Open enrollment for Medicare is between Oct. 15 and Dec. 7 of this year. Most people can not sign up for Medicare or change Medicare plans after this window passes.
If you are 65 or older and you or your spouse worked at least 10 years for an employer that contributes to Medicare, you are probably eligible for Medicare plans. Some people under age 65 also qualify for the program. Some exceptional situations may allow you to sign up for Medicare or change Medicare plans after the open enrollment period.
According to Medicare, its options and coverage have expanded as part of the Affordable Care Act.
Due to the government shutdown, information about specific plans may not yet be updated on medicare.gov, the official website of Medicare, or cms.gov, the official website for the Centers for Medicare and Medicaid Services. Check with plan providers or a broker to ensure you choose a plan based on the most up-to-date information because plans change year to year.
If you choose to visit a broker, be aware that not all health insurance brokers are licensed by the state to enroll clients in Medicare. You can check the licensing of a broker by emailing the New Mexico Office of Superintendent of Insurance at firstname.lastname@example.org.
You also can check the provider affiliations and continuing education activities of brokers at the website of the office, osi.state.nm.us, and clicking on the button that says “Agent, Adjuster, Company and Business Entity search.”
Local health insurance brokers Nicole McWilliams and Stephanie Amaro, of Swickard Agency Inc., urge Chaves County residents eligible for Medicare to look into plans as soon as possible, in case a current plan has changed.
McWilliams especially cautions current and potential medicare clients to look closely at Prescription Drug Plans (PDPs) offered by providers.
PDP formularies, which are the list of medications covered by a PDP, sometimes change year to year. So, a medication covered in one year may not be covered the next year, even under the same plan.
While PDPs are optional, Medicare clients who do not sign up for PDPs when they are eligible will face fines if they later decide to purchase the plans, according to McWilliams. She says the fine will be tacked on to monthly PDP premiums for as long as the client elects to purchase a PDP thereafter.
For those interested in Medicare Advantage Plans, only providers Lovelace and Presbyterian offer advantage plans in Chaves County, according to McWilliams and Amaro.