Medicare Advantage
Medicare Advantage Plans
Enrollment Periods
Initial Enrollment Period
Your initial enrollment period for Medicare (all four parts) begins three months prior to the month you turn 65 and lasts until the end of the third month after your birthday month—a total of seven months. If you don’t sign up during the initial window, you can sign up between January 1st and March 31st each year for coverage that begins July 1st. Failure to sign up during the initial enrollment period, however, could result in permanently higher premiums—unless you qualify for a special enrollment period.
Special Enrollment Period (SEP)
If you are still covered by a group health plan provided by your employer (or your spouse’s) when you turn 65, you may qualify for a special enrollment period. In general, the SEP requires that you enroll in Medicare no later than eight months after your group health plan or the employment on which it is based ends (whichever comes first). One important exception to SEP rules: If your group health plan or employment on which it is based ends during your initial enrollment period, you do not qualify for a SEP.
Other Enrollment Periods
There is an open enrollment period for Medicare Advantage and prescription drug coverage each year, from October 15th to December 7th. There is also a new annual Medicare Advantage open enrollment period, from January 1st to March 31st, during which you can switch to traditional Medicare from an MA plan and join a Medicare prescription drug plan to add drug coverage.
Parts of Medicare
Medicare Part A - Hospital Insurance
- Inpatient Hospital Care
- Skilled Nursing Facility
- Home Health Care and Hospice Care
Medicare Part B - Outpatient Care
- Doctor Visits
- Outpatient Care
- Home Health Care
- Durable Medical Equipment
- Ambulance Services
Medicare Part C - Medicare Advantage Plans
- Health plan offered by a Medicare approved private insurance company
- Includes all benefits and services covered under Part A & Part B
- May offer additional benefits and services
- May include prescription drug coverage
Medicare Part D - Prescription Drug Coverage
- Helps cover the cost of prescription drugs
- Offered by a Medicare approved private insurance company
- Can be included in a Medicare Advantage plan or purchased separately in a standalone plan
Key Takeaways
- For Americans 65 and older, conversations about health insurance should include Medicare.
- There are four parts to Medicare—A, B, C, and D—that cover different healthcare needs.
- Medigap insurance is provided by private insurance companies and can help pay for expenses not covered under Medicare.
- When you're first eligible for Medicare, the open enrollment period lasts roughly seven months and begins three months prior to the month of your 65th birthday.
Sorting Out Your Options
All of this can lead to confusion about which options are right for you. Schedule a consultation with a licensed Medicare insurance broker by calling LeSean Wittkop using the click to call button below.
For more information, visit medicare.gov
