Medicare Open Enrollment and What’s New for 2019

For qualified persons (65 and older), it’s important to stay informed about Medicare, the program provided by the federal government to help with healthcare expenses. One of the best ways to keep abreast is by bookmarking Medicare.gov and dropping in frequently to review program announcements, updates, and other information. You can also set up your own account at MyMedicare.gov to view and manage claims, keep track of coverage, and check your enrollment status.

It’s always good to review the basics, especially for those approaching retirement or otherwise new to the somewhat complicated terminology that goes with Medicare. Your original eligibility to enroll in Medicare begins three months before the month in which you turn 65, includes that month, and runs for three months afterwards. It is usually best to enroll when you first become eligible, even if you are still covered under an employer’s plan, in order to avoid late enrollment penalties. Remember, too, that there are four main parts to Medicare:

• Part A, which covers hospitalization expenses and is provided by the government;
• Part B, which covers other medical expenses such as office visits and is provided by the government;
• Part C, which covers expenses you would pay out-of-pocket even with Medicare Part A, and is provided by a private insurer (sometimes referred to as “Medigap coverage”);
• Part D, which covers prescription drug costs and is provided by a private insurer.

Parts A and B, provided by the government, are what is meant by “original Medicare.” Some people utilize Medicare Advantage policies to combine all four parts of Medicare in a single package.

This year, the open enrollment period, during which you can make changes in your Medicare plan, begins October 15 and ends December 7. You can use this window of time to switch from original Medicare to Medicare Advantage, to change Medicare Advantage plans, or to switch from one Medicare prescription drug plan (Part D) to another. Also, for those who didn’t sign up for a Part D plan upon original eligibility, the open enrollment period offers an opportunity to obtain this coverage, though a late enrollment penalty may apply in some cases.

This year there are also some changes in the provisions for Medicare Advantage. Between January 1 and March 31 each year, you can leave your plan and return to original Medicare or buy a Part D plan to supplement your original Medicare. And now, beginning in 2019, you can also use this period to change Medicare Advantage plans. So, Medicare Advantage plan holders now have two opportunities each year to change plans, though only one change is allowed per spring enrollment period (there is no such limitation during the fall open enrollment period).

If you are already enrolled in original Medicare and a Part D plan, or if you are in Medicare Advantage, and you don’t want to make any changes in your coverage, you don’t have to do anything during the open enrollment period and your coverage will continue, unless a private insurer has sent you a non-renewal notice. Benefits and coverage can change from year to year, however, so it’s important to check with your private insurer.

In 2019, Part B premiums rose slightly for most enrollees, and a new, higher premium bracket was put in place for higher-income enrollees ($500,000/year single, $750,000/year married). In 2020, expect to see changes in plans that cover out-of-pocket expenses for Part B that will likely result in discontinuation of some plans. On a more positive note, the so-called “donut hole” (a gap in coverage of prescription drug expenses) will be completely closed by 2020. It is also likely that Medicare Advantage plans will continue to change and revise their provisions and coverage.

As mentioned earlier, it’s important to review your Medicare coverage periodically and to stay informed about changes in provisions and coverage. As a benefit to our Medicare-eligible clients, we are able to offer the services of a Medicare expert to help sort through the “alphabet soup” and insure the most cost-efficient and complete coverage possible. We’d value the opportunity to answer your questions and provide assistance.

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Go to the Bernhardt Wealth Management Blog where this was first published to read this and other blog entries.

About Gordon J. Bernhardt: President and founder of Bernhardt Wealth Management and author of Profiles in Success: Inspiration from Executive Leaders in the Washington D.C. Area, Gordon and his team provide financial planning and wealth management services to affluent individuals, families and business-owners throughout the Washington, D.C. area. Since establishing his firm in 1994, he and his team have been focused on providing high-quality service and independent, unbiased financial advice to help clients make informed decisions about their money. For more information, visit Bernhardt Wealth Management and Profiles in Success.