There is so much about Medicare that is downright confusing. When it comes to purchasing a Medicare Supplemental plan, consumers are perplexed when attempting to understand the difference between Open Enrollment and Guaranteed Issue.
Open Enrollment and Guaranteed Issue are similiar, but they are different. They can overlap which makes it all the harder to comprehend.
To hopefully clear up some confusion, Open Enrollment is best understood by remembering this: When you are signing up for Part B for the first time, you are in your Open Enrollment. Whether you are 65 and signing up for Part B or are 70 and have just retired, as long as you are enrolling in Part B for the first time, you are in your Open Enrollment Period. Your personal Open Enrollment Period will begin on the first day that your Part B started and end six months later. As an example, if your Part B begins on May 1st, your Open Enrollment Period would end on October 31st.
During this Open Enrollment Period, you are able to purchase a Medicare Supplemental Plan that is available in your state without having to pass any medical underwriting.
There are also Guaranteed Issue Periods where you can enroll into a Plan A, C, or F plan without going through medical underwriting or answering medical questions.
Guaranteed Issue Periods usually happen when your employer’s group health plan ends or you are in a Medicare Advantage plan and you move outside of the plan’s service area. In these circumstances, you have 63 days to choose a plan.
As mentioned previously, you could possibly be in both your Open Enrollment and Guaranteed Issue at the same time.
You may be losing your employer coverage and decide to enroll into Part B for the first time. Many people will enroll into Part B when they are first eligible for Medicare at age 65, but if they have credible coverage through their employer (this means that their employer group plan is equal to or better than what Medicare offers), they can wait to enroll into Part B. If this is the case, they are technically in both Open Enrollment and Guaranteed Issue.
In this scenario, it would be better to go with the Open Enrollment because all of the Medicare Supplemental Plans are available with no medical underwriting.
To top off the confusion, there is also another period each year that is called the Annual Election Period, but is often called Medicare Open Enrollment. The Annual Election Period runs from October 15th through December 7th each year. This is the time of the year that you can change either your Medicare Advantage or Medicare Prescription Drug Plans. This is not the time to change Medicare Supplemental Plans.
The Medicare maze as we like to call it isn’t easy to navigate through. It may take several appointments to answer your questions about all your options.
At Balanced Care, we have experience with Medicare, Medicare Supplemental Plans, Medicare Advantage Plans, and Medicare Prescription Drug Plans. We don’t pretend to know it all and aren’t afraid to ask questions to the insurance companies we work with.
After all, we know that the decision you make on your healthcare plan could affect you for years to come.
It’s a responsibility we take very seriously.
Terri Trepanier is the owner of Balanced Care Health and Supplemental Insurance and a licensed insurance consultant and broker with Associated Brokers. Licensed in both Maine and NH, her specialty is working with small businesses, individuals, and families with their health and life insurance needs. She is certified to offer health plans both on and off the exchange and is contracted with every health insurance company that offers plans in both New Hampshire and Maine. Her other passion is assisting Medicare beneficiaries with their Medicare Supplemental, Medicare Part D Prescription Drug Plans, and Medicare Advantage plans. Terri has seen firsthand the importance of insurance products and how they help families. Her goal with Balanced Care is to “Insure Security and Peace of Mind One Family at a Time”.