Medicare open enrollment can get confusing

Beginning Jan. 1, 2023, if you sign up the month you turn 65, during your Initial Enrollment Period, your coverage starts the first day of the month you sign up.

When you become eligible for Medicare during this period, you can join a Medicare Advantage Plan. You can then switch to another Medicare Advantage Plan or join Original Medicare within the first three months you have Medicare.

A reader wrote: "I am very confused about the deadlines for enrolling in Medicare, when coverage starts, and changing options. For example, if I am enrolled in a Medicare Advantage Plan, and want to change to another plan, when can I do it?"

An excellent source of information about options, deadlines and the start of coverage is "Medicare and You 2023." This handbook is published by the Centers for Medicare & Medicaid Services, a U.S. government body, and is updated each year. To get a free copy of a state-specific book, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. A summary of major enrollment periods follows.

Initial Enrollment Period: You can first sign up for Part A and/or Part B during the seven-month period that begins three months before you the month you turn 65. The period includes the month you turn 65, and ends three months after the month you turn 65. If you enroll in Part A and/or Part B during the first three months of your Initial Enrollment Period, in most cases, your coverage begins the first day of your birthday month. But if your birthdate is on the first day of the month, your coverage starts the first day of the prior month. If you sign up and are paying for Part A and/or Part B the month you turn 65, or during the last three months of your Initial Enrollment Period, the start date will be delayed in 2022.

Beginning Jan. 1, 2023, if you sign up the month you turn 65, during your Initial Enrollment Period, your coverage starts the first day of the month you sign up.

Special Enrollment Period: If you didn't sign up for Part A or B when you were first eligible because you were still employed and were covered by a group health employer plan, you can sign up for Part A and/or Part B during this period. You can enroll any time you are still covered by the group health plan; or during the eight-month period that begins the month after employment ends or the coverage ends, whichever happens first.

General Enrollment Period: (Jan. 1 to March 31) If you have to pay for Part A, but did not sign up for it, and/or didn't sign up for Part B during your initial Enrollment Period, and you don't qualify for the Special Enrollment Period, you can enroll during the General Enrollment Period. However, you may have to pay a higher Part A and/or Part B premium for late employment.

Open Enrollment Period: (Oct. 15 to Dec. 7) You can join, switch or drop a Medicare Advantage Plan each year, effective Jan. 1. If you change your mind, you can switch to Original Medicare or change to a different Medicare Advantage Plan during the Medicare Advantage Open Enrollment Period (Jan. 1 to March 31). During this period, you can also join, switch or drop a Medicare drug plan.

Medicare Advantage Open Enrollment Period: (Jan. 1 to March 31) If you are in a Medicare Advantage Plan during this period, you can switch to another Medicare Advantage Plan or drop your Medicare Advantage Plan and return to Original Medicare; you also are able to join a separate Medicare drug plan. You cannot switch from Original Medicare to a Medicare Advantage Plan. You also can't join a separate Medicare drug plan if you have Original Medicare. You also cannot switch from one Medicare drug plan to another if you have Original Medicare. You can switch plans only once during this period.

Medigap (Supplemental Insurance) Open Enrollment Period: This is the six-month period that begins the first month you have Part B coverage and are 65, or older. You must have both Part A and B to be eligible. Medigap pays for the 20% of the cost of covered services and supplies not covered by Part B. This includes copayments, coinsurance and deductibles.

Summary of changes you can make now: Since you are now in the Open Enrollment Period (Oct. 17 to Dec. 7), act fast if you want to join, switch or drop a Medicare Advantage Plan and/or a Medicare drug plan. Your coverage starts on Jan. 1 as long as you make your request by Dec. 7 – that's this coming Wednesday.

Elliot Raphaelson welcomes your questions and comments at [email protected].

Beginning Jan. 1, 2023, if you sign up the month you turn 65, during your Initial Enrollment Period, your coverage starts the first day of the month you sign up.

The Savings Game

Elliot Raphaelson

Guest columnist

For your reference

"Medicare and You 2023."

This handbook, published by the Centers for Medicare & Medicaid Services, a U.S. government body, is updated each year and is an excellent source of information about options, deadlines and the start of coverage.

To get a free copy of a state-specific book, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.