The rules for Medicare are always changing, making it confusing for Medicare recipients to know their options or when they can make changes in their healthcare plans.
Insurance agents and brokers can help sort out the confusion by being available to answer Medicare-eligible people’s questions about their choices and informing them about the various enrollment periods.
By providing accurate information about Medicare and any recent changes in the program, brokers and agents assist clients in making the best healthcare decisions for themselves and their partners.
Understanding the Medicare Enrollment Period
Any discussion involving clients switching Medicare plans must include a discussion about enrollment periods. Clients may not be aware they are limited to certain times of the year or circumstances when considering making changes to their Medicare plan.
It may be helpful to send clients a resource that details the various Medicare enrollment periods and what changes they can make during those periods.
Here is what they need to know about enrollment periods:
- Initial Enrollment Period – The initial period when a person becomes eligible for Medicare. It runs from three months before a person turns age 65 to three months after they turn 65. Coverage begins on January 1 as long as they sign up by December 7 of the previous year. Clients can also sign up for the Medicare supplement plan during this period.
- Open Enrollment Period (OEP) – This is also called the annual election period (AEP), which runs from October 15 through December 7 every year.
- General Enrollment Period – Allows people to sign up for Medicare if they missed the timeframe when they were first eligible and were also not eligible for the special enrollment period.
- Medicare Advantage Open Enrollment Period – Runs from January 1 until March 31 every year.
- Special Enrollment Period – This period applies to the following people:
- People who moved out of their plan’s service area
- People moving back to the United States
- People who moved into or out of a short or long-term facility
- An employer-sponsored health plan ends
After having an understanding of the enrollment period timeframes, clients need to understand the types of changes they can make during certain periods.
Timeframes When Medicare Recipients Can Make Changes
Medicare recipients can make certain changes to their Medicare plans during specific enrollment periods as follows:
- Initial Enrollment Period – Enrollees can make one change during this period.
- Open Enrollment Period – Enrollees may switch from original Medicare to a Medicare Advantage plan or enroll in Medicare Part C. They can also join, switch, or drop a plan. Furthermore, they can disenroll, change, or join a Part D prescription plan.
- Medicare Advantage Open Enrollment Period – Enrollees can make changes to their Medicare Advantage plan or change to the original Medicare plan, but they may only do it once during this period.
Note that when insurance clients switching Medicare plans do so during the Open Enrollment Period, they will automatically be taken out of their previous Medicare plan.
Final Thoughts
To provide good service to your health insurance clients, encourage them to review their current plans just before the Open Enrollment Period, just as they might review their home or auto insurance policies annually. This allows you to touch base with them and continue building trust.
To learn more, contact us at American Senior Benefits. Our affiliated experts will be happy to answer any questions you have.
