Sunset Stories

Medicare Open Enrollment Time is Approaching

Posted by Gayle Young on Sep 16, 2019 11:37:20 AM

The Open enrollment period for 2020 Medicare coverage begins October 15 and runs through December 7, 2019. Annual enrollment is the time for making any changes to your existing Medicare policy, such as switching from Original Medicare to a Medicare Advantage plan. Updates made during the open enrollment timeframe take effect on January 1, 2020.

We put together a list of some commonly asked questions concerning Medicare open enrollment, as well as questions about general coverage issues. Be sure to check with a qualified financial advisor to get your specific questions answered, or call 1-800-MEDICARE for assistance.

I thought the government automatically enrolled me in Medicare. Why is there an open enrollment period?

If you're a US resident and a Social Security or Railroad Retirement Board benefit recipient, the government automatically enrolls you in Medicare (Parts A and B) when you turn 65. The annual open enrollment period allows you to make changes to your coverage. For example, you can move from Original Medicare to Medicare Advantage, switch Medicare Advantage plans, or add Medicare Part D prescription drug coverage. Or, if you like your current coverage as it is, you can do nothing at all.

Why would I alter my Medicare coverage?

Medicare plans—as well as your expected healthcare needs—often change from one year to the next. Although you might be happy with your current policy, it’s good to make sure your coverage is still the best option for you. For example, premiums and co-pays could increase, you might need additional prescription medications, or treatment coverages could face elimination. The open enrollment period allows you the chance to make changes to reflect your current coverage needs.

Sunset Medicare Open Enrollment

What if I change my mind?

If you modify your Medicare coverage during the open enrollment period and then discover you made a mistake, you have another opportunity to make changes. Between January 1 to March 31 each year, you can alter certain aspects of your Medicare coverage. For example, Medicare Advantage enrollees can change back to Original Medicare, or switch to a different Medicare Advantage plan. If during this period, you leave Medicare Advantage and return to Original Medicare, you can add Medicare Part D to your coverage.

What is the Medicare Donut Hole?

The term “donut hole” describes the gap within Medicare Part D's prescription drug benefit. It's the point where incurred drug expenses fall between your plan's initial coverage limit and its catastrophic coverage level.

Initially, Medicare Part D required enrollees to pay 25 percent of their prescription costs up to the initial coverage limit ($3,820 in 2019) and 5 percent after exceeding the catastrophic level ($5,100 in 2019). However, within the donut hole, patients paid 100 percent of their drug costs.

Fortunately, the coverage gap causing the donut hole has been closing in recent years. By 2020, patients will pay 25 percent of drug costs until reaching the catastrophic level.

Where can I find help making decisions?

Medicare Plan Finder allows users to compare Medicare plans online. You can enroll in Medicare Part D and Medicare Advantage plans, compare benefits among Original Medicare and Medicare Advantage plans, and view drug coverage across Part D plans. The recently redesigned website also lets users determine whether generic versions of their prescription medications are available. As mentioned above, a qualified financial advisor can help you sort through all the options. Assistance is also available by calling 1-800-MEDICARE.

Are the costs for an assisted living facility covered by Medicare?

Medicare does not pay the costs for an assisted living facility. In the event you require skilled nursing after a hospital stay lasting three days or longer, Medicare A may pay a portion of a nursing home’s costs for up to 100 days.

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Topics: Planning, Senior Care Terms, Healthcare, Medicare