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Understanding Your Senior’s Medicare Open Enrollment

Understanding Your Senior’s Medicare Open Enrollment

Managing medical needs and paying for care are common caregiver duties. Medicare open enrollment gives you the chance to ensure that your loved one’s health plan covers her needs without paying for options she isn’t using. During the open enrollment window, any senior on Medicare can sign up for a new plan or change her coverage. In most cases, no changes are needed. However, it’s still a good idea to review the plan with your loved one each year.

Open Enrollment Period

Annual Medicare open enrollment for Parts A and B is held from January 1 to March 31. Open enrollment for Part D occurs from October 15 to December 7. Those happy with their current plan can leave the plan alone. This will ensure your loved one’s plan continues on unchanged for the following year.

If changes do need to be made, however, there are a number of options. Original Medicare can be swapped for a Medicare Advantage Plan, or your loved one can drop an Advantage Plan and return to original Medicare. Changes can also be made to prescription drug coverage, including joining a plan, swapping plans, or dropping drug coverage completely. For more information, you can call 1-800-Medicare or visit theirwebsite.

Additional Plan Options

If your senior has missed the enrollment period but still needs to make changes to the plan, there are additional times when changes can be made without waiting for open enrollment. These include:

  • Initial enrollment, a seven-month period that begins three months before a senior turns 65 and is eligible for Medicare
  • Any time your loved one wants to switch to a plan that has a five-star quality rating on Medicare.gov
  • Special enrollment periods, which can be triggered by moving to another state or into a nursing home, qualifying for Medicaid, or the Extra Help program that assists with prescription drug costs

Medigap and Medicare Advantage Enrollment

If your loved one decides that original Medicare does not meet his needs, he might consider Medicare Advantage or Medigap coverage. These plans offer additional coverage and may be affected when changes are made.

Medicare Advantage, used by about 30 percent of seniors, offers both healthcare and drug coverage. The open enrollment period for Medicare Advantage plans is the same as Part D, though seniors can disenroll from Medicare Advantage between January 1 and February 14. They can also switch to a prescription drug plan during this time.

Medigap coverage, sometimes known as a Medicare supplemental plan, works with Medicare to cover more health-related costs. These plans are used by about 20 percent of Medicare beneficiaries. Rather than an annual enrollment period for Medigap coverage, seniors can sign up during a six-month period that begins the month they turn 65 and enroll in Part B. Seniors can purchase any Medigap plan available in their area during this time. Once this period has ended, your loved one can still add a plan at any time. However, he must apply for the coverage and meet medical underwriting requirements.

By understanding Medicare open enrollment, Medicare billing, and other aspects of paying for your senior’s health care, you’ll be better able balance the care your loved one needs with the money that must be paid for these services.

Caregivers look out for their senior loved one in many ways. Just as financial planning can bring peace of mind, so can investing in a medical alert system, which provides caregivers and seniors with 24/7 support.

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