Over 8.6% of the American adult population remains uninsured. For qualifying adults in need of health care, Medicare is a federal health insurance program that assists those with greater medical needs.

If you need health insurance, Medicare may be a viable option. The premiums are lower, making coverage less of a financial burden. However, to qualify, you will need to sign up during the open enrollment window. Keep reading to learn more about Open Enrollment Medicare for 2022.

Qualifications for Medicare

Only qualifying adults can sign up for Medicare, so it’s crucial to know your eligibility before signing up. Enrollment Eligibility falls into two categories: initial and regular.

Initial Eligibility

Initial eligibility covers people who are 65 and over. These people are eligible for Medicare up to three months before their 65th birthday. If you turned 65 between July and December, you’re eligible for Medicare for the rest of the year.

Adults under 65 may be eligible earlier if they have a disability, ALS, or End-Stage Renal Disease.

Regular Eligibility

After the initial sign-up, you are automatically re-enrolled each year. If you need to make any changes to your current plan, you will need to do so during the Open Enrollment Period.

What is Medicare Open Enrollment?

Medicare Open Enrollment is the joining period where you can change or cancel a plan. If your current plan doesn’t suit your needs, you must be aware of this window to make appropriate changes. Each year, this window is from October 15th – December 7th.

Parts of Medicare Coverage

There are four parts to Medicare coverage. Each part covers specific services and is accepted by any medical practice that accepts Medicare.

Part A – Hospital Coverage

Part A of Medicare is responsible for hospital coverage needs. This includes services like inpatient hospital stays and home health care. Sometimes, Part A covers skilled care that takes place in a nursing facility.

Often, most individuals do not need to pay for part A if they paid Medicare taxes for a set length of time while working because it is then covered. When combined with Part B, this part is known as Original Medicare Coverage.

Part B – Outpatient Medical Coverage

Part B, often combined with Part A coverage, covers outpatient services, doctor visits, preventative screenings, lab tests, and x-rays. Enrolling in Part B provides access to these services and is a necessity if you wish to sign up for the Medicare Advantage Program.

Part C – Medicare Advantage

Part C is a Medicare plan offered by private health insurance companies. You receive the same services as the Original Medicare, but you may also receive additional services, coverage, and perks with Medicare Advantage.

Part D – Prescription Drugs

This portion of Medicare is only offered by private insurance companies and covers a wide range of vaccines and prescription drug plans. It is often included in the Medicare Advantage plan or can be added separately under a Part D Plan.

The Benefits of Medicare

One of the benefits of Medicare is that it provides access to insurance for millions of aging Americans. Unlike other private insurance programs, Medicare doesn’t break the bank with small monthly out-of-pocket payments.

Medicare also provides a variety of options. With several different parts and Medicare Advantage, you can select the services that work best for you.

How to Find the Right Medicare Plan

When choosing a Medicare plan, there are several factors to consider. Cost, services, coverage area, preferred doctors, and prescriptions are all things that will vary depending on the level of medicare plan you choose.

Take time to determine your top priorities for your healthcare plan. By understanding your wants and needs, you’ll be able to choose the right plan for you.

When to Enroll in Medicare

If you are new to Medicare, you’ll need to enroll during the open enrollment period. The period for open enrollment for Medicare is from October 15th to December 7th each year.

What Can You Update During Medicare Open Enrollment?

During open enrollment, there are several changes you can make to your Medicare plan. You can switch your Medicare Advantage plan to another plan or revert to Original Medicare.

If you’re on the Original Medicare plan but find you need more, you can upgrade to the Advantage plan. You can also enroll in the prescription drug plan if that’s something you opted out of during your initial enrollment.

What Happens if You Miss the Enrollment Window?

So you want to sign up for Medicare but missed the enrollment period. What next? If you missed out on the initial sign-up period, you’ll have to wait for a special enrollment period or the next general enrollment period.

During the general enrollment period, which occurs annually from January 1st until March 31st, you can sign up for Medicare parts A and B. You may have the option to enroll in the Medicare Advantage or Prescription Drug Program later that year.

Late enrollment comes with penalties if you don’t qualify for the special enrollment period. These penalties hold you responsible for any or all premiums plus additional amounts depending on the plan you choose.

Complete an Annual Medicare Review

Once you’ve enrolled in Medicare, health insurance providers recommend that you complete an annual review of your plan. While automatic renewal is an easy way to continue your coverage, circumstances and benefit offerings change over time.

It’s important to review your benefits to ensure they’re still meeting your current needs. If you discover that you need something changed in your plan, you’ll be able to during the enrollment period without impacting your coverage.

Understanding Open Enrollment Medicare for 2022

Health insurance often feels daunting, but Medicare provides coverage to qualifying Americans each year. With this guide, you’ll be sure to have all the information you need to prepare yourself for open enrollment in Medicare for 2022. 

At Real Performance Marketing, we can help health insurance providers successfully spread the word about the Medicare Open Enrollment Period. Contact us today to learn more.