POPULARITY
Changes are coming in 2023 when Medicare Part B coverage starts; however, what is not changing if you are eligible at age 65, is your Initial Enrollment Period (IEP): •Begins three months before your 65th birthday; •Includes the month of your 65th birthday; and •Ends three months after your 65th birthday. If you are automatically enrolled in Medicare Part B — which provides outpatient medical coverage — or if you sign up during the first three months of your Initial Enrollment Period, your coverage will start the month you're first eligible. If you sign up the month you turn 65,...Article Link
Maybe you're not quite sure when to enroll in Part B, or you're unfamiliar with the coverage and costs involved in Medicare's outpatient insurance. If so, this video is a must-watch as we're unboxing everything you need to know about Medicare Part B.You'll use your Part B at doctors' offices, as it's your outpatient coverage. Part B covers medically necessary services given by a provider. This includes preventive care, surgeries, and other treatments.Some medically necessary services Part B will cover include mammograms, colonoscopies, lab testing, durable medical equipment, occupational therapy, transplants, home health services, medications administered at the doctor's office, outpatient mental health services, ambulance services, vaccines (such as for the flu or Hepatitis B), and some services you receive in the hospital.Moving on to Medicare costs, Part B comes with a monthly premium. Each year, there is a standard premium amount that is adjusted if your income is higher. Each year, the Part B premium is subject to increase and the standard amount is announced each year in the late fall, as is the annual deductible for Part B.In addition to the premium and deductible, Part B also involves coinsurance. Medicare pays 80% of the approved amount, leaving the beneficiary responsible for the remaining 20%. This means you'll need to pay 20% for all services received at the doctor's office.Unfortunately, Part A and Part B don't have out-of-pocket maximums. So, the 20% you pay out-of-pocket can quickly add up. Luckily, this is where Medicare Supplement (Medigap) plans can help. They cover the 20% coinsurance, thus protecting you.Last but not least, we're going to let you know when to enroll in Part B. The first enrollment window every Medicare beneficiary has to enroll in Part B is the initial enrollment period. It's unique to you and starts three months before your 65th birthday, ending three months after your 65th birthday. Thus, you have seven months to enroll in Part A and Part B. Keep in mind that if you don't enroll during the first three months of this period, your coverage could be delayed and won't become active until after you turn 65.If you're collecting Social Security benefits, you'll automatically enroll in Original Medicare (Parts A and B), and your Part B premium will be deducted from your Social Security check each month. If you're not collecting Social Security, you'll have to enroll yourself. If you have another form of creditable coverage, like group medical insurance through a large employer, you can delay enrollment in Part B and avoid penalties.Once you leave your employee group coverage when you retire, you'll get a Special Enrollment Period of eight months. Make sure to get the right documentation for proof of coverage.Those who miss their Initial Enrollment Period and don't qualify for a Special Enrollment Period can use the General Enrollment Period to sign up for Part B. This enrollment period occurs annually, from January 1 through March 31. If you sign up during this time, your coverage will begin on July 1.When you lack creditable coverage at the time of enrollment, you'll face a penalty of 10% for every 12 months you went without coverage. Unfortunately, this penalty will stick with you forever. This is why it's so important to be familiar with what constitutes creditable coverage and why you shouldn't just assume you don't need Part B yet.Resources: https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-b/Our YouTube Channel: https://www.youtube.com/medicarefaqOur Facebook Community: https://www.facebook.com/groups/medicarefaq
If you find the different enrollment periods within Medicare confusing, don't go anywhere. In today's video, we'll go over every part of Medicare and the enrollment periods that come with each.My name is Lindsay Engle, and I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com.Medicare comes with many different parts and plans. Each one has a specific enrollment period, and some have multiple. In this video, I discuss which enrollment periods fall under each part.First, we'll discuss Part A and Part B. Part A is your inpatient coverage, and Part B is your outpatient coverage. These parts come with two different enrollment periods:• Initial Enrollment Period: When you can first enroll in Parts A and B. Begins 3 months before your 65th birthday, lasts the month of, and continues 3 months after your 65th birthday• General Enrollment Period: If you miss your Initial Enrollment Period, this is the next time you can enroll in Parts A and B. It occurs annually between January 1 and March 31. Your coverage will start on July 1– If you have a change of circumstance, you can qualify for a Special Election Period (example: having creditable group coverage through your employer)Next, we'll discuss the different enrollment periods that come along with Medicare Advantage plans.• Initial Coverage Election Period (ICEP): Begins three months before your 65th birthday and when it ends is dependent on when your Part B becomes effective• Annual Enrollment Period: If you miss your ICEP, the next time you can enroll is during the Annual Enrollment Period (AEP), which occurs each year between October 15 and December 7• Medicare Advantage Open Enrollment Period: If you're enrolled in an Advantage plan, and you want to make changes, you can do so annually between January 1 and March 31– You could also qualify for a Special Election Period due to a change in circumstancePart D prescription drug coverage also comes with similar enrollment periods.• Initial Enrollment Period: During this time, you can also sign up for Part D• Annual Enrollment Period: If you miss your Initial Enrollment Period, the next time you can enroll is during the Annual Enrollment Period– You can also qualify for a Special Election Period, just like Parts A, B, and C (Advantage)Now, let's go over when you can enroll in a Medigap plan.• Medigap Enrollment Period: This is your only enrollment period for Medigap. It lasts six months and begins once you enroll in Part B – it isn't annual like the others– Outside of the Open Enrollment Period, you can enroll in a Medigap plan at any time of the year as long as you have Part B – the only difference is you will have to answer health questionsA common misconception is that you can enroll in a Medigap plan during the Annual Enrollment Period without having to answer any health questions. This is not true unless it overlaps with your Medigap Open Enrollment Period.The last enrollment period we'll go over today is for those eligible for Medicare due to a disability.Initial Enrollment Period: You become eligible for Medicare once you collect Social Security Disability Income for 24 months. After 24 months, your Initial Enrollment Period will begin. This is the same 7-month window we discussed at the beginning of the videoSecond Initial Enrollment Period: In addition to your Initial Enrollment Period, you get a second one when you age in at 65Thank you so much for watching! If you'd like more information on the different enrollment periods mentioned, make sure to check out our enrollment period playlist.Make sure to subscribe to our YouTube channel if you found this video helpful and turn notifications on, so you know as soon as we upload a new video.Facebook Community: https://www.facebook.com/groups/MedicareFAQ
If you're aging into Medicare, don't go anywhere. In today's video, we're going to talk about your Initial Enrollment Period.Medicare comes with many different enrollment periods. It's important to understand the difference between each one. Your Initial Enrollment Period is the first window of opportunity you have to enroll in Parts A and B, as well as Part D.Your Initial Enrollment Period is a seven-month window. It begins three months before your 65th birthday, lasts the month of your birthday, and will continue three months after your birthday. If your birthday happens to fall on the first of the month then your IEP will begin the month before your 65th birthday. For example, if your birthday is on July 1, your IEP begins on March 1, and your coverage will become effective on June 1.It's important to know that your Initial Enrollment Period only comes around once in your lifetime. The only exception is for those collecting Social Security Disability Income, in which case, your IEP comes around twice. Your first IEP will begin 24 months after you first collect SSDI. When you turn 65, you will have another IEP.During this window, you can enroll in Original Medicare (Parts A and B) and Part D. When you enroll during your IEP, you can avoid the late penalties that come with Part B and Part D when you don't have creditable coverage. You can also enroll in a Medicare Advantage plan during this window because your Initial Coverage Election Period for Advantage is also a seven-month window beginning six months before your 65th birthday and ending the last month before you enroll in Part B or the last month of your Initial Enrollment Period.When it comes to Medicare Supplements, your Initial Enrollment Period is important because it will activate your Medicare Supplement Open Enrolment Period once you enroll in Part B. When you enroll in Part B, your six-month window to enroll in a Medicare Supplement plan without having to answer any health questions will begin.If you're collecting Social Security Income before turning 65, you'll be automatically enrolled in Part A and Part B when you age in. If you're not collecting Social Security by age 65, then you'll need to actively enroll in Parts A and B.If you work for an employer with fewer than 20 employees, have retiree insurance, or TRICARE, you'll want to take advantage of your IEP and enroll in Parts A and B. This is because your Medicare becomes primary and your other coverage becomes secondary. If you don't enroll in Parts A and B when you're first eligible, you could be subject to paying 80% of your medical costs out-of-pocket.If you work for an employer with more than 20 employees, your employer coverage becomes primary. At this time, you'll have the option to enroll in Part A or B without penalties if you delay coverage.Since Part A is premium-free for most, the majority of people choose to enroll in it. You can choose to delay enrolling in Parts B and D since your employer group coverage is considered creditable and you'll get a Special Enrollment Period when you leave it.Now, if you happen to miss your IEP, you will have to wait until the General Enrollment Period to enroll in Parts A and B. This occurs annually between January 1 and March 31. However, your coverage won't begin until July 1. This could leave you with a gap in coverage. If you went more than 12 months after your IEP, you could start incurring penalties if you didn't have creditable coverage.If you didn't enroll in a Part D plan during your IEP, the next opportunity you have is the Annual Enrollment Period. This enrollment period occurs each year between October 15 and December 7.Youtube Video : https://youtu.be/ez15SApv8aE
Are you new to Medicare and considering delaying enrollment in Part D? Don't go anywhere – in this video, we explain how the Part D penalty works.My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.Part D works as prescription drug coverage alongside Parts A and B. The best time to enroll is when you're first eligible, during your Initial Enrollment Period.Your Initial Enrollment Period begins three months before your 65th birthday. Will be the month of, and continues for three months after your 65th birthday. This gives you a seven-month window to enroll.Like Parts A and B, Part D comes with a late penalty if you delay enrolling without creditable coverage. If you don't have creditable coverage, you may qualify for a Special Election Period to eliminate this penalty.This penalty works differently from the Original Medicare penalties. With Part D, you'll be charged a penalty equal to 1% of the national average premium for every month you delayed enrolling without creditable coverage.You'll pay this penalty every month as long as you have Part D coverage. If you're penalized, you can appeal the penalty by submitting a reconsideration request. This is available on CMS's website.For example, say you waited 33 months after your Initial Enrollment Period to enroll in a Part D plan. Unless you had creditable coverage or qualify for a Special Election Period, you'd be charged 1% of the national average Part D premium for each of those 33 months.Currently, the average premium for Part D is $33.06. The penalty is calculated by multiplying $33.06 by 0.33 (33 months), which equals $10.90. The Part D penalty is rounded to the nearest 10 cents. Therefore, your Part D premium would be somewhere around $43.97. Your premium would continue to increase, as the average premium does each year.Each Part D carrier sets its premium and drug formulary. Even if you think you don't need Part D prescription drug coverage right now, many different carriers offer these plans nationally. The monthly premiums start at around $15.When choosing between paying the premium now and paying the penalty for the rest of your life, it makes more sense to enroll sooner. This way, you'll avoid the penalty.Part D plans change annually. Each September, you'll receive an Annual Notice of Change letter that will go over your drug formulary and notify you of any premium increases.During the fall Annual Enrollment Period from October 15 through December 7, you'll have the opportunity to compare other plans in your area and make sure you have the lowest premium available.As has been noted, the best time to enroll in a Part D plan, and avoid penalties, is during your Initial Enrollment Period.Part D: https://www.medicarefaq.com/original-medicare/medicare-parts/medicare-part-d/Part D Late Enrollment Penalty: https://www.medicarefaq.com/faqs/medicare-part-d-late-enrollment-penalty/Initial Enrollment Period: https://www.medicarefaq.com/faqs/medicare-initial-enrollment-period/Special Election Period: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/Annual Enrollment Period/Open Enrollment Period: https://www.medicarefaq.com/faqs/fall-medicare-open-enrollment-period/We hope you enjoyed this video! Don't forget to subscribe to our YouTube channel. Turn on notifications, so you know when we upload a new video.If you use Facebook, please join our Community: https://www.facebook.com/groups/medicarefaq#MedicarePartD #LateEnrollmentPenalty #PrescriptionDrugPlan
If you're considering delaying enrollment into Original Medicare Parts A and B, don't go anywhere. In this video, we'll go over what you need to know about Medicare's late enrollment penalties.My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com. When you first become eligible for Medicare, you may consider delaying enrollment. However, there are penalties associated with delaying enrollment in Medicare. We're here to explain what they are and how to avoid them.Part A is your inpatient or hospital coverage. Most people are entitled to premium-free Part A, as long as they paid into enough quarters while still working. The late enrollment penalty for Part A is 10% of the current Part A premium. You'll pay this for twice the number of years you were eligible but didn't enroll.For example, if you were eligible for two years but never signed up, you would have to pay 10% above the standard premium for four years.Part B is your outpatient or doctor's coverage. The Part B penalty is 10% above the standard premium for every 12 months you went without coverage. Unlike Part A penalty, the Part B penalty is lifelong. The only way around it is if you're eligible for a Special Enrollment Period.An example of the Part B penalty is if you were eligible for coverage in November 2013 but chose not to enroll until March 2017. This would mean you delayed enrolling for 40 months, or three years and five months. This time would count as three full 12-month periods, meaning you would have to pay a late enrollment penalty for 30% above the standard premium.Now, how do you avoid both of these penalties? To avoid the Part A and Part B penalties, you'll want to enroll when you're first eligible; during your Initial Enrollment Period.Your Initial Enrollment Period starts three months before the month of your birthday includes the month of your birthday, and continues three months after. Once you miss your seven-month IEP, you may begin to incur penalties, unless you're eligible for a Special Enrollment Period.The majority of beneficiaries choose to enroll in Part A because it's premium-free for most. The most common reason for delaying Part B is if you have group employer coverage and your employer has more than 20 employees. In this case, the coverage is considered creditable, and you can delay enrollment into Part B with no penalty.One of the most common questions we receive is if there's a cap on the Part B penalty. Unfortunately, at this time, there is no cap.Another thing to note is if you're eligible for Medicare due to a disability and were paying penalties on your premiums, the premiums will be eliminated once you turn 65.If you feel that the penalties you have incurred shouldn't have applied to you, you can submit a reconsideration request to Medicare. [LINK HERE]I hope you found this video helpful! If you did, don't forget to subscribe to our YouTube channel. Turn notifications on so you'll know as soon as we upload a new video.If you use Facebook, join our Medicare Community today: https://www.facebook.com/groups/medicarefaq
There are many different enrollment periods for Medicare. Today, we will discuss one of the most important ones: the Medicare Annual Enrollment Period, which comes around every fall.My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.The Medicare Annual Enrollment Period is commonly referred to as the Annual Election Period or the Medicare Open Enrollment Period. It occurs annually, in the fall, between October 15th and December 7th.This enrollment period is for beneficiaries who are already enrolled in Medicare to make changes to their coverage. This means that you must either be enrolled in Part A and Part B of Original Medicare, a Medicare Advantage Plan, or a stand-alone prescription drug plan under Part D.If you're enrolled in Medicare Advantage, you can change from one carrier to another carrier or switch back to Original Medicare. When you switch back to Original Medicare, you can then choose to enroll in Medigap and Part D plans if you wish to do so.If you're currently enrolled in Part D, you can choose to switch from one plan to another or drop your coverage altogether. You can also enroll in a Part D plan at this time if you only have Original Medicare without any prescription drug coverage.A first key point to remember is if you're not already enrolled in Medicare, this is not the enrollment period for you. If you're looking to enroll in Part A and Part B for the first time and you're outside your Initial Enrollment Period, you'll have to wait until the General Enrollment Period, which runs annually between January 1st and March 31st.Another key point to remember is that if you're choosing to enroll in a Medicare Supplement Plan at this time, you'll still have to answer health questions and go through medical underwriting. The only way around this is if your Medicare Open Enrollment Period is also happening during the Annual Enrollment Period or, due to a specific circumstance, you qualify for a Special Election Period.The Annual Enrollment Period does not give you guaranteed issue rights. You can enroll in a Medigap plan at any time of the year. The only thing to remember is if you are outside of your Open Enrollment Period, which is the first six months after your Part B effective date, you will have to answer health questions. Any coverage changes you make during the Annual Enrollment Period will become effective January 1st of the following year.Each September, your Medicare Advantage carrier or Part D carrier will send you a plan annual notice of change that will give you a brief summary of all your benefits.Your notice of change will explain any plan coverage changes that will become effective the following year. You will want to pay attention to your premium. If you feel that the premium is increasing more than expected, it may be time to shop around for new plans.If you have Medicare Advantage, you should also pay attention to the doctor network. Make sure your doctor is still within your plan's network.Another important thing to check is your Part D drug formulary to ensure your current prescriptions will still be covered.Thank you so much for watching! If you have any questions about the Medicare Annual Enrollment Period, make sure to leave them in the comments section below.Like what you see? Join our Facebook group! It's a group dedicated to helping people become educated on Medicare. Whether you're a current Medicare beneficiary, taking care of a loved one on Medicare, or will be aging into Medicare shortly, this is your Medicare resource center. https://www.facebook.com/groups/MedicareFAQ/
There are many different enrollment periods for Medicare. Today, we will discuss one of the most important ones: the Medicare Annual Enrollment Period, which comes around every fall.My name is Lindsay Engle, and I'm the Medicare Expert for Elite Insurance Partners and MedicareFAQ.com.The Medicare Annual Enrollment Period is commonly referred to as the Annual Election Period or the Medicare Open Enrollment Period. It occurs annually, in the fall, between October 15th and December 7th.This enrollment period is for beneficiaries who are already enrolled in Medicare to make changes to their coverage. This means that you must either be enrolled in Part A and Part B of Original Medicare, a Medicare Advantage Plan, or a stand-alone prescription drug plan under Part D.If you're enrolled in Medicare Advantage, you can change from one carrier to another carrier or switch back to Original Medicare. When you switch back to Original Medicare, you can then choose to enroll in Medigap and Part D plans if you wish to do so.If you're currently enrolled in Part D, you can choose to switch from one plan to another or drop your coverage altogether. You can also enroll in a Part D plan at this time if you only have Original Medicare without any prescription drug coverage.A first key point to remember is if you're not already enrolled in Medicare, this is not the enrollment period for you. If you're looking to enroll in Part A and Part B for the first time and you're outside your Initial Enrollment Period, you'll have to wait until the General Enrollment Period, which runs annually between January 1st and March 31st.Another key point to remember is that if you're choosing to enroll in a Medicare Supplement Plan at this time, you'll still have to answer health questions and go through medical underwriting. The only way around this is if your Medicare Open Enrollment Period is also happening during the Annual Enrollment Period or, due to a specific circumstance, you qualify for a Special Election Period.The Annual Enrollment Period does not give you guaranteed issue rights. You can enroll in a Medigap plan at any time of the year. The only thing to remember is if you are outside of your Open Enrollment Period, which is the first six months after your Part B effective date, you will have to answer health questions. Any coverage changes you make during the Annual Enrollment Period will become effective January 1st of the following year.Each September, your Medicare Advantage carrier or Part D carrier will send you a plan annual notice of change that will give you a brief summary of all your benefits.Your notice of change will explain any plan coverage changes that will become effective the following year. You will want to pay attention to your premium. If you feel that the premium is increasing more than expected, it may be time to shop around for new plans.If you have Medicare Advantage, you should also pay attention to the doctor's network. Make sure your doctor is still within your plan's network.Another important thing to check is your Part D drug formulary to ensure your current prescriptions will still be covered.Annual Enrollment Period: https://www.medicarefaq.com/faqs/medicare-annual-enrollment-period/Medicare Supplement Open Enrollment Period: https://www.medicarefaq.com/faqs/medicare-supplement-open-enrollment/General Enrollment Period: https://www.medicarefaq.com/faqs/medicare-general-enrollment-period/Medicare Advantage Open Enrollment Period: https://www.medicarefaq.com/faqs/medicare-advantage-open-enrollment-period/Initial Enrollment Period: https://www.medicarefaq.com/faqs/medicare-initial-enrollment-period/Special Enrollment Period: https://www.medicarefaq.com/faqs/medicare-special-enrollment-periods/Annual Notice of Change: https://www.medicarefaq.com/faqs/medicare-annual-no
You become eligible for Medicare, which is a federal health program, when you turn 65 years old. You're also eligible if you've been collecting Social Security Disability Income for 24 months or diagnosed with End-Stage Renal Disease. There are two main parts to Original Medicare. This includes Part A and Part B. Part A is your hospital coverage and Part B is your doctor and medical coverage. When it comes to signing up for Medicare. Some are automatically enrolled in others will need to actively enroll. If you've been collecting Social Security benefits for at least 4 months, you'll be automatically enrolled into both Parts A and Part B. Your effective date will be the first day of the month you turn 65 years old. If your birthday happens to fall on the 1st of the month then your effective date will be the 1st of the month before your birthday. For example, if your birthday falls on July 1st, then your effective date will be June 1st. You'll receive your Medicare card around 3 months before your birthday. If you're not collecting Social Security benefits, then you'll need to actively enroll into Part A and Part B. You'll want to enroll during your Initial Enrollment Period. Your Initial Enrollment window will be 7 months and starts 3 months before your birthday, will last the month of your birthday and will end 3 months after your birthday.There are three ways you can enroll in Medicare. The 1st way is going down to your local Social Security Office. The 2nd way is to go ahead and give the Social Security office a call to enroll. The 3rd way and probably the most easy way is to do it online.To begin the online application process you'll need to visit Social Security's web site. That's ssa.gov/benefits/Medicare. Then you'll scroll to the bottom of the page until you see the big blue button that says apply for Medicare only. If you recently have started an application and did not complete it, you can return to your saved application here also. It will bring you to the next page that talks a little bit about the online application and an option to start a new application. So go ahead and select start a new application. And then it will ask you if you're applying for yourself or someone who's not with you. So select applying for myself. Then it will ask if you have a My Social Security account. If you do not have one you will need to create one. If you do have one it will then ask you to sign in. So let's assume that I currently do not have a My Social Security account. You will need to have an address that's within the United States and US Territories to create the account. So select yes and hit next. At this point it will bring you to secure.ssa.gov to create an account. At this point it's going to ask you a few personal questions. The form will take about 15 to 20 minutes to fill out. If you would like you can save it and complete it later.You will receive a letter from Social Security Administration once they made a decision about your enrollment. Now, if you only have Part A and you delayed enrolling into Medicare Part B there are two additional forms that you'll need to complete to enroll in Part B. So if you already have Part A and you're only enrolling in Part B, then you'll need to also complete 40B form. Which is application for enrollment in Part B. Once you complete this form, you'll want to include it in your online application or mail into the Social Security office. Now, if you delayed Part B due to having group employer coverage, you'll also need to complete the L564 form. Which is request for employment information.MedicareFAQ: https://www.medicarefaq.com/faqs/applying-for-medicare/Social Security Website: https://www.ssa.gov/benefits/medicare/40B Form: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdfL564 Form: https://www.cms.gov/medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf
Compare Medicare Supplement Plans Here: https://www.seniorhealthcaredirect.com/quote-3/ Medicare Advantage Open Enrollment Period This description is taken directly from Medicare's Website: https://www.medicare.gov/sign-up-change-plans/joining-a-health-or-drug-plan What can I do? If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage). You can drop your Medicare Advantage Plan and return to Original Medicare. You'll also be able to join a Medicare Prescription Drug Plan. What can't I do? Switch from Original Medicare to a Medicare Advantage Plan. Join a Medicare Prescription Drug Plan if you're in Original Medicare. Switch from one Medicare Prescription Drug Plan to another if you're in Original Medicare. When? January 1–March 31 Note: If you enrolled in a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare. If you have any questions regarding Medicare, please give our office a call at 1-855-368-4717 or visit one of our pages: Website - https://www.seniorhealthcaredirect.com/ Facebook - https://www.facebook.com/MedicareBob/ Podcast - https://anchor.fm/MedicareBob Twitter - https://twitter.com/MedicareBob YouTube - https://www.youtube.com/c/RobertBache?_confirmation=1
If you do not register throughout your Initial Enrollment Period, you might have the ability to register throughout the General Enrollment Period that occurs every year from January 1 to March 31; your protection would begin on July 1. When you are very first eligible to do so, you might be subject to a late-enrollment charge if you do not register in Medicare Part A. If you do not immediately receive Medicare Part A, you can do so throughout your Initial Enrollment Period, which begins 3 months prior to you turn 65, consists of the month you turn 65, and lasts for 3 extra months after you turn 65. Some individuals are immediately registered in Medicare Part A, while you might have to by hand register for it in other cases. Medicare Part A is one half of Original Medicare, the federal health-care program comprised of Part A (hospital insurance coverage) and Part B (medical insurance coverage). Normally speaking, Part A covers healthcare facility services and materials thought about clinically needed to deal with a condition or illness. Together with Medicare Part B, it makes up exactly what is understood as Original Medicare, the federally administered health-care program. Medicare Part A pays for the expense of inpatient medical facility care, while Part B covers outpatient medical services. Older Americans qualified for Social Security benefits can sign up for Medicare. Eligible persons can choose Original Medicare or Medicare Advantage. Eligible older Americans can join Medicare and select Medicare Part A only if they so choose. The initial enrollment period is the best time to select and apply for complete Medicare coverage. Learn all about Medicare: https://www.medicareonvideo.com
When you’re first starting Medicare, this is called your Initial Enrollment Period, or IEP. You have 3 months before, the month of and 3 months after your 65th birthday to shop for you Part D drug plan. Anytime after that is called the Annual Enrollment Period, or AEP. This time frame allows you to shop your Part D drug plan once every year. The dates for this period start on October 15th and end on December 7th. If you are losing retirement/group insurance or you have moved out of the service area of your plan, this is called a Special Election Period, or SEP. Once you find out you are losing your coverage, you have 60 days before the last day of your coverage and 63 days after you lose your coverage to enroll in a Part D drug plan.
When you're first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. - The three months before the month you turn 65 - The month of your 65th birthday - The three months after the month you turn 65 For more Medicare enrollment tips and advice, visit: 3 Ways to Prepare for Medicare Enrollment: https://blog.trustedseniorspecialists.com/3-ways-to-prepare-for-medicare-enrollment 5 Crucial Medicare Enrollment Mistakes: https://blog.trustedseniorspecialists.com/5crucialmedicareenrollmentmistakes For immediate Medicare questions or concerns, or to enroll in a Medicare plan today, give our licensed agents a call at 1-855-474-6234 TTY 711 or set up an appointment https://www.trustedseniorspecialists.com/schedule-your-appointment
Hey Medicare Nation! Over 17.5 Million of you are on a Medicare Advantage plan. And many of you have been, or know of a situation where your doctor has left the “network” and you are told by your Medicare Advantage Plan Carrier that you must find a new doctor. You tell your Medicare Advantage Plan carrier that you would like to change plans to keep your doctor, and they will tell you something that goes like this….”I’m sorry, you are unable to change plans mid-year. You will have to wait until the Annual Enrollment Period occurs to change plans, unless you have a special election. So….you’ll need to change doctors at this time.” Sound familiar? Well…..on today’s show, I’m going to discuss a “special election (SEP),” called – “Significant Network Change,” that many, many Insurance Agents don’t even know about. Revisions were made to the Medicare Managed Care Manual, which went into effect on April 22, 2016. The Significant Network Change Special Election Period, as written in the Medicare Managed Care Manual is listed as: “Pursuant to 42 CFR § 422.62(b)(4), enrollees who meet the exceptional conditions of being substantially affected by a significant no-cause provider network termination may be afforded a special election period (SEP). If CMS determines that an MAO’s network change is significant with substantial enrollee impact, then a “significant network change SEP” may be warranted. CMS will use a variety of criteria for making this determination, such as: (1) the number of enrollees affected; (2) the size of the service area affected; (3) the timing of the termination; (4) whether adequate and timely notice is provided to enrollees, (5) and any other information that may be relevant to the particular circumstance(s). The Medicare Advantage Organization will be required to notify eligible enrollees of the significant network change SEP if the SEP is granted by CMS. SEPs will not be granted when MAOs make changes to their network that are effective on January 1 of the following contract year, as long as affected enrollees are notified of the changes prior to the AEP. According to the rules, if a Medicare Insurance Carrier makes a “significant change” to one of their Medicare Advantage plan’s networks, that plan’s beneficiaries could possibly be granted a Special Election Period. This provider network change SEP allows beneficiaries “three months” to switch to traditional Medicare, with or without a stand-alone Prescription Drug Plan, or switch to a different Medicare Advantage plan, with or without Part D coverage. Whether or not beneficiaries qualify for this SEP is entirely up to CMS. CMS states in the Medicare Managed Care Manual that they may grant a provider network change SEP to beneficiaries based on some of the following factors: The amount of beneficiaries affected Whether or not beneficiaries received adequate and timely advance notice of the provider terminations The size of the plan’s service area The time of the year that the plan made changes to its provider network So…..if you have lost your primary care doctor, due to a non-cause termination in your Medicare Advantage Network, and it has caused you a “significant change” to your healthcare due to your doctor’s termination from the network, call Medicare and fight for this SEP! If Medicare denies your request for a SEP and you honestly feel you qualify under one or more of the criteria stated……. Call me and hire me to contact Medicare on your behalf! I have listed other Special Enrollment instances when you can make changes to your Medicare Advantage Plan outside of the Annual Enrollment Period. For a complete list, go to www.Medicare.gov TRADITIONAL MEDICARE SPECIAL ENROLLMENT PERIOD Here’s quick guide to when you can make changes to your Medicare Advantage Plan: You can make your initial selection of a Medicare Advantage Plan when you enroll in Medicare at age 65. During the Annual Enrollment Period which is between October 15th through Dec 7th every year. You can dis-enroll from a Medicare Advantage Plan between January 1- Feb 14th, but you would have to go back on to Original Medicare because you cannot switch to another Medicare Advantage Plan at this time. You may have a “Special Election” that qualifies you to change your plan. The Special Election Period that qualifies you to change your Medicare Advantage Plan, is what we want to focus on today. There are certain circumstances which allow you to qualify for this option. If You Move If you move and your new residence is not in your plan service area. You would need to notify Medicare as soon as possible, because you have the rest of the current month you are moving and the following 2 full months as the Special Election Period. If you move to a new address and your plan is still in your service area, but by moving you now have new options available to you that you didn’t previously have, then you would have a Special Election Period to change to one of the new option plans. Snowbirds that live in 2 locations, have to determine which of those residences is your primary residence. Where you vote and where you pay taxes are going to determine which is your primary residence. If you move out of the country for a period of time and now you are coming back to live in the US, that will trigger a Special Election Period. If you are moving into a long term care facility or a Skilled Nursing Facility with round the clock skilled nursing care, you would have a Special Election Period when you move into the facility, while you are residing in the facility and when you move out of the facility. Losing Coverage: If you leave your Employer's Insurance Plan, or union through retirement, turning 65, etc. If you had an involuntary loss of drug coverage that was as good or better than Medicare drug coverage(credible coverage), that triggers a SEP. Or if you have had drug coverage through a Medicare Cost Plan and you leave the Cost Plan. If you leave a PACE (Program All-Inclusive Care for the Elderly) Program. If you had Medicaid and lost eligibility because of income requirements. When there are plan changes with Medicare Contracts: If your Medicare Advantage Plan was sanctioned by CMS, then you would be able to contact Medicare directly to request a Special Election Period to choose another Medicare Advantage Plan. If Medicare terminated a contract with your Medicare Advantage Plan, that will trigger a Special Election Period and CMS will notify you. Special Circumstances You qualify as a Medicare & Medicaid recipient, you may change Medicare Advantage Plans as often as you'd like! If you qualify for LIS (Limited Income Sources) you may get extra help with prescription drug coverage and a Special Election Period to enroll in a different Medicare Advantage Plan. During your Initial Enrollment Period for Medicare, you may have enrolled in a Medigap plan, and decided to change to a Medicare Advantage Plan during your first enrollment year. If you decide you want to change back to a Medicare Supplement Plan during your first year of coverage, you qualify. SNP Plan - for chronic conditions (Diabetes, Heart Disease, COP) - may change your current Medicare Advantage Plan to enroll in a SNP plan, or you may no longer qualify for a SNP, so you can choose another Medicare Advantage Plan. f an error was made by a federal employee when you signed up for Medicare, and you can prove it, you may be granted an SEP. If you have a Medicare Supplement - a Medigap plan, you can change plans whenever you want because there is no SEP for Medicare Supplement Plans. Precautions: If you have a chronic illness, cancer, cardiovascular disease or other medical conditions, a Medicare Supplement (MediGap) plan does not have to enroll you after your first year of enrollment. You need to be careful and make sure you are going to be able to get coverage when you change plans. The Medicare Supplement carrier may not take you due to pre-existing conditions and once you drop your Medicare Advantage Plan, you may be "locked out" and not able to re-enroll until the next open enrollment period..Medicare Supplement Carriers can discriminate due to pre-existing conditions! The price of Medicare Supplement plans do change as you age, and where you live. Keep that in mind. Need more information on "Special Enrollment Periods?" See the entire list at www.Medicare.gov Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here) Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com
Welcome Medicare Nation! We have a question today and I know many of you need this information! MEDICARE SPECIAL ENROLLMENT PERIOD SHOW NOTES Here’s quick guide to when you can make changes to your Medicare Advantage Plan: You can make your initial selection of a Medicare Advantage Plan when you enroll in Medicare at age 65. During the Annual Enrollment Period which is between October 15th through Dec 7th every year. You can dis-enroll from a Medicare Advantage Plan between January 1- Feb 14th, but you would have to go back on to Original Medicare because you cannot switch to another Medicare Advantage Plan at this time. You may have a “Special Election” that qualifies you to change your plan. The Special Election Period that qualifies you to change your Medicare Advantage Plan, is what we want to focus on today. There are certain circumstances which allow you to qualify for this option. If You Move If you move and your new residence is not in your plan service area. You would need to notify Medicare as soon as possible, because you have the rest of the current month you are moving and the following 2 full months as the Special Election Period. If you move to a new address and your plan is still in your service area, but by moving you now have new options available to you that you didn’t previously have, then you would have a Special Election Period to change to one of the new option plans. Snowbirds that live in 2 locations, have to determine which of those residences is your primary residence. Where you vote and where you pay taxes are going to determine which is your primary residence. If you move out of the country for a period of time and now you are coming back to live in the US, that will trigger a Special Election Period. If you are moving into a long term care facility or a Skilled Nursing Facility with round the clock skilled nursing care, you would have a Special Election Period when you move into the facility, while you are residing in the facility and when you move out of the facility. Losing Coverage: If you leave your Employer's Insurance Plan, or union through retirement, turning 65, etc. If you had an involuntary loss of drug coverage that was as good or better than Medicare drug coverage(credible coverage), that triggers a SEP. Or if you have had drug coverage through a Medicare Cost Plan and you leave the Cost Plan. If you leave a PACE (Program All-Inclusive Care for the Elderly) Program. If you had Medicaid and lost eligibility because of income requirements. When there are plan changes with Medicare Contracts: If your Medicare Advantage Plan was sanctioned by CMS, then you would be able to contact Medicare directly to request a Special Election Period to choose another Medicare Advantage Plan. If Medicare terminated a contract with your Medicare Advantage Plan, that will trigger a Special Election Period and CMS will notify you. Special Circumstances You qualify as a Medicare & Medicaid recipient, you may change Medicare Advantage Plans as often as you'd like! If you qualify for LIS (Limited Income Sources) you may get extra help with prescription drug coverage and a Special Election Period to enroll in a different Medicare Advantage Plan. During your Initial Enrollment Period for Medicare, you may have enrolled in a Medigap plan, and decided to change to a Medicare Advantage Plan during your first enrollment year. If you decide you want to change back to a Medicare Supplement Plan during your first year of coverage, you qualify. SNP Plan - for chronic conditions (Diabetes, Heart Disease, COP) - may change your current Medicare Advantage Plan to enroll in a SNP plan, or you may no longer qualify for a SNP, so you can choose another Medicare Advantage Plan. f an error was made by a federal employee when you signed up for Medicare, and you can prove it, you may be granted an SEP. *****You cannot get an SEP because your Doctor left the network******** If you have a Medicare Supplement - a Medigap plan, you can change plans whenever you want because there is no SEP for Medicare Supplement Plans. Precautions: If you have a chronic illness, cancer, cardiovascular disease or other medical conditions, a Medicare Supplement (MediGap) plan does not have to enroll you after your first year of enrollment. You need to be careful and make sure you are going to be able to get coverage when you change plans. The Medicare Supplement carrier may not take you due to pre-existing conditions and once you drop your Medicare Advantage Plan, you may be "locked out" and not able to re-enroll until the next open enrollment period..Medicare Supplement Carriers can discriminate due to pre-existing conditions! The price of Medicare Supplement plans do change as you age, and where you live. Keep that in mind. Need more information on "Special Enrollment Periods?" www.callsamm.com - has all of this information available for you. Download the Quick PDF List for Special Election Periods. Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here) Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com