Happy new year from the Medicare Reporter
Medicare General Enrollment Period; Medicare Advantage under increased scrutiny
Happy new year to all of you.
Welcome to my new subscribers, and thank you all for supporting the Medicare Reporter. Spread the word.
Another new year has begun, and it sure feels like they’re coming faster than they once did. But regardless of the time of year, Medicare is on our minds for one reason or another.
The new year brings yet another Medicare enrollment period – the Medicare General Enrollment period. Yes, I know, the names and dates of the enrollment periods are just as confusing as Medicare itself.
Readers of the Medicare Reporter know that Medicare has different enrollment periods with different dates and different, often confusing functions and rules. Because why should the government make things simple, right?
As it happens, we’re in the General Enrollment Period right now until the end of March.
Medicare General Enrollment Period (GEP)
This occurs each year from January 1 to March 31. During this time, you can enroll in Medicare Parts A and B if you didn’t enroll during your Initial Enrollment Period. If you enroll during the general period your coverage will begin the month after you enroll. But if you’re signing up during the GEP because you didn’t sign up during your Initial Enrollment Period AND you haven’t had other health insurance through a spouse or because you’re still working, you may face a lifetime late-enrollment penalty.
Medicare Initial Enrollment period (IEP)
The Initial Enrollment Period is generally your first chance to sign up for Medicare. And it’s the most significant. It begins three months before you turn 65 and ends three months after your 65th birthday. That gives you plenty of time if you know about it, but so many people don’t.
It’s essential that you sign up during your IEP even if you won’t actually be using your benefits until a later date because depending on your individual circumstances, some benefits may be subject to a lifetime late-enrollment penalty.
Equally important, the IEP is the best time to buy private Medigap (aka Medicare supplement) insurance. During your IEP, you can buy Medigap insurance regardless of your health, no questions asked. After this period, you could be subject to medical underwriting or you could be refused altogether.
Open Enrollment Period (OEP)
This is what you will hear about ad nauseum on television, online, and through the mail from the summer until after Thanksgiving. This sales and marketing barrage comes from private insurance companies that want to sell you Medicare Advantage insurance. In fact, Medicare Advantage’s name is deliberately misleading as it’s not actually Medicare, but private insurance. The only advantage is for the insurance companies that make a fortune on this insurance from our tax dollars.
Note: You don’t need an insurance agent to sign up for traditional Medicare and don’t let anyone con you into thinking you do.
During this OEP, October 15 – December 7, you can join, switch, or drop an insurance plan. You can switch from Traditional Medicare to Medicare Advantage or vice versa. Your coverage will begin on January 1 as long as the plan gets your request by December 7.
Traditional Medicare vs Medicare Advantage
I’ve talked about the many reasons why you should choose traditional Medicare over Medicare Advantage in every issue of the Medicare Reporter. But I also want to give you the opportunity to see what other reliable news outlets and health-insurance experts have to say about it.
Here’s a round up from the last few months:
The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions “By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been accused in court of fraud.” The New York Times
Medicare enrollees warned about deceptive marketing schemes “With Medicare’s open enrollment underway through Dec. 7, health experts are warning older adults about an uptick in misleading marketing tactics that might lead some to sign up for Medicare Advantage plans that do not cover their regular doctors or prescriptions and drive-up out-of-pocket costs.” The Los Angeles Times
How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions “The costs to taxpayers from improper payments have mushroomed over the past decade as more seniors pick Medicare Advantage plans. CMS has estimated the total overpayments to health plans for the 2011-2013 audits at $650 million, yet how much it will eventually claw back remains unclear.” NPR.org
U.S. Health Officials Seek New Curbs on Private Medicare Advantage Plan “Proposed regulations would crack down on misleading ads for the private plans and would enhance scrutiny of denials for coverage of medical care.” The New York Times
The Great Big Medicare Rip-Off “Since its creation in the 1990s, the Medicare Advantage program has allowed seniors to get coverage through private insurance companies that receive monthly, per-person payments from the government to offer services comparable to traditional Medicare’s. Early proponents of Medicare Advantage, who came from across the political spectrum, saw it as a way to provide retirees with more choices and flexibility to retain existing patient-physician relationships. The program also was meant to save taxpayers money. But it never has. Instead, Medicare Advantage has become rife with waste, abuse, and potential fraud, with private insurers taking advantage of loopholes to overcharge the government.” The Atlantic
Here is the Truth: Medicare Advantage Is Neither Medicare Nor an Advantage “Right now, well-funded lobbyists from big health insurance companies are leading a campaign on Capitol Hill to get Members of Congress and Senators of both parties to sign on to a letter designed to put them on the record “expressing strong support” for the scam that is Medicare Advantage.” Common Dreams.org
Medicare Advantage? More like Medicare Disadvantage “When the annual enrollment period for Medicare ends on Dec. 7, analysts expect that, for the first time, more seniors will receive their 2023 health-care coverage from Medicare Advantage than the traditional program.”
“That’s not a good thing for either elderly Americans or federal coffers. And while seniors are well advised to approach these plans with caution, we should all be paying attention to what’s going on.” The Washington Post
That’s all for this issue. If you have an opinion about the future of Medicare, this is the perfect opportunity to tell your federal representatives. United States House of Representatives; United States Senate