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Enrollment Periods
Clients who have been receiving benefits from Social Security or the Railroad Retirement Board for at least four months before they turn 65, are enrolled into Medicare Part A and Part B insurance automatically. Those who have not been receiving benefits from disability (or the RRB) must sign up with Social Security to get Part A and Part B coverage. Either way, there WILL be a valid enrollment period to utilize, when enrolling clients into the plan that best fits their needs.
- Initial Enrollment Period – begins three months before the month you turn 65; is still open the month you turn 65 and ends three months after the month you turn 65.
- General Enrollment Period – January 1 – March 31 (annually)
- Annual Enrollment Period – October 15 – December 7
- 8-Month Special Enrollment Period – starts a month after the employment ends, or the month after group health plan insurance, based on when current employment ends.
- Special Enrollment Period - available if you’re a volunteer, serving in a foreign country.
When Should Beneficiaries Enroll in Medicare?
In some cases, beneficiaries can be penalized for not enrolling into Medicare once they initially become eligible. It’s extremely important to understand what causes a “late-enrollment premium penalty” and exactly how the penalty can be avoided.
- Part A - To avoid a penalty for Part A, you should apply for Medicare online or visit your local Social Security office during your IEP, if you don’t already receive Social Security or RRB benefits.
- Part B - To avoid a penalty for Part B, you should apply for Medicare online or visit your local Social Security office during your IEP, if you don’t already receive Social Security or RRB benefits or have qualified group health plan coverage from an employer.
- Part D - To avoid a penalty for Part D, you should join a Medicare drug plan during your IEP to prevent going 63 days or more in a row without creditable drug coverage.
Medicare Advantage Open Enrollment Period (OEP)
The Medicare OEP gives current Medicare Advantage enrollees a time frame to make a one-time change. The Open Enrollment for Medicare Advantage is from January 1st through March 31st.
What can you do?
- If you’re in a Medicare Advantage Plan (with or without drug coverage), you can switch to another Medicare Advantage Plan (with or without drug coverage).
- You can drop your Medicare Advantage Plan and return to Original Medicare. You'll also be able to join a Medicare Prescription Drug Plan.
What can't I do?
- Switch from Original Medicare to a Medicare Advantage Plan.
- Join a Medicare Prescription Drug Plan if you're in Original Medicare.
- Switch from one Medicare Prescription Drug Plan to another if you're in Original Medicare.
The standard Part B premium amount in 2022 will be $170.10. Most people will pay the standard Part B premium amount. If you modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
2021 Medicare Part A Hospital Inpatient Deductible & Coinsurance.
2022 2021
Part A Deductible $1,556.00 $1.484.00
61-90 Days $389.00 $371.00
91+ Days (Lifetime reserve days) $778.00 $742.00
SNF 21-100 Days $194.50 $185.50
Medicare Part B
Part B Deductible $233.00 $203.00
HDF Deductible $2490.00 $2,370.00
OOP Limit Plan K $6,620.00 $6,220.00
OOP Limit Plan L $3,310.00 $3,110.00
Part B Premium
Standard monthly $170.10 $148.50
MACRA Changes to Medicare Supplement Plans Effective January 2020
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) made a significant change to Medicare Supplement plans (sometimes called Medigap). MACRA prohibits Medicare Supplement plans from providing first-dollar coverage of the Medicare Part B deductible for “newly eligible” beneficiaries on or after January 1, 2020. “Newly eligible”individuals are those who turn 65 on or after January 1, 2020, and those who become eligible for Medicare benefits for the first time due to age, disability, or End-Stage Renal Disease (ESRD) on or after January 1, 2020.
Medicare Supplement Plans C and F have traditionally covered 100 percent of the Part B deductible. For that reason, those plans will no longer be options for newly eligible beneficiaries on or after January 1, 2020.
View the MACRA new plan chart for new 1/1/2020
Currently, Medicare Supplement plan options include 10 standardized plans, each with its own specified benefits/coverage levels. For those individuals eligible for Medicare on or after January 1, 2020, there will only be 8 plans from which to choose. Existing Plans C and F will not be options for these “newly eligible” individuals. In other words, Plans C and F will NOT be available to sell to Medicare beneficiaries who turn 65 on or after January 1, 2020. However, Plans D and G will be available and will have similar benefits to Plans C and F (except for Part B deductible coverage).
Medicare Supplement Plans C and F are NOT being discontinued. If your client is currently enrolled in either Plan C or Plan F, they will still have access to those plans. For those who are eligible for Medicare prior to January 1, 2020, Plans C and F will remain available options, and will include coverage of the Part B deductible.
Because Plan F with a high deductible (which reimburses the Part B deductible) cannot be sold to newly eligible beneficiaries on or after January 1, 2020, it will be replaced by a Plan G high-deductible option. While high-deductible Plan G does not cover the Part B deductible, the amount paid toward the Medicare Part B deductible will also count toward meeting the Plan G deductible.
F, prior to January 1, 2020 or thereafter.