Open enrollment for 2021 Medicare coverage runs from October 15th to December 7th this year.
During this roughly seven-week window (sometimes referred to as the Annual Election Period, or AEP), adults 65 and older and younger people with certain disabilities can apply for federal health insurance coverage for the first time, or make changes to existing policies effective January 1st, 2021. Open enrollment for Medicare Advantage – purchased through private insurance companies – comes later, from January 1st through March 31st.
For Medicare and Medicare Advantage enrollees satisfied with existing coverage, no action is required (assuming your current plan remains available, that is. Your carrier will notify you prior to open enrollment if that’s not the case.). For all others, choices made in the open enrollment window can have a serious bearing on next year’s medical coverage and related spending. A few important tips for making the process smoother and your selections stronger:
EXPECT CHANGES TO MEDICARE IN 2021
Efforts to reduce federal Medicare spending mean shifts are in store. Details are still emerging, but 2021 Medicare coverage will likely allow nurse practitioners to serve as primary caregivers and will include increased telehealthcare coverage.
Also likely to increase in 2021? Out-of-pocket costs. Specifics won’t be announced until later this year, but premiums for Plan B coverage are expected to rise by 5 to 10 percent. In better news, end-stage renal disease patients formerly excluded from Medicare Advantage are finally eligible, thanks to the 21st Century Cures Act. Passed back in 2016, the Act gives Medicare-eligible persons with end-stage renal disease access to Medicare Advantage plans beginning January 1st, 2021.
NOT QUITE 65? IT MIGHT BE TIME TO ENROLL REGARDLESS
Americans become eligible for Medicare during the seven-month period beginning three months before their 65th birthday– so not too long after you blow out 64 candles. At the very least, be sure you’re successfully enrolled in Medicare before your 65th birthday. This ensures that drug coverage will kick in on the first day of your birthday month. Wait until you’re 65 to enroll, and coverage will be delayed a few months.
UNDERSTAND THE DIFFERENCE BETWEEN MEDICARE AND MEDICARE ADVANTAGE
Original Medicare, sometimes called traditional Medicare, consists of Part A (hospital insurance) and Part B (medical insurance). Dental and vision and most prescriptions are not covered, which is why original Medicare enrollees have the option of Plan D. Sometimes called the Medicare prescription drug benefit, Plan D helps cover prescription costs.
For all of its advantages, one of traditional Medicare’s drawbacks is no cap on out-of-pocket costs. To protect against excessive spending, some older Americans opt for Medicare Advantage instead – a private plan that includes Parts A and B and, in most cases, add-on prescription care coverage in addition to spending limits. Despite its growing popularity, though, Medicare Advantage has a fatal flaw: It limits enrollees to their plan’s provider network, becoming a serious obstacle for enrollees facing severe illness.
UNDERSTAND THE DIFFERENCES BETWEEN THE OPEN ENROLLMENT WINDOWS.
The January 1st to March 31st Medicare Advantage window only applies to people who already have Medicare Advantage – not people looking to enroll. If you’re applying for Medicare Advantage for the first time, whether you already have traditional Medicare or not, do so during the traditional Medicare open enrollment window from November 7th through December 15th. The January through March window is for Medicare Advantage enrollees looking to switch to original Medicare (with or without Plan D) or from one Medicare Advantage plan to another.
The specifics of Medicare coverage can be confusing and can have a significant impact on your treatment options and out-of-pocket costs during your golden years. We’re here to help you make sense of it all – and to help you make the best choice for you. Call Health & Benefits Partners today at 215-240-1263.