Changes To Medigap At The End Of 2019

When you are purchasing a Medicare supplemental policy it is crucial that you use care when making your selection, especially over the next few months. At the end of 2019 certain Medigap plans will no longer be available.

Medigap Plan F, which is known as the premier supplemental insurance plan, will no longer be available for new enrollees. Medigap Plan F is currently the most comprehensive supplemental insurance plan available for purchase. If you are a Medicare beneficiary that doesn’t want any healthcare cost surprises, then this is the ideal plan for you, but it all ends at the end of 2019.

Even though Medicare Supplemental Insurance Plan F will no longer be available after the end of 2019 for new enrollees eight different options in Medigap will be. Participants that are enrolled in Medicare Plan F before the cut off at the end of 2019 will still be allowed to continue coverage. Industry experts are predicting that the premium of Plan F may make it so that it is not cost effective and participants would be better off enrolling in Plan G.

Currently Plan F is the most expensive Medigap plan available. Medicare enrollees are willing to pay top dollar to be enrolled in this plan because they can see any doctor and go to any hospital that accepts Medicare patients without having to worry about a surprise bill after. With Medigap Plan F there is no deductible, no co-pay, or coinsurance. The next closest Medigap policy to Plan F as far as coverage goes is Plan G. The only difference as of right now is that there is a deductible that enrollees must cover at the beginning of every year.

Rates for Medicare Supplemental Insurance differ state to state and between insurance companies as well. In the last few years the lower costs associated with Medigap Plan G have been drawing beneficiaries of Medicare away from Plan F. Although a number of predictions have been made as to the effects that eliminating Plan F will have on Medigap, we won’t know for sure until the change goes into effect at the end of next year.

Some thoughts are that in 2020 Medigap Plan G rates will jump as all new enrollees will be accepted regardless of their health. Another thought is that the participants still enrolled in Medigap Plan F after they stop accepting new patience’s at the end of 2019 will have to pay more for the same coverage. Without enrolling healthy young people to help offset the costs, sicker people will make up the majority of enrollees. In order to cover Plan F the premium that it paid will increase.

The experts at eMedigap Plans, powered by Omega, have all the answers you are looking for when it comes to your Medigap Supplemental Insurance needs. More information can be found at https://emedigap-plans.com.

Medigap In Michigan

For Medicare beneficiaries enrolled in Original Medicare Part A and Part B have the opportunity to enroll in Medigap. Original Medicare does not cover comprehensive health care coverage and therefore additional plans in the form of Medigap need to be purchased to fill in the gaps. Medigap policies cover a wide range of health care expenses including: copayments, deductibles, coinsurance, and other out of pocket expenses.

Medigap plans are regulated by the Federal government. When comparing Medigap plans you will find that Medigap Plan F in Michigan is the same exact coverage that is offered in Medigap Plan F in Tennessee. Most states offer all ten of the Medigap policies that are available within Medicare.

Medicare enrollees should enroll in Medigap during their six-month open enrollment period that begins the first day of the month in which they turn 65 and are enrolled in both Medicare Part A and Medicare Part B. No matter what your current state of health is, enrollment is guaranteed if done within that open enrollment period. If you do not enroll during this period not only will you pay a late enrollment fee, medical underwriting will be required, premiums can be based on pre-existing conditions, and coverage is not guaranteed. To avoid complication in enrollment, take time to research and reserve your spot in a Medigap plan during your Medicare open enrollment period.

Comparing Medicare Supplemental Insurance Plans, Medigap, In Michigan

Medigap plans vary in cost depending on the area in which you live as well as the provider that you choose to purchase your plan though. Medigap benefits are the same between each lettered plan no matter where you live. Once you have chosen a plan that fits your health care needs a Medicare agent can help you compare costs between available providers. This ensures you get a Medigap plan that not only meets your health care needs but also fits within your budget.

Medicare agents are your best source of information when it comes to finding out more about each individual Medigap plan. Plans vary a great deal amongst one another so even though all ten policies are the same coverage no matter where it is purchased, each lettered plan is unique. To work with a Medicare agent simply visit our website at http://emedigap-plans.com and plug in your zip code. After this is done you will receive a list of available plans, insurance companies and rates to compare. If at any point during the process you have questions you can always reach out to one of our expert Medicare representatives at 888.452.7949.

Common Medicare Questions Answered

When it comes to Medicare and Medigap health insurance there is a ton of confusion. Here are the top questions that our Medicare agents get when Medicare enrollees are seeking more information on Medigap supplemental insurance plans.

When can beneficiaries enroll in Medicare?

There is a seven-month window in which beneficiaries can sign up for Medicare Part A, Part B, prescription drug coverage, and Medigap supplemental insurance. This period of time includes three months before you turn 65, the month of your birthday, and the three months after you have turned 65. When you are receiving Social Security, beneficiaries will automatically be signed up for both Medicare Part A and Part B starting the first day of the month in which you turn 65.

Do my spouse and I have the same plan?

Spouses do not share Medicare plans. Each Medicare and Medigap plan are issued on an individual basis.

Does Medicare offer coverage for long-term care?

Long-term care is not medical care, in most circumstances, but instead long-term care covers the basics of what it takes to live daily life. Medicare will not cover long-term care if that is the only service that is needed. Medicare covers: care within a long-term care hospital, certain skilled nursing care within a skilled nursing facility, home health services that are eligible, and hospice/respite care.

Does Medicare cover nursing homes?

Skilled care within a certified nursing facility for Medicare beneficiaries is covered under Medicare Part A. More information can be found by reaching out to our Medicare agents or visiting www.medicare.gov.

Why would Medicare beneficiaries choose a Medicare Advantage Plan over Original Medicare?

The decision to choose between Original Medicare and Medicare Advantage Plans is up to each individual beneficiary. Medicare Advantage Plans are popular in situations when:

You need prescription drugs. With very few exceptions, prescription coverage isn’t covered under Original Medicare. Many Medicare Advantage Plans include prescription coverage whereas under Original Medicare a separate Medigap policy is needed, Medigap Plan D.
You would like to cap out-of-pocket spending. Original Medicare does not have out-of-pocket maximums. With Original Medicare you will continue to pay a portion of the costs of your services whereas with Medicare Advantage plans there is a $6,700 out-of-pocket maximum. Once this limit is reached the rest of the financial burden is covered through Medicare.
You want an alternative to the 20% coinsurance that is charged by Original Medicare Part B.
You need vision and dental coverage. Original Medicare Part A and Part B does not cover these services. Some of the Medicare Advantage Plans offer vision and dental coverage.

What makes a participant choose between Medicare Advantage HMO and PPO?

Medicare Advantage Health Maintenance Organization plans (HMO’s) allow participants choose from a network of doctors that are contracted to provide services. Beneficiaries will choose one primary care physician from doctors within the planned network. This physician will then refer beneficiaries to specialists when further care is needed. The specialists need to be within the plan network. The highlights of a Medicare Advantage HMO are:

Low out of pocket costs
Must go to physicians within the network
May include prescription drug coverage

This type of plan is often chosen because of the cost-savings. If you can live with the restriction of choosing a physician within the network, then a Medicare HMO would work well.

Medicare Advantage Preferred Provider Organization plans (PPO’s) are similar to HMO plans in that participants choose from a network of doctors that are contracted to provide services. Unlike an HMO plan, you are also allowed to see physicians outside of the network and hospital, you will just pay more out of pocket. The highlights of a Medicare Advantage PPO are:

Can see physicians in and out of network
Monthly premiums are often higher than Medicare Advantage HMO plans
Out-of-pocket expenses
May include prescription drug coverage

How do prescription drug plans, Medicare Plan D, differ?

Each Plan D have its own list of covered generic and brand-name drugs. Each Plan D covers certain drug categories however drugs covered in each category may differ by carrier. Medigap Plan D plans set monthly premiums and costs may differ between carriers.

How do I know what is best for me Medicare Advantage Plans or Original Medicare Plans with Medigap Plans?

Each and every participants health care and budget needs are different. In order for you to find what the best option for you is to reach out to our Medicare Agents to find out more information on each plan and how it benefits you.

How do Medicare Supplemental Insurance/Medigap Plans Differ?

Each Medicare Supplemental Insurance Plan, letters A-N offer different levels of coverage. Each lettered plan includes the exact same coverage regardless of where you live and what carrier it is offered through. Price differs based on each carrier. Some supplemental plans offer services that Original Medicare doesn’t like travel outside of the United States.

What Will I Have to Pay for Medigap Coverage?

For many Medicare beneficiaries determining how much they have to pay out of pocket for Medicare and Medigap can be quite tricky. It’s figuring out what essential coverage, Medicare Parts A, B, and D, is going to cost, only to find out that these three plans don’t fully cover you. Not only will additional Medigap coverage have a monthly premium, you will also need to determine how much the deductible and co-insurance will run. With most Medigap plans, beneficiaries can expect to be responsible for up to 20% of their outpatient medical expenses. It is important when planning for retirement that these estimated costs are considered so that you can be financially prepared.

Choosing a Medigap Plan

Medicare’s standardized supplemental insurance plans date back to 1990. Since then it has been simpler for Medicare recipients to compare the costs of these plans between providers which is clearly important for a number of reasons. Of the ten standard plans available there are two high premium plans that have more complete coverage then any of the other eight, Medigap Plans F and G. The benefit of choosing one of these two plans is that although the monthly premium is higher there is little to no out of pocket needs.

Participants that want a lower monthly premium and are okay with sharing the cost of treatment as they go along should consider Medigap Plans K and N. These plans both offer lower monthly premiums however offer fewer benefits. Participants will share more of the expenses as needed along the way.

There are a number of factors that go into determining your monthly premium. If you are enrolled in Medigap within your open enrollment period, you will not pay more based on pre-existing conditions however other factors do play a role. These include age, gender, tobacco usage, the policy you choose, when enrollment takes place, and discounts for more than one enrollee in a household. This will depend strictly on the carrier who is allowed to set rules for these discounts. A Medigap broker will help you determine which carrier is offering you the most coverage at the best rate.

Where you are located is another factor in determining the amount you will pay for Medigap plans. From state to state, zip code to zip code, Medicare supplemental plans premiums vary a great deal. Consider this: Medigap Plan F in Fort Worth, Texas can run between $149 – $180 per month for a non-tobacco using 65-year-old male whereas the same coverage in Los Angeles, California will run between $169 – $190 per month. Medigap in Florida is even costlier as this same person would most likely pay between $275 – $336 per month. This may just be one of the many reasons that many Medicare enrollees in FL choose a Medicare Advantage Plan instead.

It is also crucial to consider healthcare related expenses that are not covered through Medicare or Medigap what-so ever. Medicare does not help pay for expenses related to long-term care which is always a shock to seniors. It also limits the type of care and equipment it will pay for often have strict stipulations in place for home health care needs and medical equipment. Often in order for these items to be covered a doctor must be in charge of prescribe them and proving that they are necessary. Certain dental needs, vision care, and hearing costs may also not be covered as well.

Getting Medigap Can Be a Challenge for Those on Traditional Medicare

Fall open enrollment is a smart time to look for a Medigap policy to fill in the gaps left by your Medicare health coverage.

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If you’re on traditional Medicare, buying a supplemental “Medigap” policy may seem like a no-brainer. After all, Medigap helps pay co-payments, deductibles and other costs that Medicare doesn’t cover. But getting access to these policies—and determining which plan is right for you—may be anything but simple.

You’re guaranteed access to a supplemental policy during your Medigap open enrollment period—the six-month period that starts when you are 65 or older and also enrolled in Part B. Many people who miss that window do not have “guaranteed issue” rights, meaning Medigap insurers can charge them extra based on their health status or deny coverage altogether. That’s a potential headache for the millions of people on traditional Medicare who lack supplemental coverage as well as Medicare Advantage enrollees looking to switch to traditional Medicare and pick up Medigap.

The Medigap hurdles complicate decision-making during the annual fall Medicare open enrollment period, which extends through December 7. Open enrollment is a time for seniors to reassess their coverage and switch between traditional Medicare and Medicare Advantage plans offered by private insurers—but many who prefer traditional Medicare may find they’re effectively locked out of the Medigap market.

Upcoming changes to Medigap plans are generating added confusion. Starting in 2020, two of the most comprehensive Medigap plans—those that cover the Part B deductible—will no longer be available to people newly eligible for Medicare. “Agents have been using the 2020 changes to convince people to change coverage,” says Bonnie Burns, a consultant at California Health Advocates—even though the changes don’t affect current Medicare beneficiaries.

Medigap is a critical backstop for millions of seniors because traditional Medicare requires beneficiaries to pay a significant share of costs and has no cap on out-of-pocket spending. In 2018, for example, beneficiaries typically pay 20% of the Medicare-approved amount for doctor services and a $1,340 deductible for inpatient hospital services. Medigap can also help make health costs more predictable and, in some cases, offer benefits not available in traditional Medicare, such as emergency health coverage overseas.

To buy Medigap, you must be enrolled in Medicare Parts A and B. (Part D is optional.) Enrollees in Medicare Advantage plans, which place caps on annual out-of-pocket spending, can’t use Medigap policies.

Even if you have a Medigap plan that you like, you should keep an eye on other supplemental insurance options. You may be able to save hundreds or even thousands of dollars a year with another Medigap policy that offers the same benefits. Here’s how to find the right policy, maximize your Medigap dollars and overcome the obstacles to accessing these plans.

Get Medigap Outside Open Enrollment

For most people, the best time to buy a supplemental policy is during their six-month Medigap open enrollment period. So what happens if you’re beyond that window?

A few other circumstances can qualify you for a guaranteed-issue Medigap policy under federal law. These include losing employer-sponsored retiree coverage or other supplemental coverage and moving to a new location that’s outside your Medicare Advantage plan’s coverage area. You may also have Medigap guaranteed-issue rights if you sign up for a Medicare Advantage plan but decide to switch to traditional Medicare within the first 12 months.

These are minimum federal requirements; states offer a hodgepodge of additional protections. Twenty-eight states, for example, offer guaranteed-issue rights to people whose employer-sponsored retiree health coverage has changed, and nine offer these rights to people who have lost Medicaid eligibility, according to the Kaiser Family Foundation. Four states—Connecticut, Maine, Massachusetts and New York—provide guaranteed-issue protections either continuously or on an annual basis to all Medicare beneficiaries age 65 and older, Kaiser found. Some insurers may also offer guaranteed-issue protections that go beyond state law.

People under age 65 who are eligible for Medicare because of a disability or disease face a particular challenge. “Under federal law, if you’re not 65 or over, the Medigap company doesn’t have to sell you a policy,” says David Lipschutz, senior policy attorney at the Center for Medicare Advocacy. But 31 states require insurers to offer at least one type of Medigap policy to Medicare beneficiaries under age 65, according to Kaiser.

To pin down the guaranteed-issue protections available in your state, contact your state health insurance assistance program. Go to shiptacenter.org to find your local program.

If you don’t have any guaranteed-issue protections, don’t give up. “That doesn’t necessarily mean you can’t get Medigap,” Burns says. “It just means you’ll have to go through the medical screening, which isn’t—for most companies—very intense.” It’s worth trying multiple insurers because one may accept applicants with a particular medical condition that another rejects.

Once you have a Medigap policy, it’s guaranteed renewable. Your coverage will continue as long as you pay the premiums.

Find the Right Medigap Policy

In most states, there are 10 types of Medigap policies, identified by letters A through N. (Plans E, H, I and J are no longer sold.) Each type offers a different set of standardized benefits. The plans offer varying levels of coverage of Part B co-insurance or co-payments. Most cover some or all of the Part A deductible, some cover a portion of foreign travel emergency costs, and two—Plans C and F—cover the Part B deductible. To compare plan benefits side by side, go to Medicare.gov and type “compare Medigap” in the search box. To find all plans available in your area, go to medicare.gov.

The 2020 changes to Plans C and F have spawned much misinformation that can lead seniors astray. These plans are closing only to people who become newly eligible for Medicare after the start of 2020. People who are Medicare-eligible before then can still buy C and F in 2020 and beyond, “and it’s available to that entire group of people ad infinitum,” says William Schiffbauer, a Washington, D.C., attorney who works with Medigap insurers.

But some companies seeking to sell Medigap policies would have seniors believe otherwise, claiming that current Medicare beneficiaries who want Medigap to cover the Part B deductible should enroll in Plan C or Plan F before 2020. Salespeople “are circulating all kinds of phony information,” Burns says.

While the 2020 changes shouldn’t trigger any panicked Medigap plan shopping, you may have other reasons to shop around—such as potentially saving thousands of dollars per year on premiums. Considering that policies of the same letter type must offer the exact same benefits, you might think they’d be similarly priced. But that’s not the case at all. A 65-year-old male in Connecticut, for example, could pay anywhere from $2,898 to $7,405 a year for Plan F, while a 65-year-old woman in Texas could pay $1,678 to $5,272 for Plan C, according to Weiss Ratings. “Whatever you do, don’t simply look at the insurer that you know and love, because you might find they are charging you hundreds or thousands of dollars more,” says Gavin Magor, director of ratings at Weiss Ratings.

You may find a real head-scratcher when you compare premiums for Plan F versus Plan G. The only difference between these plans is that Plan F covers the Part B deductible—$183 in 2018—and Plan G does not. Yet on average, Plan F costs nearly $450 more than Plan G for men and roughly $380 more for women, according to Weiss. While it’s a convenience to have the Part B deductible covered, Burns says, financially it may make more sense to simply pay it out of pocket.

In addition to the initial premium, pay attention to each plan’s premium “rating” system, which helps you “anticipate how premiums will rise in the plan over time,” says Gretchen Jacobson, associate director of Kaiser’s program on Medicare policy. States can regulate which of three rating systems insurers may use, and you may have a choice of plans using various systems. In “community rated” policies, typically all enrollees are charged the same premium, regardless of age or gender. In “issue-age rated” policies, the premium is based on your age when you buy the policy. And in “attained-age rated” policies, the premium is based on your current age—potentially leading to unpredictable rate increases as you grow older.

Original Source: https://www.kiplinger.com/article/retirement/T039-C000-S004-getting-medigap-can-be-a-challenge-medicare.html

Original Date: Oct 24 2018

Written by: Eleanor Laise

2019 Changes in Medicare

2019 is bringing on some big changes in the world of Medicare. If you are a Medicare enrollee it is important to take note of the changes. This will help make sure you are getting the coverage that you need. Medicare has been around for over 53 years but that doesn’t mean that it stays the same from year to year. Each year it is important to review your Medicare coverage.

Open Enrollment Changes

Medicare Advantage Plans will have an open enrollment period between January 1 – March 31. At this time participants will be able:

Drop Medicare Advantage and return to Original Medicare
Change from one Medicare Advantage Plan to another Advantage Plan
Enroll in or drop Medicare Part D, standalone prescription drug coverage

Closing the Gap in Medicare Part D

Medicare Part D, prescription drug coverage requires seniors with high prescription drug costs to pay more for medication once they have reached a certain dollar amount spent each year. There is a gap that occurs between when enrollees hit the initial spending cap and catastrophic coverage begins. This will no longer exist in 2019 for brand name prescriptions. In 2020 the gap will close for generics as well.

Telehealth Care

More consultations will take place between patients and caregivers will happen over the phone or via the internet. Participants in Medicare with end-stage renal disease and being treated or strokes will have access to this same telehealth care services.

Enhanced Handbook

Each and every year Medicare sends each enrollee a handbook that give the details of their coverage for the current year. In 2019 the handbook will also include:

In order to choose the right program checklists and flowcharts will be added
The online Medicare Plan Finder tool will be easier for seniors to access and use
The online coverage wizard will help enrollees to compare Medicare and Medigap costs and coverage

Removal of the Therapy Cap

Up until 2019 there have been limited coverage available for Medicare participants needing speech, occupational, and physical therapy. Congress has removed this cap in 2019.

Changes to Consider During 2019 Medicare Open Enrollment

There are many changes coming to the world of Medicare in 2019. Most of these changes will involve coverage in Medicare Advantage and Medicare Part D. From more health care plans to choose from to lower premiums and added benefits now is a good time to start reviewing your current plans and future options.

An Increase in Medicare Advantage Plan Choices

In 2019 Medicare expects to see an increase of upwards to 600 new Medicare Advantage plan options varying between locations. More than ninety percent of Medicare enrollees will have the option of ten or more Medicare Advantage plans to choose from in their area. Medigap Plan D, prescription drug coverage is also upgrading and offering Plan D business plans in 2019.

Medigap Plan D, Prescription Drug Coverage, Premiums Decrease

Enrollees in Medigap Plan D can expect to see a decrease in plan premiums by $1 a month in 2019. It is important to remember that when looking at coverage there is more to the cost than just the initial premium. Some plans offer a low premium, but the cost of prescriptions co-pays is much higher than a higher costing premium plan. A Medicare Supplemental Insurance Agent or the Medicare Plan Finder online are tools available to assist you in comparing all ten Medigap rates and plans.

Preferred Pharmacies

Medigap Plan D will include more preferred pharmacies. When choosing a plan that offers a preferred pharmacy you can expect to pay lower premiums and decreased co-payments. If you go outside of the preferred pharmacy to have prescriptions filled, you will be paying a premium. If you are adamant of sticking with a certain pharmacy, you will need to see if a plan option exists with them as the planned pharmacy. If not, you will need to change pharmacies or pay the additional cost of prescriptions.

Less Expense in The Donut Hole

The coverage gap which makes participants pay more out of pocket for prescriptions known as the donut hole, will close in 2019. When your total prescription drug expense reaches $3,820 you will pay 25% of the cost of brand-name (37% of generic) up until you have reached $5,100 in which you will then only be responsible for 5%.

Medicare Advantage Premiums Decreasing

In 2019 the premium for Medicare Advantage will run on average $28 per month, down $1.81 from 2018. There will also be more zero premium options available with Medicare Advantage coverage. It is always good to note that often lower-premium policies have a smaller network of providers. If this does not bother you than this may be a good option to help cut costs.

Medigap Plans – Two Popular Plans Ending In 2020

Are you enrolled in Medigap? Do you turn 65 soon and know you will be applying for Medicare and enrolling in a Medigap policy? If so it is important to note that two of the most popular Medicare Supplemental Plans will no longer be available to enroll in. Medigap Plans F and Plans C are being discontinued as an enrollment option as of 2020.

Medigap insurance is purchased to cover the medical expenses that are not covered under Original Medicare. Believe it or not Medicare Insurance doesn’t cover 100% of copayments or deductibles and also has limitations to what it will cover. Private insurance companies offer Medigap plans, also known as Medicare Supplemental Insurance Plans, were created to fill in these voids. Currently in 2018 there are 10 different Medigap plans available. Each of the ten plans offers a different combination of insurance benefits. This allows participants to decide the combination of benefits that is right for their health needs and budget.

Two Most Popular Plans

Medigap Plans F and Plan C remain the most popular plans offered because they both cover the full deductible of Medicare Part B. This means that if enrollees participate in Medigap Plan F or C they do not have to pay the Medicare Part B deductible. In fact, Medigap Plan F is the most complete Medigap coverage available to participants including: doctors fees, medical tests, and hospital fees. Medigap Plan C is very similar to Plan F however does not cover extra fees that doctors charge over what Medicare allows. These two plans, Medigap Plan F and Medigap Plan C are the most enrolled in plans available, more than 53% of enrollees have coverage under one of these two plans.

Litigation was passed by Congress in 2015 that states in 2020 private Medigap insurers are no longer going to be allowed to offer any Medigap plans that cover the Original Medicare Part B deductible. Participants that enroll in either Medigap Plans F or C will be allowed to keep their coverage for the rest of their lives, but no new enrollees will be allowed to enroll in either of these plans. Critics believe Medigap Plan F makes it too easy for Medicare enrollees to see a doctor without considering the cost.

The Future Of these Two Plans

For participants that are able to enroll in Medigap Plan F and Plan C before they no longer exist may seem like a no brainer. While it appears that you would want to lock in the coverage while you still can participants should note that premiums could increase over time as there would be no new enrollees. This occurs because the participants enrolled in these plans will continue to age without the younger, healthier participants enrolling to offset the expense. As premiums rise participants enrolled in these Medigap plans may no longer be able to afford to stay enrolled.

Choosing a Medigap plan is crucial as it is difficult to switch once you are enrolled. During your open enrollment plan, companies cannot consider pre-existing conditions in deny coverage or set the costs of premiums. After this six-month period which begins on the 1^st day of the month you turn 65 because there is not a guarantee that you won’t be charged more based on your health.

While Medigap Plans F and Plans C are being phased out there are still an abundance of Medigap coverage to choose from when picking a plan that will help participants fill in the health care gaps left from Original Medicare.

Avoiding Late Enrollment Penalties

No one wants to pay more for something than they need to. This is true of all things, Medicare included. To avoid having to pay late enrollment fees when enrolling in Medicare and Medigap there are a few important dates to keep track of.

Three months BEFORE you are to turn 65, you should start receiving information about Medicare’s open enrollment period. The enrollment period lasts for the three months before, the month of, and for the three months after your 65^th birthday. If participants enroll outside of this period, they are subjected to a late enrollment penalty.

Enrollees should understand that there are several different late penalty fees that can apply. If enrollment is delayed for Medicare Parts A, B, and D a late penalty fee can incur.

Late Enrollment Penalty – Medicare Part A

Most often participants automatically qualify and are enrolled in Medicare Part A when the patient turns 65. Medicare Part A is premium-free health care. Automatic enrollment occurs if the participant or their spouse worked at least ten years in the United States. If participants do not meet this requirement a premium must be paid when they become eligible, otherwise a late enrollment penalty applies. This penalty increases the monthly penalty up to ten percent. The premium increase will need to be covered for double the number of years in which you could have had Medicare Part A but didn’t.

Medicare Part B – Late Enrollment Penalty

Medicare Part B works similarly to Medicare Part A. Most participants are automatically enrolled in Part B. If you are not automatically enrolled in Medicare Part B you must enroll when the participant becomes eligible. If you do not enroll within the allotted time frame enrollees will be required to pay a late fee. The penalty has the potential to increase up to ten percent for every year the participant could have signed up but did not. Medicare Part B is elective coverage. Enrollees are not required to participate in Medicare Part B, but it is encouraged.

Late Enrollment Penalty – Medicare Plan D (Medigap – Prescription Drug Coverage)

Participants are not automatically enrolled in and must take the initiative to enroll in Plan D, prescription drug coverage within the same open enrollment period of Medicare Part A and B. If enrollees do not sign up during this period of time and do not have any other credible prescription drug coverage a late enrollment penalty will apply. The Medigap Plan D penalties are a bit more complicated then those associated with Original Medicare. Plan D’s enrollment penalty multiples one percent of the national base beneficiary premium times the number of months that participants were not enrolled in prescription coverage.

Exceptions

Some participants may qualify for a special enrollment period. This occurs if enrollees are eligible for Medicare but choose not to participate because you are still working. This situation exempts Medicare participants from penalties.

What Every Senior Needs to Know About Medigap Prescription Drug Coverage

Up until 2006, many Medigap plans included prescription drug coverage. This is no longer the case. Today if you would like prescription drug coverage you must enroll in Medigap Part D, prescription drug coverage.

Medigap Part D provides individuals with prescription drug coverage. In order to enroll in Medigap Part D you must be a participant in Medicare Part A and Part B. Medicare Supplemental Insurance Part D coverage can be purchased by any private insurance company that is authorized by Medicare.

Why do you need Medicare Supplemental Insurance Plan D, prescription drug coverage?

Medicare Part B includes limited outpatient prescription drug coverage. It doesn’t cover most of the drugs that you need to get at the pharmacy. Drugs that are needed as part of a daily regimen for chronic conditions such as high blood pressure require Medigap Part D to be covered.
Even if you do not use prescription drugs right now, you will have to decide about Medigap Part D. It not only lowers your drug costs today but provides you will essential protection against high costs in the future or being denied coverage at a later date.
If participants don’t join Medigap drug coverage when first eligible but decide the need it at a later date they can be required to pay a late penalty (depending on the circumstance) and/or have to pay increased monthly premiums.

How do participants go about enrolling in Medicare Prescription Drug Coverage, Medigap Part D?

In order to enroll in Medigap Part D you must already be enrolled in Original Medicare, Part A and Part B. Participants must also live in the service area of the plan that provides prescription drug coverage.

Things you should know before joining Medigap, Medicare Supplemental Insurance Part D.

In addition to the premium that is paid with Medicare Part A and Part B, participants must pay for Part D. Some enrollees qualify for financial aid.
Consider all of your options for drug coverage before making a decision. Prescription drugs coverage varies a great deal in the drugs that are covered, how much you will pay, and what pharmacies you can use.
You may not be able to make changes to your plans for a year so choose carefully when you sign up.
Understand that the drug plan you have today may change from year to year. It may not cover the same prescriptions from year to year.