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What is the Medicare Open Enrollment Period?

The Medicare Open Enrollment Period is the time during which people with Medicare can make new choices and pick plans that work best for them. Each year, Medicare plan costs and coverage typically change. In addition, your health-care needs may have changed over the past year. The Open Enrollment Period is your opportunity to switch Medicare health and prescription drug plans to better suit your needs.

When does the Open Enrollment Period start?

The Medicare Open Enrollment Period begins on October 15 and runs through December 7. Any changes made during Open Enrollment are effective as of January 1, 2021.

During the Open Enrollment Period, you can:

  • Switch from a Medicare Advantage Plan to Original Medicare
  • Add, drop, or switch your Medicare Prescription Drug (Part D) Plan (late penalties may apply if adding)
  • Make changes to a Medicare Advantage Plan

What should you do?

Now is a good time to review your current Medicare plan. As part of the evaluation, you may want to consider several factors. For instance, are you satisfied with the coverage and level of care you are receiving with your current plan? Are your premium costs or out-of-pocket expenses too high? Has your health changed, or do you anticipate needing medical care or treatment, or maybe you are on new or pricier prescription drugs?

Open Enrollment Period is the time to determine whether your current plan will cover your treatment and what your potential out-of-pocket costs may be. If your current plan does not meet your healthcare needs or fit within your budget, you can switch to a plan that may work better for you.

Be sure to also consider how these changes impact your eligibility for a Medicare Supplement Plan as medical underwriting may be required.

What’s changing for 2021?

Medicare Part B (hospital insurance) premium and deductible costs capped for 2021. A provision of the short-term government spending bill recently passed limits potential Medicare Part B premium and deductible increases to 25% of what they would otherwise be. Most Medicare costs for the following year are typically announced in late October or early November, so actual Medicare Part B costs for 2021 will not be available until then.

Expansion of telehealth services. Medicare Advantage plans may now cover a wider range of telehealth and other virtual services, including virtual check-ins and E-visits that allow you to talk with your doctor or other health-care providers using an online patient portal.

Medicare Advantage for beneficiaries with End-Stage Renal Disease (ESRD). Medicare-eligible individuals with ESRD are eligible to enroll in a Medicare Advantage plan during Open Enrollment. Plan coverage will start January 1, 2021.

Acupuncture coverage for back pain. Medicare now covers up to 12 acupuncture visits in 90 days for chronic low back pain.

Lower out-of-pocket costs for insulin. You may be able to join a drug plan that offers supplemental benefits for insulin (Part D Senior Savings Model). The copay for a 30-day supply of insulin will be $35 or less. Coverage will begin on January 1, 2021.

Part D late enrollment penalty

You can sign up for Part D coverage through Medicare with no penalty if you previously had “creditable” drug coverage. This refers to Medicare’s requirement to carry comparable coverage for at least 63 days in a row after your initial enrollment period. If you did not enroll in Part D at that time, and do not currently have a comparable drug program, you may have to pay a late enrollment penalty which is added to your monthly Part D premium for as long as you remain on Medicare.

Your initial enrollment period is the seven-month period that starts three months before you turn age 65 (including the month you turn age 65) and ends three months after the month you turn 65.

Where can you get more information?

Determining what coverage you have now and comparing it to other Medicare plans can be confusing and complicated. If you have questions, reach out to your Medicare Supplement Provider or your SFMG

Wealth Management Team for additional assistance with making these decisions.