Medicare Fall Open Enrollment: What You Need to Know

The annual Medicare Fall Open Enrollment Period, also known as the Annual Election Period, is a time when people with Medicare can choose or alter their Medicare coverage. The Medicare Fall Open Enrollment runs from Oct. 15 to Dec. 7 of each year.

Finding the right Medicare plan to fit your needs, reviewing deductibles and understanding the prescription drug coverage gap, or “donut hole,” can be confusing when you don’t know where to look for information.

What follows are some FAQs that beneficiaries should consider during the Medicare Fall Open Enrollment Period:

Q: What’s the Medicare Fall Open Enrollment Period?

A: The Medicare Fall Open Enrollment Period, which runs from Oct. 15 through Dec. 7, is the window for Medicare recipients to review, tailor or change their plans. There are roughly 61.2 million Medicare recipients, according to a Kaiser Family Foundation analysis of the Centers for Medicare & Medicaid Services’ Medicare enrollment files.

During the Medicare fall open enrollment period, beneficiaries are able to:

— Change between a Medicare Advantage plan and Original Medicare, Part A and Part B.

— Change from one Medicare Advantage plan to another.

— Enroll in a Part D prescription drug plan, change from one Medicare prescription drug plan to another or opt out of Medicare prescription drug coverage completely.

Changes made during this period go into effect Jan. 1 of the next year.

Some Medicare plans during the past year may have been altered or premiums may have risen or fallen, says Paula Muschler, former operations manager for Allsup, a private company that advises Medicare beneficiaries on their coverage options. “Don’t put it aside, don’t think your plan isn’t changing,” he says. “It might be small changes, but they may be changes you need to pay attention to.”

Medicare beneficiaries are encouraged to review their Medicare coverage every year during fall open enrollment to see if there are new Medicare plan options that may better suit their needs.

[READ: What Is a Health Savings Account?]

Q: I turn 65 in a few months — I’ll be eligible for Medicare, but I haven’t enrolled yet. What should I do during my Initial Enrollment Period?

A: People who will become Medicare-eligible soon have a different deadline.

When you’re first eligible for Medicare, people turning age 65 can sign up for Medicare during a seven-month window that begins three months before their 65th birthday and ends three months after their birthday month. This enrollment period is known as the Initial Enrollment Period. It’s encouraged not to wait until the last minute to review the Medicare plan options available to you.

“The reason you want to start early is you don’t want any (medical coverage) gap,” Muschler says. “You need to review your options and how you will use your coverage.”

Things to consider:

— Do you have a preferred health care provider or hospital?

— What are your health needs?

— Will your particular choice of Medicare coverage travel with you if you move?

— Are your medications covered, and how much will you pay out-of-pocket each time you fill them?

— Are there restrictions on where you can fill your prescriptions, and if so, are the plan’s preferred pharmacies close to where you live?

[See: Guide to 2021 Medicare Enrollment and Best Insurance Companies.]

Q: Should I sign up for the Affordable Care Act instead?

A: Not if you’re enrolled in or eligible for Medicare. The Health Insurance Marketplace under the ACA is designed to help individuals not eligible for Medicare access health insurance.

Moreover, it’s illegal for an insurance broker or a health plan to sell you a Marketplace plan if it’s clear that you’re eligible for or are currently covered by Medicare.

[Read: Best Insurance Companies for Medicare Part D Prescription Drug Plans.]

Q: Where can I get information about and assistance signing up for Medicare?

A: There are many available resources.

For free personalized counseling services you can reach out to your State Health Insurance Assistance Program. Find yours at shiptacenter.org.

The Medicare Rights Center also has a national helpline, which can be reached at: 1-800-333-4114.

Medicare advisory Allsup also provides personalized assistance selecting Medicare coverage and can be reached at 866-521-7655, as do websites such as AARP. U.S. News also has a guide that offers information for consumers who are seeking to understand or purchase Medicare plans.

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Medicare Fall Open Enrollment: What You Need to Know originally appeared on usnews.com

Update 11/10/21: This story was previously published at an earlier date and has been updated with new information.

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