What is Medicare Open Enrollment?

Each year, from October 15 through December 7, Medicare beneficiaries may make changes to their healthcare and prescription coverage for the following year. Specifically beneficiaries may change their healthcare coverage between Original Medicare and Medicare Advantage, and/or change their prescription plan.

More Information

For more information about what changes can be made during open enrollment, see AARP’s article, “8 Things You can Do during Medicare Open Enrollment,” and/or this one minute video by the federal Centers for Medicare and Medicaid Services.

How to Make Medicare Open Enrollment Changes

Beneficiaries may alter their coverage for the coming year by phone, through a counselor, or online.

• By phone: 1-800-MEDICARE

• By counselor: Federally funded State Health Insurance Assistance Programs (SHIPs) provide free assistance to Medicare beneficiaries with open enrollment. Local SHIPs are listed below. To find a SHIP nationwide, visit the website of the SHIP National Technical Assistance Center.
  • (DC) – Health Insurance Counseling Project: 202-739-0668
  • (MD, Montgomery) – State Health Insurance Assistance Program: 301-255-4250
  • (MD, Prince George’s) – State Health Insurance Assistance Program: 301-265-8471
  • (VA, Alexandria & Arlington) – VICAP: 703-228-1700
  • (VA, Fairfax) – VICAP: 703-324-5851

• Online: Beneficiaries also can make changes online via Medicare’s Plan Finder. Tips on using Medicare’s Plan Finder can be found in this 12 ½ minute video by federal CMS, and/or this slide show by the state of Illinois.

Where to Find Guidance

Several nonprofits and government agencies offer free online guides for selecting among plan choices. Several are listed below.

• Choosing Between Original Medicare and Medicare Advantage? Free guidance available from US News & World Reports, and from the federal Centers for Medicare and Medicaid Services.

• Choosing Among Medicare Advantage Plans? Free guidance available from Consumer Reports, and from the Medicare Rights Center.
• Choosing Among Medicare Part D plans? Free guidance available from the Medicare Rights Center, and from the National Council on Aging.
• Choosing Among Medigap Policies? Free guidance available from Medicare Interactive, and from the federal Centers for Medicare and Medicaid Services.

Help for Low-Income Beneficiaries

Like most private health insurance policies, Medicare’s coverage is not free. Beneficiaries pay premiums, deductibles, and co-pays. These costs can be challenging for elders on tight or restricted incomes. Luckily, the federal government offers financial assistance to low-income beneficiaries in the form of Medicare Savings Programs, which help with costs associated with Medicare Parts A and B; and Extra Help, which helps with costs related to Medicare Part D.

Glossary

• Extra Help – This subsidy, for low-income beneficiaries, helps cover some of the costs of Medicare Part D.

• Original Medicare – One of two ways in which a beneficiary may choose to receive coverage (the other is Medicare Advantage), Original Medicare operates like many traditional health insurance policies, in that beneficiaries may choose their own medical providers (so long as the provider accepts Medicare). Original Medicare consists of Medicare Parts A and B.

• Medicare Advantage – See Medicare Part C.

• Medicare Part A – Part of Original Medicare, this subsection of Medicare covers inpatient (e.g. hospital) care.

• Medicare Part B – Part of Original Medicare, this subsection of Medicare covers outpatient (e.g. medical appointments) care.

• Medicare Part C – Also called, Medicare Advantage, this program offers managed care coverage equivalent to care under Medicare Parts A & B (of Original Medicare); and may offer additional coverage for care (e.g. dental, and eyeglasses) not covered under Original Medicare.

• Medicare Part D – Covers the cost of prescriptions.

• Medicare Savings Programs – These subsidies, for low-income beneficiaries, helps cover costs associated with Medicare Parts A and B.

• Medigap – These secondary insurance policies, sold on the private market, cover costs that Medicare doesn’t cover, including premiums, co-pays, and deductibles.

By Leland Kiang

Leland Kiang, LICSW is manager of Iona’s Information & Referral Help Line, whose staff answers questions about senior services throughout the DC metro area.  Leland also has written articles for BIFOCAL, Unite Virginia, and the National Resource Center on LGBT Aging.