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Medicare Open Enrollment vs. Marketplace Open Enrollment

Hi blog readers!  This is Heather Heppner with the AARP Illinois Communications Team back with your Tuesday health care law post.  I'm going to switch gears a little bit this week and talk about Medicare Open Enrollment.  With the launch of the new health care marketplaces and Medicare open enrollment happening at the same time, there is a bit of confusion out there.  Hopefully this blog post will help clear things up!

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Medicare's annual open enrollment period begins on October 15, 2013 and runs through December 7, 2013.  During this time, you can shop for Medicare Advantage and Medicare Part D prescription drug plans, or keep the coverage you have.  If you want to keep the coverage you have, you do NOT need to take any action during Medicare open enrollment.  However, since costs and benefits for many plans change from year to year, Medicare open enrollment provides a good opportunity to review your plan to make sure it will still meet your needs in the coming year.

This year, Medicare's open enrollment overlaps with open enrollment for the new health insurance marketplaces created under the Affordable Care Act.  In Illinois, our marketplace is called Get Covered Illinois.   Don't let this confuse you. The marketplaces are not for Medicare beneficiaries.

SCAM ALERT!  It is illegal for someone to knowingly sell a Medicare beneficiary a marketplace plan.  Watch out for scammers during open enrollment!


Here are a few frequently asked questions about Medicare and the health insurance marketplaces (and their answers!):

Q: I've just become eligible for Medicare, but I haven't signed up yet and haven't started collecting Social Security.  Can I choose coverage on the marketplace instead of Medicare?

A: Yes, but be aware that if you fail to sign up for Medicare during your initial seven-month enrollment period, you may have to pay a late enrollment penalty for as long as you have Medicare.

Q: I'll turn 65 in 2014 and will become eligible for Medicare, but I don't have health insurance now.  Can I use the marketplace?

A: Yes, you can buy health insurance coverage in the marketplace now that will be effective January 1, 2014.  Once you receive Medicare coverage, you should cancel the marketplace plan.

Q: I have only Medicare Part A.  Do I need to buy more insurance to meet the legal requirement that I have insurance?

A: No, whether you're in a traditional Medicare or a Medicare Advantage plan, you meet the insurance requirement.

If you're happy with your Medicare plan, you don't need to take any action during Medicare open enrollment.  However, if you would like to shop around for a new plan, use the Medicare Plan Finder tool to compare plans and select one that better meets your needs.  If you need help with this process, you can contact the State Health Insurance Assistance Program.

Until next week....be healthy!

~Heather

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