Medicare Enrollment Periods: A couple of basics
Article published in Northampton Living
(January 2022)
EXPERT CONTRIBUTOR
ERICA ANNE BEAUDRY
Medicare Advisor
EA Financial Solutions
413 626 9906
info@eafinancialsolutions.com
www.eafinancialsolutions.com
The most frequently asked question I receive as an independent insurance agent specializing in Medicare is “When do I enroll?” In this age of technology, the amount of information available is overwhelming. The process of applying for and receiving Medicare benefits can also be overwhelming but it doesn’t have to be because independent agents, such as myself, are here to help!
Initial Enrollment Period – (7 months)
Sometimes the first time is the hardest time but you know what they say? Practice makes perfect and I practice a lot alongside my clients. Here is the scoop, about six months before your 65th birthday you will start to receive a lot of mail. Well-meaning companies are letting you know the options they offer and enticing you to call a 1-800 number for more info. The problem with this strategy is that everyone is doing it and it mostly creates confusion. Suddenly ‘new to Medicare’ members are completely overwhelmed by all of the options and jargon coming their way. In-network, Out-of-network, PPO, Supplement, Donut Hole... the list goes on!
What’s most important to keep in mind is that when you are turning 65 you have a window of 7 months to enroll into Original Medicare (the red, white and blue card) and then choose an option to fortify your coverage. This 7-month window includes the 3 months prior to your birthday, your birthday month, and the 3 months after your birthday.
The fortification tools we use are either a Medigap plan (also known as a Supplement) paired with a stand-alone prescription drug plan (PDP) OR a Medicare Advantage plan which most often includes prescription drug coverage. Why the emphasis on drug coverage? Well, most people who are new to Medicare quickly discover that Original Medicare does not cover prescription drugs and if you don’t enroll in a Part D (“D” stands for Drug) plan you may face a penalty that follows you through your lifetime.
The bottom line here is don’t worry, start the process early because it can take 6-8 weeks to receive your Original Medicare card. Work with a professional such as myself who will help you sift through options that are available to you specifically by zip code. Keep in mind that options vary by county so skip the generic internet search that will lead you down rabbit holes of false information and anxiety.
Annual Enrollment Period – (Oct 15 – Dec 7)
I am enrolled now what? Each year during the Annual Enrollment Period everyone currently enrolled in Medicare has the option to make a change. You can pick up a Medicare Advantage Plan for the first time, change companies within the Advantage options in your area or you can move to a Medigap/Supplement plan, to name a few. It’s important to remember that Massachusetts is a guaranteed issue state, this means that you cannot be denied coverage and you cannot be charged a higher premium for pre-existing health conditions. So go ahead start off wherever you are most comfortable and know you can make a change at least once per year.
