A new federal regulation is coming into effect on January 1st, 2023, that makes it easier for people turning 65 to enroll in a Medicare plan. Being able to enroll in your Medicare plan and receive benefits in a timely manner is absolutely critical for many individuals, but the current system negatively affects many senior citizens that aren’t able to enroll in the window given. In addition, the current system offers penalizations to those who don’t enroll within a very small timeframe. The new system aims to correct these issues and make it easier for those turning 65 to enroll and receive benefits quickly, especially vulnerable individuals who may experience extenuating circumstances that make enrollment difficult.
The Current System
Under the current system, seniors have 7 months to enroll: the 3 months preceding the month of their 65th birthday, the month of their birthday, and the 3 months after the month of their birthday.
If you enroll in the months prior to turning 65, your benefits will kick in at the start of your birthday month. If you enroll during your birthday month, the benefits kick in at the start of the next month. If you enroll during the 3 months after your birthday month, it takes 2-3 months for the coverage to kick in. If you miss the 7-month window, regardless of the circumstances, you won’t get another chance to enroll until the Medicare General Enrollment Period (GEP) that runs from Jan. 1st through Mar. 31st. If you sign up during the GEP period, your benefits don’t kick in until July 1st.
Those who are unable to enroll within their 7-month window are also penalized by having to pay higher premiums for their Medicare Part B, which covers things like doctor visits, ambulance services, durable medical equipment, and mental health services. This penalty isn’t limited—the higher premiums remain for as long as the policyholder is enrolled.
The New System
Under the new system, the 7-month enrollment period will still be in effect, but how it works is changing slightly. If you enroll during any of these months, coverage will kick in at the start of the following month. In addition, the new regulations also allow Medicare to set special enrollment periods (SEPs) for anyone that is not able to enroll during their 7-month window due to extenuating circumstances.
Special Enrollment Periods
The special enrollment periods are important for anyone who is unable to enroll in a Medicare plan during their 7-month enrollment period around their 65th birthday. A few examples of extenuating circumstances include, but are not limited to:
- Being given incorrect information by an employer that prevented them from enrolling during the appropriate period.
- Being affected by a natural disaster or state of emergency during the enrollment period.
- No longer qualifying for coverage through Medicaid.
- Being incarcerated during the enrollment period.
Contact Aging Benefits Advisory Today!
If you need help navigating the world of senior health insurance, our advisors at Aging Benefits Advisory are here to assist. Take advantage of our free consultation to ensure that you receive the plan for your budget and needs. We specialize in Medicare Advantage, Medicare Supplements, Dental, Vision, and Final Expense insurance for the senior market of Pinellas County, Pasco County, Manatee County, Hillsborough County, Polk County, Sarasota County, Citrus County, and Marion County, Florida. If you would like a free consultation, contact us online or give us a call at 727-266-0355. For more information, follow us on Facebook, Pinterest, and YouTube.