Annual Medicare Open Enrollment
January 1, 2025 – March 31, 2025
COBRAinsurance.com makes it easy to compare and change Medicare Advantage plans and supplements.
Retiring and Transitioning to Medicare
Medicare is a federal health insurance program primarily for people aged 65 and older, as well as for some younger individuals with qualifying disabilities or specific medical conditions like End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). It helps cover hospital care, medical services, and prescription drugs, providing essential health support to millions of Americans.
Medicare Parts
- Part A (Hospital Insurance): Covers hospital stays, skilled nursing, hospice, and some home health care. Most individuals don’t pay a premium.
- Part B (Medical Insurance): Covers outpatient services like doctor visits and preventive care. Requires a monthly premium.
- Part C (Medicare Advantage): Private plans that combine Part A and Part B, often including additional benefits such as dental and vision.
- Part D (Prescription Drug Coverage): Provides prescription drug coverage, typically through private insurers.
When Should I Enroll In Medicare?
If your birthdate lands between November 1, 1959 and May 31, 1960 you now qualify for your Medicare Initial Enrollment Period.
Initial Enrollment Period (IEP)
You can sign up for Medicare Part A and Part B during the 7-month period that starts three months before the month you turn 65, includes your birthday month, and ends three months after your birthday month.
Penalties For Late Enrollment
Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working.
- If you have to pay a premium for Part A and miss your IEP, you could face a late enrollment penalty.
- The penalty is 10% of your premium and applies for twice the number of years you delayed enrollment.
Special Enrollment Period (SEP) for Part B
If you or your spouse are actively employed and have health insurance through that job when you turn 65, you have an 8-month Special Enrollment Period to sign up for Medicare Part B. This period starts when your employment ends or when your job-based insurance ends, whichever happens first.
COBRA Coverage and SEP
If you have COBRA coverage instead of active job-based health insurance, you do not qualify for the Special Enrollment Period based on active employment. The 8-month Special Enrollment Period starts when your employment ends, not when your COBRA coverage ends.
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Our federally certified Medicare consultants are ready to review your situation and advise on a plan that will work for you.
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Understanding the COBRA Trap
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals and their families to continue group health benefits after certain life events, such as job loss or divorce. While COBRA provides a temporary safety net, it can also lead to financial and coverage challenges, known as the “COBRA Trap.”
Key Aspects of the COBRA Trap
- High Costs: COBRA requires paying the full premium, including the portion previously covered by the employer, which can significantly increase monthly expenses.
- Limited Duration: COBRA coverage lasts up to 18 months, after which you must find alternative health insurance, potentially delaying access to more sustainable options like Medicare.
- Missed Opportunities: Relying on COBRA may cause you to miss enrollment periods for other plans, risking gaps in coverage or rushed decisions on new insurance.
Avoiding the COBRA Trap
To prevent falling into the COBRA Trap, evaluate all health insurance options and costs before choosing COBRA. Consider alternatives such as Medicare, especially if you are eligible, or explore plans through the Health Insurance Marketplace for more affordable and long-term coverage solutions.
What should I do if I have COBRA and become eligible for Medicare?
If you have COBRA and become eligible for Medicare, you should sign up for Medicare as soon as you’re eligible. Medicare usually becomes your primary insurance, and COBRA may only cover some of the costs that Medicare doesn’t.
The End Of COBRA Coverage
In many cases, COBRA coverage will end once you enroll in Medicare, but check with your COBRA administrator to understand your specific plan rules. It’s important to avoid gaps in your health coverage, so make sure you understand how Medicare and COBRA work together.
Frequently Asked Questions
Find answers to common questions about Medicare coverage and plans.
What is the Medicare Open Enrollment Period?
The Medicare Open Enrollment Period runs from October 15 to December 7 each year. During this time, you can review and make changes to your Medicare plans.
How do I enroll in Medicare?
You can enroll in Medicare online at the Social Security website, by phone, or by visiting your local Social Security office.
What are the different parts of Medicare?
Medicare consists of Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage), and Part D (Prescription Drug Coverage).
Can I change my Medicare plan outside of the enrollment period?
Yes, certain life events like moving or losing other insurance may allow you to make changes outside the regular enrollment periods.
How does Medicare Advantage differ from Original Medicare?
Medicare Advantage plans are offered by private companies and often include additional benefits, while Original Medicare is government-run and provides basic hospital and medical coverage.
Overview of Medicare
Medicare is a federal program providing health coverage for individuals 65 and older or those with specific disabilities. There are several coverage options to meet individual healthcare needs.
Eligibility for Medicare
- 65 and older: Most people automatically qualify for Medicare.
- Under 65: Certain individuals with disabilities or end-stage renal disease (ESRD) may also qualify.
Medicare Parts
- Part A (Hospital Insurance):
- Covers inpatient hospital care, skilled nursing facility stays, hospice care, and some home health care services.
- Most people qualify for premium-free Part A if they or their spouse have paid Medicare taxes for at least 10 years.
- Part B (Medical Insurance):
- Covers outpatient services, including doctor visits, preventive care, diagnostic tests, and some medical supplies.
- Requires a monthly premium, which varies based on income.
- Part C (Medicare Advantage):
- Private plans offered by Medicare-approved insurers that combine Part A and Part B.
- Often includes additional benefits like dental, vision, hearing, and prescription drug coverage.
- May have lower out-of-pocket costs compared to Original Medicare.
- Part D (Prescription Drug Coverage):
- Offers coverage for prescription drugs through private insurers.
- Part D plans vary in terms of covered drugs, costs, and pharmacy networks.
Medicare Supplemental Insurance (Medigap)
Medigap policies help cover costs that Original Medicare does not, such as copayments, coinsurance, and deductibles. These plans are sold by private insurance companies.
Key Points to Remember
- Medicare typically covers 80% of medical costs, leaving 20% for the individual to cover unless additional coverage is purchased.
- Enrolling during your Initial Enrollment Period (3 months before and after your 65th birthday) avoids late enrollment penalties.
Enrollment Process
- If receiving Social Security, you’re automatically enrolled in Parts A and B.
- If not receiving Social Security, you must enroll manually through the Social Security website, by phone, or in person at a Social Security office.
Medicare Does Not Cover
- Prescription drugs without Part D
- Long-term care
- Routine dental, vision, and hearing care
- Hearing aids and exams
