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What You Need to Know About Open Enrollment

Know About Open Enrollment

Every year during Open Enrollment Medicare beneficiaries have the opportunity to enroll in Medicare Plans or review the Medicare benefits and elect to change their coverage.   You are eligible for Medicare (a federal health insurance plan if you are: 65 years or older, disabled, or suffer from permanent kidney failure. Open Enrollment only comes around once a year, and gives you the opportunity to learn about   the changes for the upcoming year and pick the best plan for you. Medicare enrollment opens on October 15th and closes December 7th. Here is everything you should know:

You Have Limited Time to Act

Open Enrollment is from October 15th to December 7th. During this period, you are able to switch to a different plan or drop your plan. Once you enroll, your coverage will typically begin the following January.

You Can Change Plans

  • This is the only time of year when ALL Medicare beneficiaries are able to make changes to their coverage for the following year. For example, those with Original Medicare can switch their plan to Medicare Advantage.
  • Those with Medicare Advantage can switch to Original Medicare.
  • Those enrolled in Medicare Advantage can switch to a different Medicare Advantage plan.
  • Those with a Part D prescription drug plan can switch to a new Part D prescription drug plan.

Part C is a Medicare Advantage Plan

Around 30% of those on Medicare nationwide are enrolled in Medicare Advantage plans. Medicare Advantage plans are offered through a private company or health insurer who is contracted with Medicare.

If you enroll in Part C, you will receive all the benefits from Parts A and B. These plans cover hospitalization, outpatient care, and often prescription-drug coverage under one plan. Medicare Advantage plans typically cover extra services that are not covered by Original Medicare – such as dental, vision care and transportation to doctor visits.

Information About Plan Changes

In October, the information for the next year’s plans will be released. If you are on a Medicare plan, it is important to review the materials that are being sent to you, like “Medicare and You”, and “Annual Notice of Change” (ANOC).  These will alert you to changes that are coming in.  You will also receive information in the mail about other Medicare plans in your area.    In addition, Medicare provides easy online access to information at www.medicare.gov.  If you are happy with your plan, you will not have to do anything and your coverage will continue as is. 

Limited Out-Of-Pocket Costs

In 2012, the law put a restriction on total out-of-pocket costs for those under Medicare Advantage plans to no more than $6,700, though some plans may be less. This includes fees such as deductibles, copays, and coinsurance for outpatient and hospital-related services. However, this does not include the cost of prescription-drugs.

Free Preventative Services

Most of the plans include free preventative services like yearly wellness visits, diabetes screenings, cancer screenings, and more. It is best to check to ensure which services are under your plan. If you are enrolled in a Medicare Advantage plan, you can check with your insurer for this information. If not, you can visit www.medicare.gov.

Medicare is a Requirement

If you are at least 65 years old and are receiving Social Security benefits, you are required to purchase a Medicare plan. If you are not collecting Social Security, you are able to delay enrolling in Medicare penalty-free under certain conditions.  But it is important that you check with Social Security when you turn 65.

Gonzaba Medical Group

For more information about Open Enrollment, call Gonzaba Medical Group. We have English and Spanish-speaking staffs to help answer your questions. Our staff can direct you to resources that can answer questions you may have regarding Medicare plans. Call 210-921-6680 to speak to a representative today!