Q- What and when is the Annual Enrollment Period?
A- The Annual Enrollment Period is the timeframe in the fall when you can enroll in a Medicare Advantage plan or a Medicare Prescription Drug Plan for the upcoming year, either for the first time or to make a change. The Annual Enrollment Period begins on the 15th of October and ends on the 7th of December. Applications for the upcoming year MUST be submitted during this timeframe.
Ref: www.medicare.gov
Q- What and when is the Medicare Advantage Open Enrollment Period?
A- The Medicare Advantage Open Enrollment Period is an additional timeframe for someone who already has a Medicare Advantage Plan to change to a different Medicare Advantage Plan, or to return to Original Medicare (normally along with a Supplement and Stand-Alone Drug Plan). The Medicare Advantage Open Enrollment Period begins on the 1st of January and ends on the 31st of March. If you complete an application during this timeframe, the new plan will be effective the 1st of the following month.
Ref: www.medicare.gov
Q- What is the Medigap Free Look Period?
A- You have 30 days to decide if you want to keep the new Medigap policy. This is called your “free look period.” The 30-day free look period starts when you get your new Medigap policy. You’ll need to pay both premiums for one month.
Don’t cancel your first Medigap policy until you’ve decided to keep the second Medigap policy. On the application for the new Medigap policy, you’ll have to promise that you’ll cancel your first policy.
Ref: www.medicare.gov
Q- What is the Part D late enrollment penalty ?
A- The late enrollment penalty is an amount that’s added to your Part D premium. You may owe a late enrollment penalty if at any time after your initial enrollment period is over, there’s a period of 63 or more days in a row when you don’t have Part d or other creditable prescription drug coverage.
(Ref: Medicare & You Handbook 2021 pg 79-81)
Q- When am I going to hit the doughnut hole?
A- The doughnut hole refers to a gap in prescription drug coverage under Medicare Part D. In 2021, once you reach $4,130 in prescription drug costs, which include both your share of covered drugs and the amount paid by your insurance, you will be in the coverage gap. In 2021, you will get a 70% discount on brand name prescription drugs. When your total out-of-pocket costs reach $6,550, you qualify for “catastrophic coverage”. At that point, you are responsible for only 5% of your prescription drug costs for the rest of the year. However, if you receive “Extra Help” you do not have a coverage gap.
(Ref: www.medicare.gov )
Q- What if I am losing my Health Insurance?
A- This qualifies you for a Special Enrollment Period (SEP) of 60 days to get new health insurance. If you miss that window, you will have to wait until the next Open Enrollment Period (OEP).
Q- I don’t take any or just a few medications. Do I need a Medicare Prescription Drug Plan?
A- Even if you don’t take many prescriptions now, you should consider joining a Medicare drug plan. If you decide not to join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription coverage, or you don’t get Extra Help, you will likely pay a late enrollment penalty if you join a plan later.
( Ref: Medicare & You Handbook 2021 pg 79 and 80)
Q- Can I get help with my Part D premium?
A- If you have limited income and resources, you may qualify for help to pay for some health care and prescription drug costs. Extra help, also called Low Income Subsidy, is available if your yearly income for a single person is less than $19,140 and resources less than $14,610 per year. For a married person with no dependents the income limit is $25,860 and resources less than $29,160 per year. You may apply for Extra Help at www.socialsecurity.gov keyword “Extra Help” or call your local social security office.
(Ref: Medicare & You Handbook 2021 pg 87 and 88 and www.socialsecurity.gov )
Q- If I retire, how long do I have to take Part D?
A- Don’t go 63 days or more in a row without a Medicare drug plan or other creditable coverage.
(Ref: Medicare & You Handbook 2021 pg 79 and 80)
Q- What if Healthcare.gov has me confused?
A- Call us and let us help you navigate through the process.
Q- What if I have a life changing event?
A- If you are losing employer coverage, retire, get married, have a baby, adopt a baby, have an income change, or are denied Medicaid, you will have a Special Enrollment Period to get new coverage.
Q- Do you have a handicap accessible entrance?
A- Yes, we do. If you go to the back of the building there is Handicap Only parking, and there is a ramp at the rear entrance. Once inside, there are no stairs to navigate. If you let us know when you make your appointment, we will make sure there are no obstacles in your path to the agent’s office.
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We are available Monday - Thursday 9:00 AM to 5:00 PM and Friday 9:00 AM to 1:00 PM for in-person and phone appointments.
540-586-3500
