Medicare Part D Open Enrollment Period 2020

Medicare Part B Premium Based On Income 2023

The standard Part B premium amount in 2023 is $164.90. Most people will pay the standard Part B premium amount. If your Modified Adjusted Gross Income as reported on your IRS tax return from 2 years ago is above a certain amount, youll pay the standard premium amount and an Income Related Monthly Adjustment Amount . IRMAA is an extra charge added to your premium.

The chart below shows the 2023 Part B premiums.

For more information, visit Medicare Part B Costs.

Medicare Supplement Open Enrollment Period

If youre looking to supplement your Original Medicare coverage to help with additional costs, the best time to buy a Medicare Supplement plan is during the six-month enrollment period that starts the first day of the month you turn 65 as long as you have signed up for Medicare Part B.

If you dont sign up for a Medicare Supplement plan during this Open Enrollment Period, you may not be able to buy a Medicare Supplement plan. Unless you have a guaranteed issue right, you may be required to answer medical questions.

Enrollments And Changes You Can Make During The Annual Open Enrollment Period

Open enrollment is an annual opportunity for Medicare beneficiaries to reevaluate their current plan benefits rather than enrolling for the first time.

You should weigh changes in coverage and out-of-pocket costs including Medicare deductibles, coinsurance, copayments and premiums.

Enroll or Switch During the Annual Medicare Open Enrollment Period

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The Part D Donut Hole Will Close

Beginning in 2020, the coverage gap for Part D plans wont exist anymore. Previously, beneficiaries would see increased out-of-pocket costs after the value of the covered prescriptions theyve purchased reaches $3,820. Starting January 1, 2020, beneficiaries will pay just 25% of drug costs in this coverage gap or donut holeor about the same as what they paid before entering the donut hole.

Learn more about the Part D coverage gap.

Is Aep Available To Everyone

Anyone can make important changes to their Medicare coverage each year during the Annual Election Period.

You dont have to change anything during AEP. However, experts urge people to closely compare your plan to other local options during this annual window. Studies show that more than half the people who shop around, even for an hour or two, find better coverage and often save money, too.

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Here’s What’s New With Part D Coverage

The Inflation Reduction Act, which became law in August, ushered in some changes to Part D coverage.

Starting Jan. 1, there will be a monthly $35 cap on cost-sharing for insulin under Part D some plans may already offer a $35 cap. Part D deductibles also won’t apply to the covered insulin product. For beneficiaries who take insulin through a traditional pump, which falls under Part B, the benefit starts July 1.

Additionally, there will no longer be any cost-sharing for recommended inoculations under Part D beginning Jan. 1, including the shingles vaccine.

Other provisions from the new law that are intended to reduce Part D spending take effect in later years.

This includes eliminating an existing 5% coinsurance in the so-called catastrophic phase of coverage, in 2024, and capping beneficiaries’ annual out-of-pocket Part D spending at $2,000, in 2025. Currently, there is no out-of-pocket limit, regardless of whether you get your coverage as a standalone Part D option or through an Advantage Plan.

Medicare also will be able to start negotiating the price of some drugs beginning in 2026.

Other Exceptional Circumstances Including Natural Disasters

Exceptional circumstances can be personal for example, a house fire or a serious medical condition that made it impossible for you to enroll but they also include natural disasters that impact a large number of people. They can also be triggered by political or regulatory changes. As noted above, for example, California issued a special enrollment period in August 2021 for people living in areas where a wildfire-related state of emergency has been declared.

If exceptional circumstances occur during open enrollment , and you can demonstrate to the exchange that the circumstances prevented you from enrolling by the end of open enrollment, the exchange can grant you a special enrollment period. This also applies if the exceptional circumstance happened before or during another special enrollment period for which you were eligible, and it essentially extends your special enrollment period.

HHS issued guidance in 2018 explaining how special enrollment periods work via HealthCare.gov in areas where FEMA declares a disaster that allows a county to apply for individual assistance or public assistance as a result of the disaster.

The special enrollment period continues for 60 days after the FEMA disaster incident period ends, and applicants can select an effective date in the future or the effective date they would have had if theyd enrolled during the open enrollment period .

367-6947 to discuss your situation with a licensed insurance professional.)

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Do Some People Get A Second Open Enrollment Period For Medigap

There are very few situations where a beneficiary will get a second Medigap Open Enrollment Period. Below is a list of a few.

• If you retire, enroll in Medicare Part B, then go back to work and join your employers group health care coverage, youll get a second Medicare Supplement Open Enrollment Period when you retire again and enroll back into Medicare Part B.
• If you get Medicare due to a disability when youre under 65, youll get two Medigap Open Enrollment Periods. The first will start with your Original Medicare Part B effective date before you turn 65. The second will begin when you turn 65.

One reason a beneficiary on Medicare due to disability would choose not to enroll during their first Medigap Open Enrollment Period is due to the minimal Medigap plan options available to them. Only certain states require Medicare Supplement carriers to offer Medigap plans to people under 65.

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In fact, most states only offer Plan A to those under 65. Because of this, someone qualifying due to disability may not have many options when first eligible. Allowing for a second Medicare Supplement Open Enrollment Period gives these beneficiaries access to all plans in their area.

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What Plan Changes Can I Make During The Medicare Open Enrollment Period

During the Medicare open enrollment period, you can:

• Switch from Original Medicare to Medicare Advantage .
• Switch from Medicare Advantage to Original Medicare .
• Switch from one Medicare Advantage plan to another.
• Switch from one Medicare Part D prescription drug plan to another.
• Enroll in a Medicare Part D plan if you didnt enroll when you were first eligible for Medicare. If you havent maintained other , a late-enrollment penalty may apply.

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What Can You Do To Find Out More About Your Medicare Plan Or To Get Help Comparing Plans

• Call 1-800-MEDICARE or go to medicare.gov
• Sign up direct for the drug plan through the carrier
• Work with an agent or broker
• Contact your state SHIP

If youd like further help navigating through the different parts of Medicare, please contact M3s specialized Individual Health & Medicare account executive, Virginia Van Haren.

When Is Medicare Open Enrollment

Medicare open enrollment also known as Medicares annual election period runs from October 15 through December 7 each year.

During this annual window, Medicare plan enrollees can reevaluate their coverage whether its Original Medicare with supplemental drug coverage, or Medicare Advantage and make changes or purchase new policies if they want to do so.

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When Can I Enroll In Medicare Part D

The first opportunity for Medicare Part D sign up is when youre initially eligible for Medicare during the seven-month period beginning three months before the month you turn 65, or during the seven-month period beginning three months before your 25th month of disability.

In both of these cases whether youre turning 65 or are eligible for Medicare because of a disability you likely have the option of selecting a Medicare Advantage plan that includes Part D prescription drug coverage, and using that in place of Medicare A, B, and D.

If you enroll in Medicare during the , you can enroll in a Medicare Advantage plan between April 1 and June 30. But if you already had premium-free Medicare Part A and youre just using the General Enrollment Period to sign up for Part B, youll have to wait until the fall open enrollment period to sign up for a stand-alone Part D plan. This is because Part D can be purchased when you have Part A or Part B, whereas Medicare Advantage requires you to have both. So if youve already had premium-free Part A, you were eligible for Part D as of when your Part A coverage took effect. But your eligibility for Medicare Advantage would only begin when youre enrolled in both Part A and Part B.

If youre enrolled in a Medicare Advantage plan and use the Medicare Advantage open enrollment period to switch to Original Medicare, youll also have the option to sign up for a Part D plan to supplement your Original Medicare coverage.

How Do I Enroll In Medicare Advantage

To join a Medicare Advantage Plan, you will need to have Original Medicare coverage and live in an area where an Advantage plan is offered.

A Medicare Advantage plan will wrap your Medicare Part A and Part B coverage into one plan. But youll still have to pay the government a premium for Part B, in addition to the premium you pay for Medicare Advantage .

You can enroll in a Medicare Advantage plan when youre first eligible for Medicare, or during the annual Medicare open enrollment period in the fall .

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How To Enroll In Medicare

Medicare open enrollment is for people who are already enrolled in Medicare. If youre signing up for Medicare for the first time, thats your initial enrollment window.

The steps you need to take during your initial enrollment will depend on how you become eligible for Medicare.

For example, youll need to apply directly to Medicare if youre not already receiving benefits from Social Security or the Railroad Retirement Board. People who are receiving these benefits will be enrolled in Medicare automatically when they become eligible.

You can apply for Medicare in a few different ways:

You dont need to take these steps if youre already enrolled in Medicare. Instead, you can use the open enrollment window to change your coverage.

You can do this by visiting the Medicare website and shopping for new plans. You can then select a plan you want and join.

You dont need to take any extra steps. As long as you join the new plan during open enrollment, you can just select your new plan. Remember, youre selecting coverage for the next plan year which means your plan will change in January, not right away.

Who Is Eligible To Make Changes During Annual Open Enrollment

During Medicare annual open enrollment, anyone with any type of Medicare plan can make changes to their coverage.

Who Can Make Changes During Medicares Annual Open Enrollment

• People with Original Medicare can switch to Medicare Advantage .
• People with Medicare Advantage plans can switch to Original Medicare .
• People with a Medicare Advantage plan can switch to a different Medicare Advantage plan.
• People with a Medicare Part D drug plan can switch to a different Part D plan.
• People with Original Medicare can enroll in a Part D plan for the first time.
• People with a Medicare Part D plan can drop it completely.

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Medicare Part D Premium Based On Income 2023

The Part D monthly premium varies by plan. Most people only pay their Part D premium.

If your modified adjusted gross income is above a certain limit, you may pay a Part D income-related monthly adjustment amount in addition to the plans premium. Youll pay the Part D-IRMAA amount in addition to your monthly plan premium, and this extra amount is paid directly to Medicare, not to your plan.

The chart below shows the estimated prescription drug plan monthly premium based the Modified Adjusted Gross Income reported on your IRS tax return from 2 years ago. It is the most recent tax return information provided to Social Security by the IRS.

Your Plan Changes Its Contract With Medicare

Medicare takes an official action because of a problem with the plan that affects me.

What can I do?

Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.

When?

Your chance to switch is determined by Medicare on a case-by-case basis.

Medicare ends my plan’s contract.

What can I do?

Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.

When?

Your chance to switch starts 2 months before and ends 1 full month after the contract ends.

My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare isn’t renewed.

What can I do?

Join another Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

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The Medicare Part D Open Enrollment Period: What You And Your Audience Need To Know

By its design as the national health plan for older Americans, Medicare insures a disproportionate number of people who take prescription drugs.

The majority of participants in the giant federal health program last year 52.6 million, or 86% of the 61.2 million enrolled were age 65 and older, according to the most recent report from the Medicare board of trustees, which comprises federal officials leading health, labor and retirement programs. The rest of the enrollees qualified due to disabilities.

And people are more likely to need medicine as they age, as shown in a May 2019 report from the Centers for Disease Control and Prevention . About 85% of people age 60 and older in the U.S. reported having taken one or more prescription drugs in the past 30 days, while only 47% of those ages 20 to 59 did, according to 2015-2016 data from the CDCs National Health and Nutrition Examination Survey.

Medicare Part D is an optional program to help people enrolled in the federal health program pay for prescription drugs. With annual expenses running to about $100 billion last year, it is the dominant insurer in the U.S. pharmaceutical market.

While funded by Medicare, Medicare Part D plans are managed by insurers such as the for-profit UnitedHealth and nonprofit Blue Cross Blue Shield plans. These insurers compete for customers, offering plans with varied monthly premiums and deductibles.

D Late Enrollment Penalty

The late enrollment penalty is an amount that’s permanently added to your Medicare drug coverage premium. You may have to pay 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 Medicare drug coverage or other

. Youll generally have to pay the penalty for as long as you have Medicare drug coverage.

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Why Are Longer Health Insurance Open Enrollment Periods Better

Open enrollment is your best chance to:

• Get a different insurance company, or
• Change your health insurance network type.

A great deal of flexibility disappears with a six-week open enrollment period. Smaller advertising budgets mean that there wont be a whole lot of warning for consumers before open enrollment begins. The federal government has even decided to end nonprofit programs that let people know about open enrollment and help them sign up for insurance.

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Medicare Open Enrollment Made Easier

In all the fun of fall, dont forget your important to-dos for the seasonlike signing up for Medicare. In 2019, open enrollment for Medicare coverage in 2020 is from Oct. 15 through Dec. 7. During this time, you can make changes to your Medicare coverage. With the variety of plans, new updates for 2020 and general enrollment questions, it can all be a little overwhelming. But heres an easy way to get a general understanding of what to consider during Medicare open enrollment for 2020.

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Medicare Supplement Insurance Enrollment

If you have Original Medicare and would like to enroll in a Medicare Supplement Insurance plan , the best time to sign up is during your six-month Medigap Open Enrollment Period.

• Your Medigap Open Enrollment Period starts as soon as you are age 65 or older and are enrolled in Medicare Part B.
• Insurance companies cannot deny you Medigap coverage or charge you a higher fee for pre-existing health conditions if you apply for Medicare Supplement Insurance during your Medigap Open Enrollment Period.

If you dont sign up for a Medigap plan during your Medigap Open Enrollment Period, you may still be able to buy one at any time.

Insurance companies can take your health into consideration when setting your premiums or deciding whether or not to offer you coverage, however.

You must be enrolled in Medicare Part A and Part B in order to buy a Medigap plan.

Medigap and Medicare Advantage plans are very different, and you cannot be enrolled in a Medigap plan and a Medicare Advantage plan at the same time.

Learn more about the differences between Medicare Advantage vs. Medicare Supplement Insurance.

Request a free, no-obligation Medicare Supplement Insurance quote today by visiting MedicareSupplement.com.