:
Switch from Original Medicare to a Medicare Advantage plan, or vice versa.
Change from one Medicare Advantage plan to a different Medicare Advantage plan.
Change from a Medicare Advantage plan without drug coverage to a Medicare Advantage plan with drug coverage, or vice versa.
Enroll in a Medicare prescription drug plan.
Jump from one Medicare drug plan to a different Medicare drug plan.
Quit your Medicare prescription drug coverage.
If you return to Original Medicare during this period and you want Medicare Supplement Insurance, also known as Medigap, you may pay more than you expected for a supplement policy, or you may be denied coverage. (Starting the first month you have Medicare Part B, you have six months in which you can buy any Medigap policy available in your area, regardless of your health situation. After that, with the exception of four states, Medigap providers may require a medical exam and either charge you more or deny you a policy if your health is a concern.)
Coverage will begin Jan. 1 for all changes made by Dec. 7.
If you find that you’re not happy with your Medicare Advantage plan after the Medicare open enrollment period, you can make changes during the Medicare Advantage open enrollment period, which runs from Jan. 1 to March 31 each year.
What can’t you do during Medicare open enrollment?
If you aren’t enrolled in Medicare, you can’t sign up for it during this period because Medicare open enrollment is specifically for people who are already members. If you qualify for it, you’ll need to sign up for Medicare during your initial enrollment period, during Medicare’s general enrollment period, or during a special enrollment period.
What parts of Medicare can you enroll in?
Here are the types of Medicare coverage available during the Medicare open enrollment period:
Original Medicare consists of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Everyone must first enroll in these two parts, and pay the Part B premium, before selecting additional coverage options. (If you're currently enrolled in a Medicare Advantage plan, you have the option to switch back to Original Medicare during Medicare open enrollment.)
Medicare Advantage (also known as Medicare Part C) plans are sold by private insurers as an alternative to Original Medicare. Medicare Advantage plans may offer additional benefits, including some cost-sharing for dental and vision care. And Medicare Advantage policies usually incorporate Part D prescription drug coverage into the plan.
Medicare Part D prescription drug coverage (stand-alone policies) are also administered by private insurers. Part D is an optional program that helps cover the cost of your prescription drugs. (You may owe a penalty if you go without Medicare drug coverage or other creditable prescription drug coverage for 63 or more consecutive days.)
Medicare Supplement Insurance plans, also known as Medigap plans, help pay your share of out-of-pocket health care costs incurred with Original Medicare parts A and B. If you have Original Medicare, you can apply for Medigap at any time, though you're generally only guaranteed a policy during your six-month Medigap open enrollment period, which starts the first month you have Medicare Part B.
Note: If you’ve claimed Social Security or Railroad Retirement Board benefits before reaching age 65, you’ll automatically start receiving Original Medicare (parts A and B) the month you turn 65. You will be able to opt out of Part B if you have other qualifying health insurance, but Part A comes attached to Social Security benefits.