For people who want to tweak their Medicare coverage, the time to do it starts Sunday.
The program’s fall open enrollment period runs from Oct. 15 through Dec. 7. You should evaluate your current coverage even if you’ve been happy with it.
“Insurance companies make changes every year,” said Elizabeth Gavino, founder of Lewin & Gavino in New York City, and an independent broker and general agent for Medicare plans.
In simple terms, the upcoming seven-week period is for adding or changing coverage related to Medicare Part C (known as an Advantage Plan) and Part D (prescription drug coverage). This is generally the only time of year you can make changes.
WHAT ARE ALL THOSE MEDICARE PARTS?
Part A. This covers inpatient stays at hospitals, skilled-nursing facilities and the like. As long as you’ve paid into the system by working the equivalent of about 10 years, you won’t pay any premiums. If not, you’ll have to pay for it.
Part B. Everyone pays premiums for this coverage, which generally includes outpatient services and supplies. Higher incomes generate higher premiums: If you’re single and have an income of more than $85,000 or are married with a joint income of at least $170,000, you will pay more.
Part C. Also called Medicare Advantage, the program lets people choose from a Medicare-approved private insurance plan instead of Parts A and B. Each plan comes with differing variables, ranging from coverage to deductibles and co-pays.
Part D. This is prescription-drug coverage. This often ends up being included with an Advantage Plan. If you have Parts A and B instead of an Advantage Plan, you can purchase Part D coverage separately. Although this is voluntary coverage, if you don’t sign up during your initial enrollment time and change your mind later (if you don’t meet an exclusion) you’ll likely pay a penalty that will last forever.
Note: Fall enrollment is different than the initial sign-up for Medicare. In that case, you get a seven-month window that starts three months before the month in which you turn 65 and ends three months after your birth month.
Generally speaking, you must sign up for Medicare Part A (in-patient coverage) and — unless you meet certain exclusions — Part B (outpatient care) during initial enrollment. Those two parts are often referred to as Original Medicare. You also can sign up for Parts C and D during your initial signup period.