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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, 2022.

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 2022?

COVID-19-related items & services. Medicare covers several items and services related to COVID-19. FDA-authorized vaccines are administered free of charge. Be sure to bring your red, white and blue Medicare card with you when you get the vaccine so your health care provider or pharmacy can bill Medicare. Diagnostic tests check to see if you have COVID-19 and FDA-authorized antibody tests to see if you’ve developed an immune response to COVID are both covered through Medicare. FDA-authorized monoclonal antibody treatments can help fight the disease and keep you out of the hospital if you test positive and have mild to moderate symptoms. Through Medicare you should pay nothing for this treatment.

Cognitive assessment & care plan services. Medicare now covers a separate visit with your regular doctor or a specialist to do a full review of your cognitive function, establish or confirm a diagnosis like dementia, including Alzheimer’s disease, and develop a care plan. You can bring someone with you, like a spouse or friend, to help provide information and answer questions. The Part B deductible and coinsurance apply.

Blood-based biomarker test. Medicare covers this lab test in certain cases (if available), once every 3 years. To be eligible, you must meet all of the following conditions: 1) you’re between 50-85 2) you show no symptoms of colorectal cancer and 3) you’re at average risk for colorectal cancer. You pay nothing for the test if your doctor or other qualified health care provider accepts assignment.

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.

The purpose of the update is to share some of our current views and research. Although we make every effort to be accurate in our content, the data is derived from other sources. While we believe these sources to be reliable, we cannot guarantee their validity.