Medicare Annual Open Enrollment Period – Are You Eligible?

You may have a lot of questions on how to sign up or make changes to your current Medicare plan.

Medicare Open Enrollment Period starts on October 15 until December 7 of each year. If you want to check for your eligibility, Health Plans in Oregon is here to help you.

During this annual enrollment period (AEP) / Medicare Open Enrollment Period, you can make changes to your coverage.

• You can switch from Original Medicare to Medicare Advantage plan, or vice versa.
• You can also switch from one Medicare Advantage plan to another, or from one Prescription Plan (Medicare Part D) to another.
• Drop your Medicare prescription drug coverage completely.
• If you choose to remain on your existing plan, you don’t need to do anything.
• If you don’t make any changes during Medicare Open Enrollment Period, your current Medicare coverage will renew automatically. However, you should always review the materials your carrier sends you, like the “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC) because your existing coverage may have certain changes for the upcoming year.

If you want to enroll in a Medicare Advantage plan, you must meet some basic criteria.

You must:

• be enrolled in Medicare Part A and B.
• live in the plan’s service area.
• not have End-Stage Renal Disease (some exceptions apply)

However, if you are new to Medicare…

Ideally, you should sign up for Medicare during your Initial Enrollment Period. This is pertaining to seven-month period that starts 3 months before you turn 65, includes the month of your 65th birthday, and ends 3 months later.

There are 2 main categories for qualifying for Medicare:

• You can become eligible at age 65 or older.
  Here, you must be a United States citizen or a permanent legal resident. To be “fully insured” you must have earned at least 40 work credits through paying Medicare payroll taxes at work (equivalent to about 10 years of employment). You can also qualify for “premium-free” Part A on the work record of your spouse. If the both of you do not have 40 work credits, you can still receive Part A benefits by paying monthly premiums.
• You can become eligible at an earlier age due to disability.
  You can receive Medicare sooner (before 65). This is if you have kidney failure and needs regular dialysis or a kidney transplant (end-stage renal disease or ESRD) or if you have Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS).

Other available times for enrollment:

If you missed your Initial Enrollment Period for Medicare plans then your next chance is during the General Enrollment Period. This runs from January 1 to March 31 of each year. Always remember that on this period, there may be a late-enrollment penalty fee.
If you missed the Initial and General Enrollment Period then you can enroll within an eight-month Special Enrollment Period. This period starts when your health coverage ends or when you stop working, whichever happens first.