The Medicare Annual Open Enrollment Period or AEP for 2015 begins October 15 through December 7 of 2015. With millions of baby boomers turning 65 this year, this Medicare Open Enrollment is bound to be a busy one for everybody. This time of year is when Medicare participants are allowed to make a change in their Medicare Plans usually with no restrictions for the following year.
Medicare Advantage plans are offered through private carriers as Medicare HMO or Medicare PPO plans and they can make changes every year so it is very important to review your coverage. In doing so, you may find that some changes may apply to the plan itself or to your coverage area. You can find great coverage for little to no cost for a California Medicare Advantage plan.
Once you make the changes, your plan will take effect on January 1st of the following calendar year. You are locked in to this plan until the next AEP comes around unless you qualify for a Special Enrollment Period
(SEP) which requires special circumstances. So make sure you Contact us
all of your options before making your selection for the next year.
Medicare Insurance can be very complex for the average Joe to understand. You think trying to understand all of the insurance elements is difficult? How about understanding when you can change from your current Medicare Insurance plan. That is a common topic that has been arising more often these days and we want to address this issue.
Let’s start from the beginning. Your Initial Enrollment Period (IEP) starts at age 65 and you can enroll as early as 3 months prior to your birthday month and it ends 3 months after your birthday month. So if your birthday is in April, you can start enrolling in Part A & B in January and you would have until July to have something in place. If you enroll in the 3 months after your birthday month, your Medicare coverage will start the 1st of the following month that you enrolled.
The next and most common period is the Annual Open Enrollment. (AEP) which we have previously discussed. In a nutshell, it’s the time of year when you can change your Medicare Advantage plan to another Medicare Advantage plan of equal or lesser value. More often than not, you will change to a plan that has better benefits or maybe your current plan is no longer going to be offering services in your region.
The most difficult to understand is the Special Enrollment Period (SEP). There are multiple qualifying events that would qualify you for a Special Enrollment Period if:
- You lost your creditable drug coverage due to no fault of your own
- You drop employer/union health and/or drug coverage from current or former employer
- You are institutionalized
- You are enrolled in a qualified State Pharmaceutical Assistance Program (SPAP) or lose eligibility
- You have Extra Help (State Medicad or SSI benefits)
- You want to disenroll from the FIRST Medicare Advantage plan you ever enrolled in
- You enroll or disenroll from PACE
- You permanently move (Your coverage may not be available)
- You join or lose eligibility for a Special Needs Plan (SNP)
- You have had Medicare eligibility issues (retroactive enrollment)
- There was Contract violations, misleading marketing or enrollment errors from your current carrier
- You current Medicare private health or drug plan no longer offers it in your area
- You disenroll from your current Medicare Advantage plan from Jan 1-Feb 14
- You experience a n “exceptional experience” by request to CMS only
- You qualify for a new Medicare Part D Initial Enrollment Period at age 65
These events will allow you to make the necessary changes to your Medicare Health plan. However, some of these Special Enrollment Periods only last for a specific amount of time so do not procrastinate! For more information on Medicare Insurance please talk to one of our insurance professionals for updates, news, quotes and online applications.