Now, as you get into the Medicare system,
you're going to see a lot of acronyms and individual letters that are used.
And so I just want to make just a little bit of sense
out of some of these acronyms so that you'll understand
when you come across them exactly what they mean
Welcome to Medicare School Daily, where we help
you understand Medicare, save money,
avoid making mistakes, and above all, else, get the most
out of your Medicare coverage.
Now, today's topic is what and when is the Medicare annual enrollment period?
Okay. So we're going to talk about the annual enrollment period.
But before I do, let's first talk about the different parts of Medicare.
Now, when we refer to for the parts of Medicare, that is typically parts of ABC, and D.
Now parts A and B we refer to as original Medicare.
So that means that if someone enrolls into original Medicare and they're using
original Medicare, A and B, that means that they're using their Medicare A and B card
A is for things that are inpatient type services.
B is for things
that are going to be outpatient services plus all doctor provided services.
That's original Medicare A and B, now we talk about C plans.
These actually came in existence in 2003 under the second George
Bush administration.
These are called replacement plans.
So when a person first goes onto Medicare, they're either going to use
original Medicare and B, or they're going to enroll into a C plan.
Now where it gets a little bit confusing
in order to have a C plan or an advantage plan, You do have to be enrolled in A
and B, A usually has zero premium and B usually carries a premium.
This video is being shot in 2022.
And this year, part B premium is $170.10.
So when someone is enrolled in A and B, A is free using and B
they have to pay the premium
or they have a C plan or an advantage plan, you have to be enrolled in A and B
to qualify for eligibility to be on an advantage plan.
D plan represents drug plans Now this system started in 2006
and what is going on here is these are the medications that we self-administer.
So this is your cholesterol medication, high blood pressure, maybe
heart medication or insulin type products,
but that's through drug plans you self-administer.
Now, when someone buys a C plan, they actually combine those together.
So it becomes a C plus a D plan.
All right.
And so parts of Medicare original, then Advantage plans and then drug plans.
That's the parts of Medicare.
Now, let's talk about the enrollment
periods for these different parts of Medicare.
All right.
Now, in order to understand enrollment periods,
because you're going to have to live with these your entire life on Medicare,
you have to ask yourself, if I have an enrollment period,
it means I'm enrolling into something or I have this opportunity
to enroll to something.
And there's only two some things that you're going to enroll into.
Either you're going to roll into Medicare to get the A and B of Medicare
or you're going to get insurance products
which would be advantage plans, drug plans, supplemental plans.
And so we have enrollment periods or opportunities
to get Medicare or to get other insurance products.
All right.
So that's the the different types of enrollments.
Now, if I'm going to get into Medicare, I have actually three
different opportunities
to get into Medicare to get my Medicare, A & B set up.
And you're only going to use one of these three.
Now, you're the first one is called initial enrollment period.
And this is for people that start Medicare at 65.
So they enroll around their 65th birthday
and they're using their initial enrollment period to get into Medicare A
and B, the SEP stands for special enrollment period.
And this is for people that didn't go on Medicare at
65 because they or their spouse were covered by an Employer-Provided plan
that was better than the Medicare option because as long as you have an employer
provided plan meaning you
or your spouse are actively working and that group plan is 20 or more
you do not have to start Medicare at 65 but you may decide to
go on Medicare while you're still working or you may wait till you retire.
But when you come in to Medicare beyond 65
in three months old, which means you're 65 and four months old beyond,
you're coming into Medicare using what's called a special enrollment period.
So we use the special enrollment period to set up our Medicare A and B account.
And this last was one's called a general enrollment period.
And this is for people that actually made a mistake.
They, didn't come in at 65 and they didn't use the SEP
they didn't use either one of those.
So now they're stuck
coming in during the general enrollment period to get their Medicare A and B set up.
And when they do this, they can only do this the first quarter of the year.
Medicare coverage starts at the beginning of the third quarter.
So we enroll January, February, March, we start the coverage in July.
And we also have penalties whenever we use the general enrollment period.
So you really don't want to use that one.
But all three of those will accomplish
enrollment into A and B to set up our Medicare original account.
Now, beyond that, most people are going to get other insurance products right,
supplemental plans, drug plans, advantage plans.
And so now that is what would be called insurance products.
And again, we have enrollment periods to get those.
And so we have an initial enrollment period at 65 to buy plans,
insurance plans.
We can come in after 65 and still buy those plans.
That's the special election period.
And then we have this thing called the OEP, now this OEP
actually has a couple different meanings.
We have an open enrollment period when we set up our Medicare A and B
to buy a supplemental plan with no underwriting.
And that lasts for six months of your B date.
So we enroll in A and B, and we have this open enrollment period
to buy any Medigap policy.
That's the ones that always have a letter, plan F, Plan G plan N.
And we can do that during the Medigap open enrollment period for six
months of our B date, no underwriting required.
All right.
Then lastly, and this is the one I really want to talk primarily about,
but I want to share at least a little bit of information about these other acronyms
and this is the what's called the annual enrollment or annual election period.
Okay. I'm going to give you some details about that.
So this is the enrollment period
that has to do with people that are already in Medicare.
And now we've hit that period, which is October 15th to December 7th.
And now people are going to be considering switching plans All right.
So this is our focus for the remainder of the video, the AEP or
the annual election period, October 15th through December 7th every year.
All right.
So what can you do during this annual enrollment period?
Well, number one, it just really depends on
what kind of plan you have as we go into the annual enrollment period.
If you're on an advantage plan during this period of time,
you have the right to actually switch to a new advantage plan.
You may change plans within the company that you have now.
They may offer a different plan that you like
or maybe you're going to change companies
totally and pick up a totally different new advantage company to take care of you.
So this means that you're on a business plan
and now you can switch to a new advantage plan.
Now, that new advantage plan does not go into effect until January one.
So we're all we're always on a plan for a full calendar year.
But to make a switch, we've got to do it towards the end of the year during this
seven week period, and it will start January one.
Now, to make the switch, there's no medical underwriting at all.
There's no health questions asked whatsoever.
That advantage plan that you want to switch to
just has to be available in what we call a service area.
And a service area is typically a metropolitan area
or it could be a multi county area anyway.
So and there's 37 of those around the country.
But the point is it's got to be available in your in your area.
So you may have a brother or a sister that's on Medicare
and they're on this advantage plan and they love it.
But, you know, they're five states away where it may not be available
where you are.
And so as long as it's in that area.
And you qualify and you're enrolled in Medicare A and B both.
Then you can switch your advantage plan.
October 15th, December 7th, it will go effective January one.
Another thing you can do is if you're on an advantage plan during this open
enrollment period, you can actually switch to a supplemental plan.
So a person that has a supplemental plan, that means that they are enrolled in A
and B and Medicare pays first.
Well, Medicare pays pretty well, but it doesn't pay for anything.
100% other than preventive.
And so there's always gaps or financial liabilities
you're responsible for in original Medicare.
A and B, so when I switch
from the advantage to a supplemental plan, I'm going back to original Medicare.
A and B, and because of those gaps, I don't want to be responsible for those.
I will buy a supplemental plan.
And there's ten such possibilities of those plans, and I buy one of those.
And what's happening with that is I'm taking
all the
risk or most of the risk of my gaps in original Medicare.
A and B, and I'm transferring those
that risk and getting rid of that risk and giving it to an insurance company.
Of course, if they take the risk from me, I'm going to have to pay them a premium
to do that.
So I pay them a premium and they issue to me a supplemental policy.
They're also called Medigap.
And so during the open enrollment season, I can do this if I'm on an advantage plan,
I want to switch. Now, you got to keep this in mind.
If I make that switch, almost always you have to medically qualify to do that.
There are a few exceptions, but it's rare but
almost everybody has to in this switch, has to medically qualify.
So that means that supplemental company that you want to go with
is going to put you through underwriting.
That means that we have to ask you 25 or 30 health questions.
We're going to check your medications now and the medications
you've been on the last 24 months to know what you're being treated for.
Probably get a statement from your doctor as well.
And so all that is
part of the underwriting process to make that switch, which means
that insurance company doesn't have to take you just because you want it.
If you don't medically qualify,
you have something going on with your health in the past or present.
They may say no to you and you cannot make that switch.
But if you can't make that switch, then once we have approval on that
Supplemental plan, then we will find a drug plan for you.
And this would be a standalone prescription drug plan.
Lots of options on those.
And that would be a separate policy with a separate premium.
All right.
So that is done during the open enrollment period, annual election period.
The third thing you can do,
let's say that you come into these dates and you have a supplemental plan
and you decide, I don't want that any longer I'm attracted now to an advantage plan.
So back up here so you can make that switch again.
October 15th to December 7th.
And keep in mind,
this is the only time in the year you can make this particular switch.
Some of these others have a few exceptions.
But I'm telling you, from supplemental plan to advantage,
this is the only time of the year you can do it seven weeks during the year.
And when you make that switch, there is no underwriting required.
That advantage company has to take you and will take you.
Okay.
Now, again, like we said up here, going to an emergency plan it has to be
available in your service area and something that's, you know, in your
in your within your physical address location.
And as long as it's available and you're enrolled in A and B,
you can make that switch to underwriting whatsoever.
Now, that supplemental plan is going to
that you're on will take you through December 31st.
That advantage plan will become effective January the first.
But we got to make the switch during those seven weeks towards the end of the year.
And then lastly, you may be on a drug plan.
Now, let me tell you this scenario here.
This is somebody that stayed in original Medicare A and B, Medicare pays first.
The secondary payer was the supplemental plan.
One of those letters, as I said, most people get F plan or G plan or an N plan.
And so when we have an A and B with the supplemental plan,
then we have a drug plan that's added to that.
And it could be a totally different company.
It's certainly a different policy, a different premium.
Most zip codes have about 15 to 30 different plans to choose from.
All right.
And so you can select the very best plan
and that very best plan, it's not going to be based upon
the premium price is based upon the medications that you take.
One size does not fit all when it comes to drug plans.
So we take your meds, the pharmacy you like to go to,
and then we have software, of course, that will actually or a web tool
that will actually allow you to make sure
that you are going to be on the right drug plan. Year to year.
But during this period of time, if we have a drug plan now, we can switch
drug plans. Well, why would someone want to do that?
Well, let's say this year you're taking less meds than you were the year before.
Maybe you're taking more meds or maybe you're on a plan and medication
that you have is no longer covered.
It was covered this year. It's not going to be covered next year.
And so you have the opportunity
to switch to get a different plan to make sure your medications are covered.
You get to go to the pharmacy that you want so we can make that switch.
And again, no underwriting required.
If that drug plan is in your service area, it's available
as long as you're enrolled in Medicare A and or B, either one of those
you qualify to switch your drug plan.
And again, it's a calendar year plan.
That plan you're on takes you to the 12-31.
We make a switch during October 15th, December 7th
and then that new drug plan will go effective January 1st
and or kick out the old drug plan.
All right.
So those are the things that you can do during the annual enrollment period.
During this time, I can assure you you will be bombarded with lots of ads and
and your mailbox will fill up and the e-mail box is going to fill up.
But lots of activity going on that during that time and the main thing is
to make sure that, first of all, you know, you really need to make a switch.
Sometimes companies will advertise and make, you
feel like you better switch.
You don't necessarily have to switch plans, but this is the time
to do this type of switching.
And if it is in your best interest, you certainly want to do that.
It'd be our privilege
to assist you during that process of the annual enrollment period
Hey, thanks so much for watching the video,
and I do hope that it was helpful.
Now if you feel like
you need to learn more about Medicare
to make sure you're making the right Medicare decision,
really the best way and the easiest way to do
that is to go to MedicareSchool.com.
That's MedicareSchool.com,
and you'll be given the opportunity to be able
to click on Get the Free Workshop.
We call that the essentials workshop
and I do all the teaching.
And there you'll learn all the ins and outs of Medicare
to make sure that you have an accurate
and thorough understanding of how Medicare works.
The second thing you can do
is click where it says, talk to a Medicare guide,
and there
you can actually set up a time
where you can discuss your situation
with a Medicare guide.
They'll explain all your options
and actually even walk you
through the enrollment process as well,
if that's what you need to do.
And so go to MedicareSchool.com,
watch the workshop or talk to a Medicare guide.
It would be our privilege to assist you further.