I’m So Confused! Medicare’s Annual Enrollment Options

It’s Medicare’s annual enrollment period.  It began on October 15th and will end on December 7th.  All new plans, should you choose to make changes, will take effect on January 1, 2022.

You may ask me why I’m addressing this again since many of you are Medicare veterans. I am because there’s still so much confusion about what can be changed and what can’t be. To do so, I’ll break down Medicare with the hope that this article will help clarify things for you.

Original Medicare – Parts A and B

Parts A and B were, and continue to be, original Medicare.  President Lyndon B. Johnson gave the go ahead for these plans to begin on July 30, 1965.

Part A is Hospital Insurance which helps cover in-patient care in hospitals, skilled nursing, facility care, hospice care, and home healthcare.

Part B is medical insurance which helps cover services from doctors, out-patient care, durable medical equipment (like wheelchairs), and many preventive services.

Unfortunately, neither of these options offer prescription drug coverage, both A and B have deductibles and copays, and there’s no coverage for long term care.  So, although Medicare is a great option for people 65 and over, it has some severe gaps in coverage.

What happened next is that private insurance companies decided to offer plans that covered those gaps, if not fully, at least partially. They created three types of plans to bridge those gaps.

Medicare Parts C and D

The first is Part C  . . . Medicare Advantage Plans (MAPD), an alternative to original Medicare in that it bundles plans A and B together and usually includes Part D (prescriptions drug coverage). Most of these plans are HMO’s and many have a zero premium. The Medicare Advantage plans can be changed during the annual enrollment period.

Part D–or prescription drug plans–were also created for those who want to stay with original Medicare and just add a drug plan.  Part D drug plans can also be changed during annual enrollment.

Medicare Supplement Plans

There are also plans called Medi-gap, aka Medicare Supplement Plans.  You may recognize them as Plan G, Plan F, Plan N, etc. These plans have monthly premiums and cover all or most of what Medicare Parts A and B do not cover.  They do not include part D (prescription drug coverage).  If you want prescription drug coverage you’ll have to purchase a Part D plan.  If you don’t get one when you’re first eligible, you’ll be penalized with higher costs when you do decide to do so.

Medi-gap/Medicare supplements typically can’t be changed during the annual enrollment period and therein lays the confusion. Part D can and Part C can, but not the Medi-gap plans.  If you want to learn when you can make changes to your Medi-gap plans, you are always welcome to contact me as the rules are quite specific and often oblique at the same time.

I hope this article was informative and also helped to clear up questions about what plans are and are not eligible for change during annual enrollment.  If anything isn’t clear, I’ll happily answer your questions.

Until next time . . . never wait to celebrate.

Yours in health,