If you're enrolled in Medicare, mark these dates on your calendar: October 15, 2011 – December 7, 2011. That's Medicare's 2012 Open Enrollment period – and you should note that it occurs a month earlier this year than in the past. Aside from exceptions made for a few special circumstances, this is the only period when current enrollees can make coverage changes for the coming calendar year.
Medicare provides health care benefits to people age 65 and older and those under 65 with certain disabilities or end-stage renal disease. For most people, the initial enrollment period is the seven-month period that begins three months before the month they turn 65. If you miss that window, you may enroll between January 1 and March 31 each year, although your coverage won't begin until July 1.
Medicare offers several plans and coverage options, including:
- Medicare Part A, which covers in-patient hospital, skilled nursing facility and hospice services, as well as home health care. People are usually enrolled automatically upon turning 65 or after having received Social Security disability benefits for 24 months. There's usually no monthly premium.
- Medicare Part B, which covers doctor's services, outpatient care and some preventive services. It's optional and has a monthly premium. Most people are automatically enrolled at the same time they begin Part A coverage, but you can opt out by following instructions accompanying your Medicare card (mailed about three months before your 65th birthday).
- Medicare Part C (Medicare Advantage) plans, which are privately run alternatives to traditional Parts A and B. Structured like HMO or PPO plans, they often include additional benefits such as prescription drugs, dental, vision and wellness programs. Monthly premiums may be higher than regular Part B, but they usually have lower deductibles and copayments; also, they require that you use the plan's provider network.
- Medicare Part D, which covers prescription drugs. It's optional and carries a monthly premium. These privately run plans vary widely in terms of cost, copayments and deductibles and medications covered.
During Medicare Open Enrollment you can:
- Switch from original Medicare Parts A, B and D to a Medicare Advantage plan, or vice versa.
- Switch from one Advantage plan to another.
- Switch from an Advantage plan that offers prescription coverage to one that doesn't, and vice versa.
- Join a Part D plan, switch from one plan to another, or drop Part D coverage altogether.
People currently enrolled in Medicare Advantage have another opportunity to make changes during a second period called Medicare Advantage Disenrollment. Between January 1, 2012, and February 14, 2012, you can switch back to original Medicare Parts A and B coverage, with the option to join Part D as well. However, during this period you cannot:
- Switch from original Medicare to Medicare Advantage.
- Switch from one Medicare Advantage plan to another.
- Switch from one Part D plan to another.
Understanding and choosing the right Medicare options can be complicated and time-consuming. For assistance, call 1-800-633-4227 or visit Medicare's website, www.medicare.gov, where you'll find:
- Helpful publications, including Medicare & Your 2011, a highly detailed guide that explains Medicare in easy-to-understand language.
- Tools to compare prescription plans, hospitals, nursing homes, home health agencies and Medigap plans in your area.
- Resources to find local doctors and other practitioners who participate in Medicare.
- Services covered by various Medicare plans.