Commentary by Bob Adams
With the Annual Enrollment from this fall well behind us, the Medicare world is less hectic. Therefore, the folks I tend to focus on most are those turning 65 or those needing help navigating through their Medicare choices.
For those turning 65 and who are new to Medicare, the most common guaranteed right is called your Open Enrollment or Initial Enrollment Period. This is like a get out of jail free card. Up to three months prior to your birth month and three months after your birth month, you can choose any plan offered by any company, and you are guaranteed to be accepted. No one can tell you no, regardless of your health.
There are also seven other guaranteed rights which are called a Special Enrollment Period, or SEP. Generally, you don’t have the same full range of options like you do when turning 65, but you do have choices.
- If your Medicare Advantage plan leaves your area, you have 60 days prior and 63 days after to choose another plan.
- If your employer coverage or Cobra is ending, you have a narrow window of time to choose a different plan.
- If you have a Medicare Select supplement or MA plan and you move out of the coverage area, you have 60 days prior and 63 days after to choose another plan.
- If you joined a MA Plan when you were first eligible at age 65 and within the first year you decide to switch back to original Medicare, you can choose most any Supplemental plan.
- If you dropped a Medicare supplement for a MA plan for the first time and you’ve been in the plan less than one year, you can switch back to the same plan you had prior to changing.
- If your Medigap insurance company goes bankrupt, you have up to 63 days to change to a different plan with no questions asked.
- If your MA plan or Supplement misled you, you have 63 days from the time the coverage ends to choose a plan.
If any of these situations apply to you, you need to contact your agent right away and discuss what might be better for you.