What You Need to Know About Medicare Open Enrollment If You’re Newly Eligible

If you’re approaching or recently turned age 65, you’ll soon be able to sign up for Medicare, the nation’s health insurance program for older Americans. The annual open enrollment period for the coming year begins Oct. 15 and ends Dec. 7.

Getting Started with Medicare

Because people can sign up for Medicare three months prior to turning 65, it’s possible you are already eligible. If you haven’t started your research into Medicare, this is a good place to start.

Let’s begin with Original Medicare. This is also known as Medicare Part A and Medicare Part B. A is for coverage if you’re hospitalized, while B pays for provider services, outpatient treatment, including preventative care in some cases, and home health care.

If you or your spouse worked and earned enough credits by paying Medicare taxes, you won’t have to pay a Part A premium. Nor will you if you currently qualify for Social Security benefits.

On the other hand, you’ll have to pay a Part B premium. How much it will cost, will depend on your income. Higher earners are expected to pay a greater share. The standard Part B premium for Medicare Part B Premium: $170.10 in 2022.

As we mentioned before, CMS runs the Medicare program. However, the Social Security Administration, or SSA, processes applications for Part A and Part B.  

You can sign up for Original Medicare using the SSA online Medicare application. They can also assist you with a replacement Medicare card, should you need one. Need help signing up? Contact us.

Medicare Part C and Part D

There’s more to Medicare than Parts A and B. Part C, Medicare Advantage (MA) coverage, which incorporates A and B and offers additional benefits; and Part D, Prescription Drug Coverage, are both sold by private insurance companies in accordance with Medicare rules.

There are also Medicare Supplement, or Medigap, plans that help cover out-of-pocket Medicare expenses such as copays, coinsurance and deductibles.

MA plans provide Part A and Part B benefits, plus additional coverage, such as for extra days in the hospital besides what Part A covers. They may lower your out-of-pocket Medicare costs. MA plans include Health Maintenance Organization and Preferred Provider Organization (HMO and PPO) plans, as well as Fee-for-Service, or FFS, plans.

If you choose a Medicare Advantage plan over Original Medicare, it will go into effect Jan. 1 of the following year.

Should you choose Original Medicare, however, you can also choose to sign up for Part D to cover prescription medications.  If you buy Part D coverage as a stand-alone plan, you’ll have to pay a premium for that, as well.  It’s important to enroll in a Part D plan when you’re initially eligible, because if you don’t, you might incur a late enrollment penalty if you choose to enroll in one later.

Medicare is complex. We can help.

If this sounds complicated, you’re far from alone. We’re just scratching the surface of Medicare here. There are other parts and plans that go by an alphabet of names. You don’t have to figure this all out alone. Our trained Medicare specialists can guide you through the process, so you choose the Medicare coverage that fits best with your needs and budget.