Health Insurance Matters: Medicare Enrollment Periods

By Harry Thal
Special to the Sun

While few people consider Medicare enrollment periods the way I do, I classify them into three distinct classifications for simplicity and to make it easier for the public.

The easiest, and least needed for people on Medicare already is the Medicare Open Enrollment Period (OEP). This runs from January 1 to March 31 each year. It is the time when a person can enroll in Medicare if they didn’t when first eligible at age 65. For the most part, people are automatically enrolled in Medicare Part A (Hospital) and due to circumstances, they neglected to enroll in Part B (Medical). If enrolled during the Medicare OEP the effective date for Part B will be July 1. Late enrollees may incur a penalty for late enrollment.

Most people enroll in Medicare during the Medicare Initial Enrollment Period (IEP). If you are receiving Social Security benefits before age 65, the Medicare card is mailed to you three months prior to your effective date. If you are not receiving Social Security benefits, you must manually enroll. This may be done by calling Social Security, going to a Social Security office or online. My office provides this as a no-charge service as well.

Medicare Advantage Annual Enrollment Period (AEP). This is the period of time when you may enroll, change or drop a Medicare Advantage (HMO) plan. You may enroll in as many plans as you want, but the last one received by Medicare is the one that will stick. The AEP is from October 15 to December 7. The AEP ends next Saturday! During the AEP, you may also change Prescription Drug Plans (PDP). Again, the last one selected is the one that you will have for the coming year. I have found some disturbing sales practices this past year. One company changed their 2019 policy’s name and raised the cost from $29.90 to $64.50. Then they used a similar name and priced the new plan at $13.20. We wrote to all our clients to advise them. I hope they all opened their mail.

Medicare Open Enrollment Period (OEP) begins January 1 and runs until March 31. During this time frame, a person on a Medicare Advantage plan (HMO) may drop their plan and either select another plan or return to Original Medicare. If they return to Original Medicare, they have a one-time opportunity to select a prescription drug plan. Insurance agents may assist people but are not allowed to advertise this OEP.

There are “Special” Enrollment Periods (SEP) throughout the year for special; reasons. People over 65 and first retiring may enroll in Part B at that time. There are enrollment forms needed to be completed by the employer and employee. We have them or call Social Security.
Medicare Advantage has special enrollment periods as well. People with certain medical issues may join or change their HMO plan throughout the year, and those on Medi-Cal may change plans once of each of the first three quarters during the year. (January – March, April – June, and July to September). There is no SEP in the last quarter.

If you are confused by all of this, just seek a Medicare Insurance specialist. There is never a charge for the services, as licensed and certified agents are paid by the insurance plans, and the commissions are regulated, so there is never a financial incentive for the agent to do anything but help you select the best plan for your circumstances.

HAPPY THANKSGIVING!

Harry P. Thal, MA, is a licensed insurance broker in California (0621106) and 24 other states. His offices are in Kernville. He is a member of the Society of Certified Senior Advisors and Past-President of the Kern Association of Health Underwriters. He may be reached at 760-376-2100, e-mail harrythal@aol.com or visit him on the web at www.harrythal.com.

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