Understand Your Initial Enrollment Period and Obligations

Some steps to help you prepare for your Initial Enrollment Period

Research your Medicare benefits

Healthcare changes often and can get expensive quickly. We can help shop plans for you, insuring the benefits that you value most are included. Our agents will help you balance cost and quality to fit a plan to your specific health needs and budget. Here are some things you can do to prepare for your Initial Enrollment Period (IEP).

Considerations include:

• Do you travel often? A supplemental plan might be ideal for you or consider emergency healthcare coverage if traveling outside the United States.
• Are you a gym-goer? Many plans are now integrating gym memberships specifically for seniors.
• Are you on any prescriptions? Be aware that some types of plans offer drug coverage, while some do not. Drug coverage may be purchased separately.
• Can you see your preferred doctors? Some plans are networked, meaning you will need to insure your doctor is within the plans network. Additionally, some plans pay nothing when you see a doctor out of network!
• Do you have a chronic condition? There may be plans tailored specifically to your chronic disease management.

Get comfortable with Medicare’s alphabet soup of coverage — Parts A, B, C and D. Understand that different parts cover hospital stays (Part A), doctor visits (Part B) and medications (Part D; more on this one in the next section). Know that some plans, like Medicare Advantage (also called Part C), cover extras such as dental, vision, hearing and gym memberships. Keep a cheat sheet nearby if you have trouble remembering which is which.

Learn the ABCs of Medicare

Consider drug benefits, even if you don’t need them now

According to an AARP study on 55+ year old respondents 77% take prescription medication on a regular basis, with many worried they will not be able to afford their medication after retirement. During your Initial Enrollment Period you have the option to join Medicare Part D without penalty. Since it is impossible to predict the future, it might be a good idea for you to enroll earlier than later. Late enrollment into Part D may also carry penalties.

Understand your budget and costs

There are deductibles, max-out-of-pockets, and premiums — coinsurance and co-payments. Admittedly, it is a lot to take in. A deductible is the amount you must pay for covered health services or prescriptions before your insurance plan begins to pay. An out-of-pocket maximum is the most you’ll pay during a policy period (usually a year) for covered health services. Once you reach your maximum, your plan pays 100% on covered health services. You should examine your budget concerns a few months before your Initial Enrollment Period.

Can you keep your current doctor, is it worth it

It is not always easy to understand the network of a plan and its participates. Newnan Medicare can help you determine if both your doctors and prescription drugs are within you plans coverage. You might decide on a plan that allows out-of-network care, allowing you to focus on other things. We can also help suggest a Medicare Advantage plan that supports all of your healthcare goals.

12 months before your 65th birthday

At this point, you probably have a retirement plan, and your Initial Enrollment Period is approaching. Medicare should be a part of everyone’s retirement planning. Familiarize yourself with the different parts of Medicare.

9 months before your 65th birthday

Have a target retirement date in mind. If you are delaying enrollment for certain parts of Medicare, you will want to time your enrollment around that date to avoid penalties and gaps in coverage. You can choose to meet with one of our agents at this time, as well.

4 – 6 months before your 65th birthday

This is a great time to speak with one of our agents at Newnan Medicare. Your IEP is just a few months away! We can help you pick the Medicare Advantage or supplement plan that supports your choices. Additionally, we can ensure your doctors and prescriptions are included within your plan’s network.

1 – 3 months before your 65th birthday

Your Initial Enrollment Period is underway! This is the seven-month window when you can enroll in Medicare. It runs from three months before the month you turn 65, through your birthday month to three months after the month you turn 65. If your birthday is on the first of the month, your IEP begins four months before you turn 65 and ends 2 months after the month you turn 65. Set a date on your calendar to enroll!

In addition to your enrollment window, be mindful of when your coverage will begin. The start date depends on when you sign up. For example, if you enroll during the first three months of your IEP, coverage begins the first day of the month you turn 65. But if you enroll the month you turn 65, then your coverage begins one month after you sign up.  

Look for your red, white and blue Medicare card in the mail. Once you have received this card, we can finalize or assist you with your plan selection. With your coverage finalized, you’ll want to set up a “Welcome to Medicare” visit with your doctor. This free, one-time checkup is available within the first 12 months of signing up for Medicare and serves as a baseline for your annual wellness checkups.