Hello Happy People! Welcome back to another episode of 65 and Counting! I’m your host, Adam Frye. I’m a Certified Medicare Planner and I’m here to ask the important questions that you want to be answered by industry professionals. This show is for anyone and everyone coming up on that important milestone of 65 years old. That means retirement, it means medicare eligibility, or it means that you’re just plain interested in the world of retirement planning. Whatever it is, on this show, you’ll hear from the people that know it best.
The Annual Election Period is coming to a close! There are only a few busy days left to jump in and have your plan reviewed for next year! Remember while you may not have changed, the plans may have changed on you! Don’t be misled by commercials on TV and mailers in your box! Certified Medicare Planners are standing by to help you make the most appropriate decision!
Speaking of the Annual Election Period, today's episode is all about the different types of enrollment periods when it comes to Medicare! We’re going to take a look at the special times you can start, change, and disenroll from Medicare Plans!
We’ll break down enrollment periods into a few different types. There are your fixed annual enrollment and disenrollment periods which include the Annual Election Period and the Open Enrollment Period and then there are Enrollment periods with dates and conditions based on individual circumstances such as your initial enrollment period, special election periods, etc.
Lets start by talking about your Initial Coverage Election Period for Medicare Advantage Plans, this is one of the widest windows you’ll have when selecting a Medicare Plan. The Initial Coverage Election Period or ICEP is the period during which someone who is newly eligible may make an initial enrollment request to enroll in a Medicare Health Plan. This period begins three months immediately before the individual's first entitlement to Medicare. For most people that’s the first of the month that is three months prior to their 65th birth month. The month of their 65th birth month, AND three months after their 65th birth month! That’s a seven-month window! A lot of people allow their neighbors, friends, family, co-workers, or even sometimes undesirable insurance agents to scare them in to thinking this window is much smaller. Don’t get me wrong, it’s important to be prepared and not wait too long on this enrollment period, but if you miss the mark, just remember there’s plenty of time to enroll!
During the ICEP you can enroll in a Medicare Advantage plan, choose a Stand-alone Prescription Drug Plan, but you can only make ONE enrollment choice under this enrollment period. Once the enrollment is made, you’ve used your ICEP and it’s gone. Again this period revolves around the window of your 65th birth month OR if you’re under 65 the 25th month of your disability but it will always relate to your first entitlement to Medicare A and B.
Now, let’s talk about that special thing that’s happening RIGHT. NOW. That’s the Annual Election Period! Or AEP. AEP runs from October 15 through December 7th every year and is available to all Medicare Advantage and Part D Prescription Drug Plan eligible people! During AEP, beneficiaries may add or drop Medicare Advantage and/ or drug coverage and return to Original Medicare, or change your MA or PDP to another MA or PDP to one that’s more appropriate for you. People that do this typically do so to follow one or more doctors to a new network that may not be part of their current plan, experience lower copays on their medication, or just simply for a different plan's benefits. You can make as many changes as you like during this period with the last change made taking effect on the first of the following year.
Now let’s quickly discuss Medicare’s Open Enrollment Period! Now this period is ONLY for people on Medicare Advantage plans! It takes place from January 1st and runs through March 31st. During this enrollment period, you can change to a different Medicare Advantage plan or disenroll from that to Original Medicare and if you’ve got a stand-alone prescription drug plan in combination with a Medicare Advantage plan (that doesn’t include drug coverage) you can change the prescription drug plan! Also, if you disenroll from a medicare advantage plan into Original Medicare, you may enroll in a prescription drug plan.
With this enrollment period, you can only make ONE CHANGE! Again, this enrollment period is only available to those with Medicare Advantage Plans. That means the ability to make changes to your prescription drug plan is limited to only those that have a Medicare Advantage.
There’s another category of enrollment periods that may apply to anyone but are not fixed annual dates! These enrollment periods start and stop depending on certain circumstances. They are called Special Election Periods. The time frames all vary, but most will begin on the first day of the month in which the qualifying event occurs and will last for a total of three months. The Special Election Period or SEP generally ends when you make the allowed change or the time period for the SEP expires.
Some examples of becoming eligible for a SEP are a change in residence, Involuntary loss of creditable drug coverage, gaining or losing Medicaid eligibility, gaining or losing extra help with your prescription drugs, leaving your employer or union group insurance, becoming a US citizen or lawfully present in the USA, dropping a Medigap policy when they’ve enrolled for the first time in a Medicare Advantage Plan while still in the “trial period”, and Individuals who have severe or disabling chronic conditions and what to move to a special needs plan designed for their condition. There’s also an opportunity for a special election period if a “Five Star Plan” becomes available in your area or if you are an institutionalized individual!
Under these Special Election Periods you’ll typically have only one opportunity to add, drop, or change your coverage.
There’s a lot of details that go into SEP’s, and if you think you might be eligible for one, get with a Certified Medicare Planner to talk about it!
Thanks for tuning in this week, we’re so happy you did! Don’t forget that the Annual Election Period or AEP is almost over! We’re here to help. Also, we’ve got workshops you can attend live and in person or virtually on your computer! Check out www.123easymedicare.com or call the office today! Don’t forget to like the video, subscribe to our page, and tell all your friends! And most importantly, have a great week!