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Annual Enrollment Period (AEP) – Time to Review Your Medicare Plan!
If you’re already enrolled in a Medicare Advantage Prescription Drug (MAPD) plan or a Medigap policy paired with a Part D Prescription Drug Plan (PDP), the Annual Enrollment Period (AEP) is your opportunity to review your current coverage and ensure it still meets your needs for the upcoming year. AEP runs from October 15 to December 7, so now is the time to evaluate any changes to your health, medication, or budget and see if your current plan is still the best fit.
Plans can change their premiums, copays, drug formularies, or network of doctors, so even if you’re happy with your current coverage, it’s worth a review. At Tsunami Health, our Tsunami Advisors are here to help you navigate these changes and compare options.
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Enrollment Deadlines Matter
Your Initial Enrollment Period (IEP) begins three months before the month you turn 65 and ends three months after. Missing this window could lead to delays in coverage and late enrollment penalties for Part B (medical insurance) and Part D (prescription drug coverage).Understand the Different Parts of Medicare
Part A (Hospital Insurance): Covers inpatient care, skilled nursing facility care, and some home health services. Most people don’t pay a premium if they or their spouse paid Medicare taxes while working.
Part B (Medical Insurance): Covers doctor visits, outpatient care, medical supplies, and preventive services. There’s a monthly premium for Part B.
Part C (Medicare Advantage): An alternative to Original Medicare, these plans often bundle Part A, Part B, and Part D (prescription drugs), and may offer additional benefits like vision, dental, and wellness programs.
Part D (Prescription Drug Coverage): Stand-alone drug coverage if you stay with Original Medicare.
Consider Your Prescription Drug Needs
Even if you don’t take many medications now, enrolling in a Part D plan when you’re first eligible can help you avoid late enrollment penalties later. Review each plan’s drug formulary to ensure it covers the prescriptions you may need.Decide Between Original Medicare and Medicare Advantage
Original Medicare offers flexibility in choosing healthcare providers but may leave you with out-of-pocket costs for services like coinsurance and deductibles. Many people buy a Medigap policy (Medicare Supplement) to help with these costs.
Medicare Advantage Plans bundle services and may offer lower out-of-pocket costs and extra benefits like vision or dental. However, you may be limited to a specific network of providers.
Check for Employer or Union Coverage
If you or your spouse are still working and have employer coverage, check how Medicare will work with your current plan. You may be able to delay Part B enrollment without penalty if you’re still covered under an employer’s plan.Medigap and Medicare Advantage Are Not the Same
If you choose a Medicare Advantage Plan, you can’t have a Medigap policy to cover gaps in coverage. Understanding this distinction is important before making your choice.Budget for Costs
Even with Medicare, you’ll have costs such as premiums, deductibles, copayments, or coinsurance. Make sure to understand what your monthly budget needs to cover for both premiums and out-of-pocket expenses, depending on the plan you choose.Preventive Services Are Covered
Medicare Part B covers a range of preventive services like screenings, shots, and an annual wellness visit at no extra cost to you. Take advantage of these to stay healthy.Review Plans Annually
Medicare plans can change every year, so it’s a good idea to review your coverage and compare new plan options annually during the Open Enrollment Period (October 15 – December 7). This ensures that your plan continues to meet your healthcare and financial needs.
By keeping these factors in mind, you can make an informed decision about your Medicare coverage and ensure that you’re getting the most out of your benefits.