What you need to know as Medicare open enrollment begins on Thursday

Posted at 3:04 AM, Oct 15, 2020
and last updated 2020-10-15 03:05:15-04

BUFFALO, N.Y. (WKBW) — Thursday is an important day that could impact the health care of many vulnerable Western New Yorkers.

Medicare open enrollment is now underway and runs through December 7th.

According to the Congressional Budget Office, last year more than 61 million Americans were enrolled in Medicare, including over 3.5 million New Yorkers.

By the end of 2020, around 63 million Americans will enroll.

Independent Health in Buffalo says these are the five most important things to know when it comes to discussing Medicare

  1. Who is eligible for Medicare?
    • You are age 65 or older, have a qualifying disability, or experience another special situation.
    • You are a U.S. citizen or legal resident (for at least five consecutive years).
  2. What are my options?
    • Original Medicare – Parts A and B
    • Part A Helps cover the cost of inpatient hospital stays, skilled nursing facilities, hospice care and some home health care services. There is no premium for most people.
    • Part B Helps cover doctor visits, outpatient care and some home health services. Most people pay a premium based on income.
    • Medicare Advantage plan – Part C
    • Part C Medicare Advantage plan – Helps cover inpatient hospital care and outpatient care, such as doctor visits, preventive health screenings and other services. (Part C covers everything covered by Original Medicare Parts A and B.)
    • However, within these two options you have many choices – prescription drug coverage (Part D), supplemental coverage and more.
    • Stand-Alone Part D (PDP) Helps cover the cost of outpatient prescription drugs. There are monthly premiums paid to a private insurance company. NOTE: Enroll when you first become eligible or you may be subject to penalties later.
    • Part D Outpatient prescription drug coverage is included in most Medicare Advantage plans. NOTE: You must enroll when you first become eligible or you may be subject to a penalty later.
  3. When can I sign up?
    • It is recommended that you sign up during the open enrollment period from now through December 7th, but you can sign up year-round.
    • You can sign up for Original Medicare or a Medicare Advantage plan three months before you turn 65, your birthday month and three months after.
    • If you have a qualifying disability, contact the Social Security Administration (1-800-772-1213, TTY 1-800-325-0778, Monday – Friday, 7:00 a.m. – 7:00 p.m.) for your enrollment time frame.
    • If you wait, you could pay more for coverage.
    • If you continue to work, additional rules may apply.
  4. What is not covered by Medicare?
    • It’s important to know that Medicare doesn’t cover all of your health care expenses.
    • You may have copays, deductibles, coinsurances and other payments for both Original Medicare and a Medicare Advantage plan.
    • Also, Original Medicare does not include prescription Part D drug coverage, and there will be other gaps in coverage that you may need to cover with additional insurance.
  5. Can I change my plan?
    • Yes.
    • If your needs change, you have an opportunity each year to change plans.

You can read more about your options by checking out Independent Health's Medicare guide below.