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Medicare Open Enrollment Period, Know Your Status

Open Enrollment for Medicare and You Handbook Credits: CMSHSS.gov
Understand Your Status During Open Enrollment Credits: BoomerBenefits.com

(SHAMELESS PLUG #44) 

To some Medicare eligible enrollee’s, the open enrollment period can be a confusing and frustrating time.  Every person experiencing the process may experience it differently, depending on your status.  Factors ranging from health, age, financial ability, how benefits were obtained and work history all play factors related to Medicare status. 

Enrollment time is a period that many Medicare eligible people can relate to unless they have a Special Election Period (SEP) that can give some the ability to make changes to the types of coverage they have, add or drop certain coverages already obtained or alter their options. 

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The period from October 15th to December 7th is called the Open Enrollment period or Annual Election Period (AEP) and it allows for a variety of changes to take place.  As stated earlier, open enrollment status does depend on a few things, so your enrollment options may vary from your friend or neighbor.  The open enrollment period addresses some of these scenarios:

  • (IEP) Initial Enrollment Period- When a person becomes Medicare eligible (Turns 65 or has been declared disables for two years or longer by their physician), can join a Medicare Advantage Plan that has a Prescription Drug Plan included.  During this period, an eligible Medicare recipient may also opt to simply add a PDP (Prescription Drug Plan) to their original Medicare to help with drug cost (There is also a 1% penalty for every month that a Medical eligible person does not have what the government calls Creditable Drug Coverage).  Plans are obligated to send their effected clients notice of a change that can make their present drug plan, out of compliance.  If that occurs, it is up to the person to find a creditable drug plan coverage within 63 days of notice to avoid future penalties.  This IEP period can occur at any time the Medicare eligible person is within their 7-month window, which occurs 3 months prior to the month of their birth, their birth month, and the 3 months following that for a total of 7 months of eligibility.  Talking with a benefits specialist, agent, Medicare, or even going online (That is why I am writing this) are avenues that will give a Medicare eligible person relevant and needed information. 
  • (ICEP) Initial Coverage Election Period- Like IEP but limited to Medicare Advantage Plans that do not have a PDP option included. 

 

Open Enrollment does not effect this status

  • (SEP) Special Election Period- Factors such as obtaining Medicaid, moving into a new area that does not offer your health insurance, present Dual-Eligible and people with Chronic health conditions can obtain SEP status (there are also many other ways) Medicare.Gov provides a list of eligible SEP periods.  This will allow them to switch, change add or drop plans outside of normal open enrollment periods. 

 

Again, understanding your insurance status is key to utilizing your healthcare options effectively and getting the maximum benefit.  If you have additional questions or would like to consult about your Medicare options, contact John Clark (973) 518-0676 or (973) 771-9211.  I can also be reached via email at JLC3Consulting@gmail.com

 

 

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