Fortune favors the prepared mind. Louis Pasteur wasn’t thinking about Medicare enrollment when he penned this famous phrase, but he could have been. If you want to luck into a Medicare plan that fits your budget while providing the benefits you need to stay healthy throughout the year, you need to get organized. A Medicare agent can help you, but make sure you bring the Medicare sign up info needed for a successful enrollment.
When to Sign Up
Most people first become eligible for Medicare when they turn 65, although some people qualify earlier based on their health conditions. If you are turning 65, you will have a seven-month Initial Enrollment Period to enroll in Medicare and choose a plan. The Initial Enrollment Period usually starts three months before your birthday month. However, if your birthday lands on the first of the month, your Initial Enrollment Period starts four months before your birthday month. You can sign up any time during your Initial Enrollment Period, but if you want coverage to start as soon as possible – meaning the first day of your birthday month – be sure to sign up before your birthday. Otherwise, coverage will start the first day of the next month.
If you miss your Initial Enrollment Period, you have two possible ways to sign up for Medicare:
- Qualify for a Special Enrollment Period. For example, if you delayed enrollment in Medicare because you had group coverage through work, you may be able to avoid a late penalty and sign up during a Special Enrollment Period after your work coverage ends.
- Sign up during the General Enrollment Period. This period lasts from January 1 to March 31 every year, and coverage starts the month after you sign up. You may have to pay a late enrollment penalty.
Once you’ve enrolled in Medicare for the first time, you won’t be stuck in the same plan forever. Each year, you’ll be given an opportunity to switch your plan during the annual election period (AEP), which runs from October 15 to December 7. During AEP, you can switch from one Medicare Advantage plan to another, from Original Medicare to Medicare Advantage, or from Medicare Advantage to Original Medicare. If you have Original Medicare, you can also switch your Medicare Part D prescription drug plan enrollment.
It’s important to note that AEP does NOT give you a chance to switch Medigap plans. The best time to enroll in a Medigap plan, also called a Medicare Supplement plan, is during your Medigap Open Enrollment Period, which lasts for six months and starts when you’re 65 and first enrolled in Medicare Part B. You can enroll in a Medigap plan after this period, but the insurer may charge you higher premiums or deny coverage based on health conditions.
Why a Local Independent Agent Is the Best Choice
If you’re still confused about Medicare enrollment, don’t worry. A Medicare agent can help you review your options and select a plan that suits your needs.
But watch out – not all offers of Medicare help are equal! You may see national commercials offering Medicare assistance, but responding to these advertisements may not result in the individualized help you need. When enrolling in Medicare, a local independent agent is the best the choice. Here’s why:
- Independent agents represent multiple insurance companies. An agent who just works for one company – sometimes called a captive agent – can only offer you plans from that company, even if those plans aren’t a good fit for you. Independent agents can offer a wide selection of plans to help you find the best fit for your budget and coverage needs.
- Local agents know the plan options in your area. Plan options vary significantly from region to region. In addition to having different networks of local healthcare providers and pharmacies, these plans can offer different benefits. A local agent will be familiar with the coverage details of plans in your area, and this makes it easier to find the best fit. Someone who’s not familiar with the in and outs of plans in your area may overlook important details.
How to Schedule Time with an Agent
The annual election period can get busy for Medicare agents, so don’t wait until the last minute. You won’t be able to sign up for a new plan before October 15, but you can reach out to an agent before October 15 to schedule an appointment.
To find a local Medicare agent, you can use a Medicare agent directory. Once you see some agents in your area, you can search for reviews online. You can also call them and ask them questions about which carriers they represent, the types of plans they offer, how much experience they have, and what your costs will be.
Once you’ve settled on an agent, go ahead and schedule an appointment ASAP. Many agents offer in-person and virtual appointment options.
Medicare Sign Up Info Needed
When it’s time to meet your Medicare agents, you’ll want to bring all of the Medicare sign up information needed to support a well-informed Medicare enrollment decision. Otherwise, your agent won’t know which plan options fit your needs.
You can ask your agent what you should bring. In general, the following items will be helpful:
- Your providers. To ensure that a plan’s network includes all of the providers you will want to see, you need to bring a list of your primary care and specialist providers. Also bring a list of any hospitals or other healthcare facilities you prefer to use.
- Your prescriptions. Bring a list of any prescription medications you take. This way, your agent can make sure any plans you’re considering cover your prescriptions.
- Any healthcare concerns. If you have a chronic condition or expect to need certain types of care in the coming year, let your agent know so they can compare costs and coverage options under different plans. Write down a list so you don’t forget anything.
- Desired benefits. Do you have current benefits that you use and want to keep, or are there benefits that you wish you had? For example, maybe you need hearing aids, but you don’t have coverage and haven’t been able to afford them, so you’d like a plan with hearing benefits. Write down a list of must-have and nice-to-have benefits.
- Current costs. Make a list of your current monthly premium along with your average out-of-pocket costs, such as co-pays for doctor office visits and prescriptions. This will allow your agent to compare your total costs under different plan options.
- Proof of Medicare eligibility. In addition to information about your coverage needs, also make sure you bring in the documentation required to enroll in Medicare. Bring your photo ID along and your Medicare card.
If you bring the Medicare sign up info above, your Medicare agent will have all the information they need to help you select a plan that fits your budget and healthcare needs. Find a Medicare agent.