Hi, I’m Parker Trasborg, Senior Financial Advisor at CJM Wealth Advisers, and I have Emily O’Halloran, Executive Director at Medicare Portal, joining me today. Medicare Portal is the Mid-Atlantic leader in Medicare education enrollment services. Emily is licensed in 10 states and has helped hundreds of individual Medicare beneficiaries navigate the often bewildering Medicare enrollment process.
Now, thanks again, Emily, for joining us today. We only have a couple of minutes, so let’s jump right into things. What are some of the most important things for someone who is new to Medicare to consider when getting ready to enroll for the first time?
Thanks, Parker. So the first thing that most people are concerned about is when to enroll. Enrollment is not necessarily automatic at age 65, and often people are working past age 65 with creditable employer group coverage, meaning that they are not required to enroll in Medicare. While that may be the case, those individuals will read so many dire warnings about the consequences of not enrolling on time that they’ll often be anxious and confused about when to enroll. So my team and I can help with that. We work with individuals and couples to analyze their specific enrollment time periods and considerations.
And then that leads to the second thing that most people will be thinking about when getting ready to start Medicare, which is the cost. So Medicare does not cost the same for everyone, as there are adjusted amounts for individuals and couples who do have higher than average incomes. We work with our clients to determine what their likely Medicare costs are so that they can weigh all of the options with their budget in mind.
And then the third thing that comes up most frequently when people are new to Medicare is: how do you decide what plans to choose? For example, we’ll often talk to people who want to know, “Is a Medicare supplement better, or a Medicare Advantage Plan? How do you find the right prescription drug coverage?” Again, that’s where we come in and we really explain the ins and outs of each of these options to our clients. You can’t really decide what’s right for you until you clearly understand how all of it works. So that is our ultimate goal when working with our clients.
So there’s a lot there already right off the bat. And Fall open enrollment is actually occurring right now through December 7th. What should someone who is currently on Medicare be thinking about as they head into open enrollment?
Right. So the annual enrollment period, also known as the AEP for Medicare, this is an important time of the year because it’s when you can join or switch or drop a Medicare Advantage, also known as Part C plan or a Part D prescription drug standalone plan. And as you mentioned, it does end on December 7th. It runs from October 15th, through December 7th of every year. Changes that are made during the annual enrollment period will become effective on January 1st of the following year. And this is an important time of the year because coverage needs can change. And this is, in most cases, the only time of the year where that can be properly addressed.
So something that can be helpful for assessing a needed change would be a notification that you would receive from your current plan. This will be the annual will notice of change, or ANOC. It’s a summary that will include information about changes in the coverage costs, service area, et cetera, that will be effective on January 1st for the plan that you’re currently in.
So you want to take a look at that because it will tell you if some critical elements will be changing and potentially having a negative impact on you and your experience with that coverage. So examples of things that may change are your annual deductible, your monthly premium, your co-pays, either for services or for prescriptions, co-insurance for services or prescriptions, as well as your maximum out-of-pocket on that coverage.
So the six changes that you can make during the annual enrollment period are: you can change from one Medicare Advantage Plan to a different Medicare Advantage Plan, you can go from Original Medicare, which is Parts A and B into a Medicare Advantage Plan, you can change from Medicare Advantage back to Original Medicare or A and B, you can change from a standalone drug plan to a different standalone Part D drug plan, if you are not currently in a Part D plan but should be or would like to be, this is the time to enroll in one, and if you’re in a Part D plan and have a reason to leave plan, this would be the time to do that as well.
So we can help with all of this. And I’ll just put my contact information up. Please feel free to reach out to us by phone or email and let us know how we can help you interpret your Medicare needs.
Great. Great. Thank you again, Emily, for joining me today. Definitely a lot and very helpful information. As you can tell, there’s a ton to Medicare and we only had time today to skim the surface. Open enrollment runs through December 7th so if you have any questions at all, please reach out directly to your planner, or to Emily, and we’d both be happy to help you out. Thank you for tuning in today and we wish you all a very happy and healthy holiday season. Bye-bye.