It’s Really Not Medicare Open Enrollment Time

October 2, 2012 in Medicare

When I wrote a few weeks ago about Medicare saying that it was “almost that time of year again,” I did not mean it was Medicare open enrollment time,  And when you read story after story over the next two months that it’s now Medicare open enrollment time, those stories are wrong.

Here’s the distinction with a difference. Buried in my too-long September blog post on signing up for Medicare for the first time was this sentence:.

“The Open Enrollment period for Medicare Parts C and D for 2013 begins October 15, 2012 and that’s a good time to check all your options.”

But you don’t currently have any 2013 options relative to Part C Medicare Advantage or a Part D Prescription Drug Plan unless

  • you are already on at least Medicare Part A (and possibly on Part B)

or 

  • your 65th birthday occurs between now and December (and you’ll need your just issued Medicare card or a letter from Social Security saying one is on the way in hand)

or

  • you are older than that but are coming from what Medicare considers employer-based minium creditable coverage (but you don’t have to be the employee) 

If you meet the criteria, this IS open enrollment for Part C and Part D Medicare but not for Medicare itself..

If you have never signed up for Medicare at all and should have and don’t have a good excuse (the employer based insurance mentioned in the third bullet above is the usual one), you need to wait until the Medicare enrollment period that runs from January to March of 2013, and your coverage will be effective July 1, 2013.

And you might have to pay a higher premium than the standard premium for your income bracket for signing up late. And many other options such as Part C, Part D and most Medigap insurance depend on your having at least Part A and usually Part B. 

As I said last month, it’s never simple. The moral of the story. Sign up for A when you turn 65.  Almost always, it’s free.  There are some good reasons not to sign up for Part B when you are 65 but make sure you understand them and know when to sign up in the future.

 

 

 

 

2 responses to It’s Really Not Medicare Open Enrollment Time

  1. Dennis – I appreciate all the info you are sharing on Medicare. I have one overall comment which is – I can’t believe how complicated the program is. Why do people put with all the complications? Is it just that this is the only option for the vast majority of people?

  2. Martha, this is somewhat of a flip answer but I think it’s accurate. There are two easy ways for a person over 65 to avoid most but not all of the Medicare complications:

    1. Keep working!! But of course it has to be for an employer that provides heatlhcare insurance as a benefit (only 70% or so in Mass do and — you probably know the statistics off the top of your head — only to those that work more than so many hours, and there are other restrictions, etc.)

    2. Retire from an employer that offers its retirees healthcare insurance!! That now accounts for around 35% of the people on Medicare but that number is dropping quickly (and also see all the asterisks in parentheses in item 1 above)

    I think the VA handles under 1% of us seniors (which has different complications), another percent of seniors have spouses still working and are covered by his or her insurance, and a few percent of us go without any kind of supplement to Medicare despite the government’s advice to get some and its help getting it. So for 65% of seniors and growing (what do you consider a “vast majority?), there is no other option but to follow these complicated processes. And hope they change the law.

Leave a reply

You must be logged in to post a comment.