What you need to know about Medicare’s open enrollment
Medicare open enrollment has begun, so now is the time for those who are eligible to do their homework.
Here are answers to questions you might have as a first time enrollee or if you need to make changes to your plan, plus resources to help you navigate this insurance landscape.
What is Medicare? Medicare is the federal government program that provides health care coverage.
Who is eligible to enroll? Those 65 and older; those under 65 and receiving Social Security Disability Insurance for a certain amount of time; and those under 65 with end-stage renal disease or Lou Gehrig’s disease.
When is open enrollment? Through December 7
What are Medicare’s parts? Medicare has four basic parts: Part A (hospital insurance), Part B (medical insurance), Part D (drug coverage) and Medicare Supplemental Insurance (Medigap).
What are my choices? Original Medicare, which includes Parts A and B, and lets you join a separate drug plan to get Part D. You can visit any doctor or hospital in the U.S. that takes Medicare. If you need help with your out-of-pocket costs, you can buy Medigap. Choice two is Medicare Advantage, a Medicare-approved plan from a private company. These plans include Parts A, B and usually D. They might have lower out-of-pocket costs and more benefits than Original Medicare, but you’ll have to use doctors who are in the plan’s network.
What if I’m enrolled but want to change my plan? According to www.medicareresources.org, during open enrollment, you can:
- Switch from Medicare Advantage to Original Medicare or vice versa.
- Switch from one Medicare Advantage plan to another.
- Switch from one Part D prescription plan to another. It’s highly recommended that all beneficiaries use Medicare’s plan finder tool each year to compare the available Part D plans, as opposed to simply letting an existing drug plan auto-renew.
- Join a Medicare Part D plan. (Late-enrollment penalty may apply.)
- Drop your Part D coverage altogether. (Re-enrolling in a later year will include a late-enrollment penalty if you’re not maintaining other creditable drug coverage.)
Where can I get help if I need it? There are numerous resources available to help you find your way. Here are some keys websites:
- The U.S. government’s official website: www.medicare.gov
- GeorgiaCares, for local help with Medicare and to register for a free Medicare webinar: https://mygeorgiacares.org
- A consumer guide: www.medicareresources.org
- To talk to someone via online chat or on the phone: www.medicare.gov/talk-to-someone
About the Author
Nancy Clanton is a lead producer for The AJC's platforms team, but also writes stories about health, travel, events and entertainment. A native of Knoxville and graduate of the University of Tennessee, she has worked at the AJC for 24 years.
