Wondering why you’re seeing an endless stream of commercials for Medicare plans, including one featuring former NFL star Joe Namath? It’s because right now it’s Medicare’s special fall enrollment period. It began on October 15 and ends on December 7, 2020.
It's a common misconception that this is the only time of year you can sign up for Medicare. Not true. You can enroll up to three months before you turn 65. And since there is a waiting period before coverage begins, you’ll want to do this as early as possible if you want to be on Medicare on or shortly after your 65th birthday.
When you enroll in Medicare, you have a choice of two kinds of coverage: standard Medicare plans and comprehensive Medicare Advantage managed care plans.
Standard Medicare options
The standard Medicare options are:
- Medicare Part A covers some inpatient, skilled nursing care and home health costs. For most people this coverage is free.
- Medicare Part B covers some of the costs of services or supplies to diagnose or treat your medical condition and limited outpatient prescription drugs. You pay a monthly premium for this coverage.
- Medicare Part D is optional and covers some prescription drug costs. Coverage is provided by private insurance companies. You’ll pay a separate premium on top of your Medicare Part B coverage and the premium will vary depending on the coverage level and provider.
- Medigap: Also called Medicare Part F, Medigap options offer supplemental coverage not included in Medicare Part B. These options are offered by private insurers and premiums and coverage levels vary.
Also called Medicare Part C, Medicare Advantage plans are comprehensive managed care plans provided by private insurance companies. They generally provide all of the services Medicare enrollees are entitled to. Most offer prescription drug coverage as well. The key benefit of Medicare Advantage plans is that their premiums are generally lower than those of standard Medicare plans.
The biggest potential disadvantage of these plans is their limited choices. With standard Medicare plans, you can visit any physician or go to any facility that accepts Medicare payments anywhere in the country. With Medicare Advantage, you’re usually limited to using the physicians and facilities in the provider’s network. This can be an issue if you travel a lot or spend some of the year living in another state where your provider doesn’t have a presence.
Fortunately, you’re not stuck with your plan
The great thing about Medicare is that you’re never stuck with a plan you don’t like. During the fall special enrollment period, you can:
- Switch from a standard Medicare package to a Medicare Advantage plan.
- Switch from a Medicare Advantage plan to basic Medicare Parts A and B.
- Change your Medicare Advantage provider.
- Add Medicare Part D coverage or change your current prescription drug provider.
- Add or change Medigap coverage options and providers.
One important consideration: If you originally signed up for a Medicare Advantage plan and want to switch to a standard Medicare/Medigap combination, you may be turned down by Medigap providers if you have a pre-existing condition.
Help is available
Whether you’re enrolling for the first time or considering changing Medicare options, the process can be extremely confusing. Fortunately, every state offers access to free Medicare consulting through its State Health Insurance Program (SHIP). You can find SHIP representatives in your area at shipatcenter.org.
Other resources you can use:
- Medicare.gov lets you compare costs and coverage for standard Medicare, Medigap and Medicare Advantage options.
- Ehealth.medicare.com can show you the available Medicare Advantage providers in your area.
- Askclaire.com provides unbiased Medicare education.
This material has been provided for general informational purposes only. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult with a qualified Medicare consultant to better understand your options.
This article was authored by Joelle Spear and Jeffrey Briskin. Joelle is a financial advisor and Partner located at Canby Financial Advisors, 161 Worcester Road, Framingham, MA 01701. She offers securities and advisory services as an Investment Adviser Representative of Commonwealth Financial Network®, Member FINRA/SIPC, a Registered Investment Adviser. She can be reached at 508.598.1082 or [email protected]. Jeffrey Briskin is Director of Marketing at Canby Financial Advisors.
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