What Are the Enrollment Periods for Medicare Advantage Plans?
Several times since Medicare's 1965 enactment, the comprehensive federal health insurance plan for America's elderly and select others has been modified to accommodate changes in people's needs. In one of its most comprehensive overhauls, Medicare began in 1997 to offer insurance through private companies. The change established something of a partnership, joining the government, these private insurance providers, medical practitioners and beneficiaries in offering a series of health-plan options, including Medicare Advantage plans. The changes expanded further in 2006 when Medicare made the cost of drugs yet another option. Medicare sets aside specific times each year during which people can enroll in these programs or change the options they had earlier chosen.
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Eligibility
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Medicare assists those 65 or older who have worked and paid Medicare taxes for at least 10 years. Their spouses, at 65, are also eligible and so are younger disabled people and those with permanent kidney failure who need dialysis or a transplant. Original Medicare provided virtually premium-free hospital insurance (Part A) and medical coverage (Part B), for which everyone paid a monthly premium deducted from their Social Security or other retirement benefit.
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Medicare Advantage
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Under Medicare Advantage, a person continues to pay the monthly Part B premium to Medicare and, perhaps, an extra monthly fee to a private insurance company in return for additional choices and benefits. Medicare Advantage provides plans for:
• Managed Care, which restricts the choice of doctors, specialists and hospitals to those on the plan's "network" but which may offer extra benefits, like prescription-drug coverage;
• Private Fee-for-Service, which lets a person visit any participating doctor or hospital that accepts the plan's payment but which may offer extra benefits, like prescription-drug coverage or extra days in the hospital;
• Preferred Provider Organization (PPO), which lets a patient go "out of network," possibly at additional cost, to visit doctors, see specialists without referrals and go to hospitals not on the plan's list; it may also offer extra benefits, like prescription-drug coverage;
• Specialty Plans, which offer more-focused health care to manage a specific disease or condition.
Annual Election Period
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If you wish to change your Medicare coverage after you have enrolled, you must wait for the annual election period, which runs from November 15 through December 31. Anyone who is enrolled in a Medicare plan can enroll in a new or different Medicare Advantage plan during this time.
Special Election Period
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A special election period allows enrollment outside of the annual election period for those who have been through some specific emergencies, such as natural disasters. No dates can be set for this kind of enrollment since neither a disaster nor a special situation can be predicted.
Open Enrollment Period
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During this period, anyone has the option to choose a Medicare Advantage Plan, whether that person signed up prior to the deadline or not. This period is set for January 1 to March 31.
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