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Educational & Guidance

What is Open Enrollment?

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There is several different plans that use this "Open Enrollment" terminology, however we are talking about Medicare Plans "Open Enrollment".

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The first "Enrollment period" we will talk about is actually your Medicare Part B "Initial Enrollment Period".

See if your eligible here to enroll and if you are, calculate your premium:  Medicare Eligability Calculator

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The first enrollment period you will experience as you approach Medicare is your "Initial Medicare Part B Enrollment Period".  

This comes three months prior to turning 65 (or on your 21st social security disability check) to three months after the month you turn 65

(or your 27th social security disability check).

For those who are already drawing social security retirementOR disability prior to being eligible for Medicare, will experience automatic enrollment

(That is unless you opt out which is what you should do if your still actively working and covered under a decent Employer Sponsored Group Plan)

into Part B with an effective date of:

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Regular Social Security Early Retirement:

     1st day of the month you turn 65 (Unless your birthday falls on the first of the month, then it is usually the first of the month preceding the month you turn 65)

          "On a personal note, it would be interesting to see how the later rule came into play".

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Disability Social Security:

     On the first day of the month following your 24rth consecutive disability check.

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If you are not drawing Social Security and do not have any intention to draw social security, but you do want your Medicare Part B: 

    You will need to go online to socialsecurity.gov or go to your local office and enroll.

You will need to make payment arrangements and your options there are:

    Pay quarterly by direct bill/statement (WHICH WE DO NOT RECOMMEND)

    Or you can agree to a monthly bank draft (This is the best way).

If you choose statement and your payment is lost in the mail, then you areout of luck!!!!

If Medicare does not receive your check they will cancel your Part B. They don't care why they didn't get your check, simply put, your disenrolled and can't get it back until the next General Enrollment Period (between January 1–March 31 each year and will not become effective until the following July 1st)

Okay, so you really want to rely on the US Postal Service to keep your Medicare going?

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If you are still working and covered under a decent Employer Sponsored Group Plan and wish to continue working but DO NOTwant Part B (what we recommend), then you are not required to enroll AS LONG as your existing coverage is Creditable Coverage. (means its just as good or better than the Medicare Plan).

If you go ahead and enroll while covered under a Employer Sponsored Group Plan, yourMedigap Open Enrollmentwill still start and runout after six month's when your Medicare Part B starts, even thoughyou did not get to use it. (we will discuss this next)

NOT TO MENTION paying for Part B premium (2014 & 2015, $104.90 for those under $80,000 per year) and not ever using it. 

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All active Employee Group Plans are always secondary to Medicare. 

So with this being explained, we recommend to those still working and not drawing social security, to hold off on enrolling into Medicare Part Buntil your Active Employer Group Planends. (provided that it is Creditable Coverage against Medicare and your group plan can & will give you that information)

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Medigap Open Enrollment

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When can I buy Medigap?

.Buy a policy when you're First Eligible: 

The best time to buy a Medigap policy is during your 6-month Medigap open enrollment period,
because you can buy any Medigap policy sold in your state, even if you have health problems.
This period automatically starts the month you're 65 and and enrolled in Medicare Part B, and once it's over, you can't get it again.

(or after your 24th social security disability check if your under 65).

You will get another Open Erollment when you turn 65 that will let you choose

any plan available just as if you never had Medicare until you turned 65.

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Medigap insurance companies are generally allowed to use medical underwriting to decide whether to accept your application and how much to charge you for the Medigap policy. However, if you apply during your Medigap open enrollment period, you can buy any Medigap policy the company sells, even if you have health problems,

for the same price as people with good health.

Outside open enrollment
If you apply for Medigap coverage after your open enrollment period, there's no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements, unless you're eligible due to one of the situations below.

In some states, you may be able to buy another type of Medigap policy called Medicare SELECT.

If you buy a Medigap SELECT policy, you have rights to change your mind within 12 months and switch to a standard Medigap policy.

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Medicare Advantage Plans & Medicare Part D Plans Open Enrollment

Please see this publication by CMS explaining all about these two enrollment periods. (Click the dark blue link).   

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Below is a great short video explaining

Medicare Enrollment Periods 

"Medicare & You: Understanding Medicare Enrollment Periods"

Published by CMS on Oct 2, 2014

3:04 minutes