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Medicare Open Enrollment: Your Guide to Optimal Coverage

Medicare Open Enrollment Starts Soon: Here’s What You Need to Know

Written By Hazel Secco

Medicare Open Enrollment is here! This annual window gives Medicare beneficiaries the chance to review and adjust their healthcare coverage to make sure it still fits their needs and budget. Hence, this is a critical period for millions of Americans.

Whether you’re just starting with Medicare or have been on it for years, this article covers everything you need to know about the Open Enrollment period. From what changes you can make to tips on making smart choices, we’re here to help you find the coverage that works best for you.

What Is Medicare?

Medicare is a federal health insurance program that covers people 65 and older, along with some younger individuals with disabilities. By understanding the four main parts of Medicare—each offering different types of coverage—you can make sure your healthcare needs are well met.

Here, we’ll break down the four parts of Medicare, covering what each one includes and who’s eligible.

  • Medicare Part A, often called Hospital Insurance, covers things like inpatient hospital stays, care at skilled nursing facilities, hospice care, and some home healthcare services. Eligibility for Part A is usually automatic for people who are 65 or older and have worked (or have a spouse who worked) and paid Medicare taxes for at least 10 years. In some cases, people under 65 with certain disabilities may also qualify for Part A.
  • Medicare Part B, also known as Medical Insurance, covers a variety of outpatient services, like doctor visits, preventive care, medical equipment, and some vaccines. Part B is optional, and there’s a monthly premium for this coverage. Most people who qualify for Part A are also eligible for Part B. Enrollment usually happens during an initial enrollment period, which is often when someone first becomes eligible for Medicare.
  • Medicare Part C, also known as Medicare Advantage, is an alternative way to get your Medicare benefits. These plans are offered by private insurance companies approved by Medicare. Medicare Advantage plans generally cover everything in Parts A and B, and often include extra benefits like prescription drug coverage (Part D), as well as dental or vision care. To be eligible for Medicare Advantage, you need to be enrolled in both Parts A and B and live in an area where a Medicare Advantage plan is available.
  • Medicare Part D covers prescription drugs, helping beneficiaries manage the cost of their medications. Like Part B, Part D is optional, and you’ll need to enroll in a separate plan through a private insurance company. To be eligible, you must already have Medicare Part A or Part B. Most people sign up for Part D during their initial enrollment period, but you can also join during the annual Medicare Open Enrollment Period.
  • You might have an extra charge added to your Part B premium called an Income Related Monthly Adjustment Amount (IRMAA). Basically, if your modified adjusted gross income from two years ago, as reported on your IRS tax return, is above a certain level, you’ll pay the standard premium plus an additional IRMAA charge. For 2024, the IRMAA additional premiums are:
MAGI – Single TaxpayersMAGI – Married Filing JointlyIRMAA Premium (Part B)
$103,000 or less$206,000 or less$174.70
Between $103,000 and $129,000Between $206,000 and $258,000$244.60
Between $129,000 and $161,000Between $258,000 and $322,000$349.40
Between $161,000 and $193,000Between $322,000 and $386,000$454.20
Between $193,000 and $500,000Between $387,000 and $500,000$559.00
Greater than or equal to $500,000Greater than or equal to $750,000$594.00
Income Related Monthly Adjustment Amount (IRMAA)

Depending on your needs and situation, you might decide to go with Original Medicare (Parts A and B), possibly adding on extra coverage like Medicare Part D for prescriptions. Or, you might look into the more comprehensive coverage options available through Medicare Advantage plans.

What Are My Enrollment Options?

Just a heads-up: Open enrollment only applies to people who are already enrolled in Medicare. If you’re not yet enrolled, your initial enrollment period is tied to your birthday, not the calendar. You’ll have a seven-month window to sign up for Medicare—starting three months before your 65th birthday month and ending three months after.

The open enrollment period gives you flexibility with each part of Medicare, letting you make adjustments to fit your needs:

  • If you’re enrolled in Medicare Parts A and B, you can switch to a Medicare Part C (Medicare Advantage) plan.
  • If you’re already in Medicare Part C, you have the option to switch back to Original Medicare or choose a different Medicare Advantage plan that might suit you better.
  • If you have Medicare Part D for prescription drugs, you can switch to a different Part D plan or even drop your prescription coverage altogether.

During open enrollment, you also have the option to sign up for Medicare Part C and Part D for the first time if you haven’t done so already. This period gives you the chance to adjust your Medicare coverage to better meet your changing healthcare needs.

Medicare open enrollment runs each year from October 15th to December 7th. Making changes to your plan during this time will affect your coverage for the upcoming year, 2024.

It’s worth noting that this open enrollment period is different from the Medicare Advantage open enrollment, which is from January 1st to March 31st. During the Medicare Advantage enrollment, individuals already in Part C plans can switch to a different Part C plan or return to Parts A and B. For other changes, though, the October-to-December window is your best opportunity.

We Are Here to Help

Feeling overwhelmed or unsure about your Medicare options? You’re not alone! It’s completely normal to feel confused when navigating the ins and outs of Medicare. That’s why we’re here—to provide the guidance and support you need.

At Align Financial Solutions, we’re passionate advocates for women who want to retire on their own terms. We help you to make informed decisions, so you can fully maximize the resources and benefits available for your financial future. If you have questions about your Medicare plan or need help with enrollment, feel free to reach out. Schedule a complimentary call with us at info@alignfinancialsolutions.com or 201-655-6572. We’re here to support you every step of the way!

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