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*Updated for 2023* Medicare and Open Enrollment Coming Soon, What You Need to Know

*Updated for 2023* Medicare and Open Enrollment Coming Soon, What You Need to Know

September 11, 2023

Do you know everything you need to know about Open Enrollment for Medicare? Open Enrollment Period (OEP) for Medicare starts October 15 and lasts until December 7th, 2023.  And unless you just turned 65 and it’s your first time signing up for Medicare (Initial Enrollment Period), there are only a few times per year when individuals 65 and older or those with disabilities can apply for this government-owned health insurance. It’s never too early to start planning ahead and researching your Medicare options to see what plan is best for you.

Medicare offers a variety of coverage options, which are divided into parts A, B, C, and D. Part A covers inpatient hospital visits, skilled nursing facilities, hospice, and some home healthcare services, Part B covers medical visits, and Part D covers prescriptions. Part C (also known as Medicare Advantage) is special coverage that bundles all of the above. Of course, each has its own costs and advantages. You can find more information onParts A and B on the website. This article from AARP covers what Parts C and D include.

There were some big changes for Medicare in 2023, including caps on insulin copays, free vaccines, lower premiums, and more! Even the higher monthly charges paid by the 7 percent of beneficiaries with high incomes saw a drop this year. However, Part A deductible costs went up $44 in 2023. It’s also a good time to sign up for Medicare; your coverage goes into effect quicker than last year. Beginning in 2023, as long as you apply for Medicare during either the general enrollment period or a special enrollment period, your coverage will take effect at the beginning of the following month.

Now that you have an idea of what you need to research, let's talk about what Medicare Open Enrollment is, who can apply during this time, what you can do if you miss Open Enrollment and important information for first-time Medicare enrollees.

What is Medicare Open Enrollment?

In a nutshell, Medicare Open Enrollment is the time of year that you can join, switch plans, or drop one of the Medicare healthcare plans. During the Medicare open enrollment period, you can make changes to your Medicare health and drug coverage that will take effect on Jan. 1st. This is the main time when people with Medicare can choose a plan, but there are other times during the year that may be called “open enrollment” or “special enrollment” periods when a person can enroll in a plan. 

So, when does Medicare Open Enrollment start and end? Also called the Fall Open Enrollment Period, this Medicare enrollment period runs from October 15th through December 7th each year. It is best to apply as soon as possible so that your coverage will begin on January 1st of the following year. 

Healthcare plans change, and so do your healthcare needs. So even if you are not enrolling for the first time, this open enrollment period is a good time to make any changes to your current plans and coverage to best suit your needs. For example, you can opt to switch from Original Medicare to an Advantage Plan (or vice versa) or switch to one that covers prescription drugs (or vice versa). Or, you can choose to drop a Medicare plan altogether.

You may be wondering what the difference between open enrollment and annual enrollment Medicare is. The short answer is, there is none. It's just another name for the same Medicare enrollment period.

However, there is a difference between Medicare Open Enrollment and General Enrollment. The GEP begins January 1st and ends March 31st. You can also sign up for Medicare for the first time during this period if you missed your Initial Enrollment Period (IEP). Starting January 1, 2023, your coverage starts the first day of the month after you sign up. You may have to pay a monthly late enrollment penalty if you don’t qualify for the Special Enrollment Period.

Who Can Apply During Open Enrollment?

In general, individuals age 65 and older can apply for Medicare during the OEP. You must be a U.S. citizen or alien that is working towards permanent residence and have been living in the U.S. for at least 5 years before filing your Medicare application.

There are special exceptions for some individuals under the age of 65. People with certain disabilities and permanent kidney failure are also eligible to apply for Medicare during the Open Enrollment Period. 

It is also important to note that income comes into play as well. Most people will pay the standard premium amount. However, if your modified adjusted gross income, as reported on your IRS ta return from 2 years ago, is above a certain amount, you may pay more.

You may be wondering if you can have Medicare and open enrollment at the same time. The answer is “yes.” Again, this enrollment period is for those signing up for the first time or those wishing to make changes to their current plans.

What if I Miss Medicare Open Enrollment?

If, for whatever reason, you miss the Medicare Open Enrollment Period, you have a few other options. As stated earlier, the General Enrollment Period begins on January 1st. You can do many of the same things during this time as you can during the Open Enrollment Period. You can also sign up for Medicare Advantage (Part C) during this time if you're looking to add extra coverage to your plan.

Numerous extenuating circumstances can also allow you a Special Enrollment Period (SEP). These include, but are not limited to, the following:

  • Moving out of your plan's service area.
  • Moving into or out of a skilled nursing facility.
  • You're no longer eligible for Medicaid.
  • You no longer receive employer-based or union-based health insurance.

These are just a few examples. If major changes are made to your plan, coverage, or your own health, it never hurts to ask if you qualify for a Special Enrollment Period (SEP).

You might also look into Medigap coverage. This is supplemental insurance that can be used in conjunction with Medicare to help pay your share of out-of-pocket costs from Medicare. Enrollment timeframes for Medigap vary for each individual. However, you can only apply for this if you are 65 and older AND are already signed up for Medicare Part B.

Initial Medicare Enrollment Period (First Time Medicare)

If you are just coming upon your 65th birthday and are beginning to research your Medicare options, let's talk about the Initial Enrollment Period (IEP). This is the 7-month period in which you are first able to sign up for Medicare around the time you turn 65.  The IEP starts 3 months before you turn 65 and ends 3 months after the month you turn 65. The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. However, coverage always starts on the first of the month.

If you are eligible for Medicare due to disability, your IEP starts 3 months before the 25th month of continuous disability payments.

You are not automatically enrolled when you turn 65 unless you are already receiving Social Security or Railroad Retirement Board benefits. Sign up as soon as possible so your coverage is not delayed. People who enroll outside of their IEP may receive penalties for delayed enrollment. 

Are You Ready to Sign Up for Medicare? 

Researching Medicare options and coverage is an important endeavor for anyone of retirement age. It will likely be your sole source of health insurance during your golden years. Such an important decision can feel daunting to many, especially with all of the ins and outs of each plan and even the variations within each.

Benefit and Financial Strategies wants you to be as knowledgeable as possible and feel confident about your enrollment in Medicare. We have been serving the needs of the Flagstaff, Arizona community and beyond for over 30 years. We work with both businesses and individuals to ensure bright futures for all of our clients. To learn more about all of our services, including insurance plans, we invite you to head over to ourFinancial Services for Families and Individuals page. Whether it's a phone call or an email, please don't hesitate tocontact us with any questions you may have about your Medicare enrollment.