If you miss this Medicare deadline, it could hurt your health

Personal Finance

It’s likely you’ve started hearing chatter about Medicare’s open enrollment period, which begins Sunday and runs through early December.

If you’re like many older Americans, the question is whether you need to do anything.

Put simply, it depends.

“A lot of people won’t need to do a darn thing,” said certified financial planner Hans “John” Scheil, CEO and owner of Cardinal Retirement Planning in Cary, North Carolina.

In basic terms, the enrollment period, which lasts until Dec. 7, is for adding or changing coverage related to Medicare Part C (also known as an Advantage Plan) and Part D (prescription drug coverage).


Part A. This covers inpatient stays at hospitals, skilled-nursing facilities and the like. As long as you’ve paid into the system by working the equivalent of about 10 years, you won’t pay any premiums. If not, you’ll have to pay for it.

Part B. Everyone pays premiums for this coverage, which generally includes outpatient services and supplies. Higher incomes generate higher premiums: If you’re single and have an income of more than $85,000 or are married with a joint income of at least $170,000, you will pay more.

Part C. Also called Medicare Advantage, the program lets people choose from a Medicare-approved private insurance plan instead of Parts A and B. Each plan comes with differing variables, ranging from coverage to deductibles and co-pays.

Part D. This is prescription-drug coverage. A voluntary option, it often ends up being included with an Advantage Plan. If you have Parts A and B instead of an Advantage Plan, you can purchase Part D coverage separately.

Here’s a quick checklist to help you decide. (All changes take effect Jan. 1.)

1. You have a Medicare Advantage plan and want to change plans (or revert back to just Parts A and B).

2. You received a notice that your Advantage plan coverage is changing and you want to comparison shop.

3. You have Original Medicare (Parts A and B), and possibly a Medigap policy and want to switch to an Advantage Plan.

4. You want to join a Medicare prescription drug plan (Part D), switch to another, or drop this kind of coverage altogether.

If you’re happy with your coverage or OK with any upcoming changes, there’s no action needed.

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