Medicare Open Enrollment: What You Need to Know


Medicare Open Enrollment began October 15, and will be open through December 7. Seniors across America are reviewing and comparing plans, trying to make the best decision for their health and finances. Whether this is your first year enrolling in Medicare or you are thinking about changing your plan, the Medicare system can seem hopelessly difficult to navigate. Where do you start, and what do you need to know about it?

1. Medicare is separated into four parts
There are four parts to Medicare:

  • Part A covers medical facilities, like inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B covers medical providers, like outpatient care, medical supplies, and preventative services.
  • Part C consists of Medicare Advantage plans, which is a type of health insurance offered by a private company that contracts with Medicare to provide both Part A and Part B benefits.
  • Part D is prescription drug coverage, and is offered by private companies approved by Medicare.

Familiarize yourself with all four parts so you can gain a clear understanding of your options, and know which plan is best for you.

2. You can apply before you turn 65
You become eligible for Medicare benefits at 65, but you can be the application process up to three months beforehand. Depending on the situation, you also may automatically receive Medicare Parts A and B without needing to apply. Otherwise, after you become eligible, you will need to apply and enroll in a timely fashion. If you don’t, you may face paying a Part B late enrollment fee.

3. You will have to pay for some premiums
You typically don’t have to pay a monthly premium for Medicare Part A if you or your spouse paid Medicare taxes while working and you are eligible for Social Security benefits. Everyone, however, has to pay for Medicare Part B. If you get Social Security benefits, your premium will be automatically deducted from your benefit payments. If you do not, you will receive a bill. The premium amount varies depending on your income, but most will pay the standard premium amount of $134 each month. You can view the estimated premium amount on

4. Medicare doesn’t cover everything
Traditional Medicare does not cover certain health expenses, like dental, hearing, and vision care. If you would like coverage for those health needs, you might want to consider a Medicare Advantage plan that is offered by a private insurer. Be careful about the plan you choose, however, as most Medicare Advantage plans restrict coverage to their own network of doctors and hospitals, and have a limited list of covered prescription drugs.

5. If in doubt, ask questions
If there is something that you don’t understand, don’t be afraid to ask for help. Social Security provides a helpline that you can call with specific questions. The phone number is 800-772-1213. According to Keith Armbrecht, founder of the Medicare resource center Medicare on Video, the best time to call is from Tuesday through Thursday between 10:00AM and 3:00PM ET.

Also consider bringing a trusted family member or friend into this process to be a sounding board and help you figure out what the best option for you is. Especially if they have previous experience enrolling in Medicare, they can be a valuable resource for you!

The Loudoun County Area Agency on Aging provides free and unbiased Medicare counseling. For more information, please visit their website or call 703-737-8036.

InsuranceLSIN Admin