Medicare Questions, Answered

The Medicare Annual Enrollment Period (AEP) runs from October 15 through December 7 every year. Any change you make during that window takes effect on January 1 of the following year.

This is the one time each year when anyone on Medicare can switch between Medicare Advantage plans, move between Original Medicare and Medicare Advantage, or join, drop or change a Part D prescription drug plan – without needing a qualifying life event.

Your Initial Enrollment Period (IEP) is a seven-month window: the three months before the month you turn 65, your birthday month, and the three months after.

Signing up during the three months before your birthday month is usually the smoothest route, because your coverage can start the first day of your birthday month with no gap. Waiting until after your birthday can delay the start of coverage.

If you are still working at 65 and covered by an employer group plan, the rules are different and worth a conversation before you do anything – delaying incorrectly can create a lifelong penalty.

They solve the same problem in opposite ways, and you generally choose one or the other – not both.

A Medicare Supplement (also called Medigap) sits alongside Original Medicare and pays the deductibles, copays and coinsurance Original Medicare leaves behind. Plans are standardized A through N, so a given plan letter covers the same things no matter which insurance company sells it. You keep the freedom to use any doctor or hospital in the United States that accepts Medicare. A Supplement does not include prescription drug coverage, so most people pair it with a separate Part D plan.

A Medicare Advantage plan (Part C) replaces the way you receive your Part A and Part B benefits, bundling them into one plan from a private insurer, usually as an HMO or PPO. Many Advantage plans include prescription drug coverage and extra benefits. You typically use a network of providers and pay copays as you go, with an annual maximum out-of-pocket limit.

Which one fits depends on your doctors, your prescriptions, how much you travel, and how you would rather pay – steadier monthly premium versus costs at the point of care.

No. If you do nothing, most plans roll over automatically into the next year.

But the plan itself can change even when you don’t. Every fall your insurer sends an Annual Notice of Change (ANOC) listing what is different for the coming year – premiums, copays, the drug formulary, and which providers are in network. A plan that fit you this year may not next year, and the drug list is where people are most often caught out.

Reviewing the ANOC each fall is worth the twenty minutes, even if you end up keeping what you have.

Nothing. There is no charge to you for our help comparing plans or enrolling, and your premium is the same whether you enroll through an agent or on your own.

We are an independent licensed agency, so we are not tied to a single insurance company. We are also here after you enroll – when a claim is confusing or a card does not arrive, you can call us rather than a call centre.

You generally have to wait until the next one, with two common exceptions.

If you are enrolled in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs January 1 through March 31. During that window you can switch to a different Advantage plan once, or drop back to Original Medicare and add a Part D plan.

Separately, a Special Enrollment Period can open if your circumstances change – moving outside your plan’s service area, losing employer coverage, entering or leaving a nursing facility, or qualifying for Medicaid or Extra Help, among others. If you think something in your situation has changed, it is worth asking rather than assuming the door is closed.

That depends entirely on the plan, and it is the single most important thing to check before you move.

With Original Medicare plus a Medicare Supplement, you can see any provider in the country that accepts Medicare, so networks are not a concern. With a Medicare Advantage plan, your doctors and the hospital systems you use need to be in that plan’s network – and networks in Northeast Ohio change from year to year.

Bring a list of your doctors to any plan review. Checking them one by one takes a few minutes and prevents the most common and most expensive surprise.

Part D is prescription drug coverage. It is sold by private insurers, either as a stand-alone plan alongside Original Medicare or built into a Medicare Advantage plan.

Part D is optional, but if you go without creditable drug coverage after you are first eligible and later decide you want it, a late enrollment penalty is added to your premium and it stays there for as long as you have Part D. That is why many people enrol in a low-cost plan even when they take few prescriptions.

Please note: we no longer provide personalized reviews of individual Part D plans. We are glad to explain how Part D works, walk you through the options available in your area, and help you make an informed decision.

Original Medicare travels with you anywhere in the United States, and so does a Medicare Supplement.

Medicare Advantage and Part D plans are sold by service area, so a move can take you outside your plan’s territory – sometimes just by crossing a county line. Moving opens a Special Enrollment Period that lets you choose a plan where you now live.

Tell your plan and your agent before the move if you can. It is far easier to line up new coverage ahead of time than to sort it out afterwards.

Nothing is required – our Medicare 101 sessions across Northeast Ohio are free, educational and carry no obligation, and plenty of people come simply to listen.

If you would like something specific looked at, three things make the conversation far more useful: a list of your current prescriptions with dosages, a list of the doctors and hospitals you want to keep, and your Medicare card or your current plan’s member card if you already have coverage.

We hold free Medicare 101 sessions and attend senior health fairs throughout Northeast Ohio – including Cuyahoga, Summit, Medina, Stark, Wayne, Lorain, Lake and Geauga counties.

Venues have included public libraries in Akron, Barberton, Wooster and Dalton, community and recreation centres in Garfield Heights, Seven Hills, Macedonia and Richfield, Discount Drug Mart and Petitti Garden Centers locations, and senior centres across the region.

Our office is in Independence, at One Independence Place, 4807 Rockside Road, Suite 660.

Call 216-901-9300 (TTY: 771) and ask for a licensed agent, or use the form on our contact page and we will reach out.

During the Annual Enrollment Period, October 15 to December 7, we recommend calling early. The closer it gets to December 7, the harder it is to get an unhurried appointment.