If I sign up for Part D during Medicare enrollment, how soon does the coverage start to take effect?

The date the coverage becomes effective depends on which enrollment period you used to sign up for your Part D plan. If you sign up for a Part D plan during the Annual Enrollment Period, which runs from October 15th through December 7th, your coverage will be effective January 1st of the following year. If you sign up for a Part D plan during the Open Enrollment Period (OEP), there are only certain situations in which you can do this, which runs from January 1st through March 31st; the coverage will be effective the first of the month after you submit your enrollment. For example, if you sign up in January, your Part D coverage will be effective February 1st. If you sign up when you turn 65 during your Initial Enrollment Period (IEP), your coverage will be effective the first of the month of your birthday month. For example, if you turn 65 on September 8th and submit your enrollment application in August, your Part D plan will be effective on September 1st. If you turned 65 but were still working and deferred your enrollment in Medicare because you had health insurance provided by your employer, your coverage will begin the first of the month following your enrollment in a Part D plan. If you enroll in a Part D plan during a Special Enrollment Period. The effective date of your coverage will generally be the first of the month following your enrollment.

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I am covered by Medicare, but I don’t take any medications

Is it necessary to sign up for a drug plan? There is nothing that requires you to enroll in a Part D prescription drug plan when you become eligible for Medicare. However, suppose you do not enroll when you first become eligible. In that case, even if you don’t take any prescription drugs, you will be assessed a Part D late enrollment penalty when you eventually enroll in a Part D plan. The penalty is assessed if you don’t have Part D coverage or other creditable prescription drug coverage for 63 or more days in a row after you become eligible for Medicare. How much the Part D late enrollment penalty is will depend on how long you did not have Part D or creditable prescription drug coverage. The penalty is calculated by multiplying 1% of the “national base beneficiary premium” ($33.37 in 2022) times the number of full, uncovered months you did not have Part D or creditable coverage. If you don’t take any prescription drugs and do not enroll in a Part D plan for several years after becoming eligible for Medicare, the Part D penalty can be a significant amount of money, and once assessed, it never goes away. There are many Part D plans with low or even $0 premiums(for some MAPD plans), so you would be wise to enroll in one even if you do not take any prescription drugs to avoid what could be a costly penalty down the road. Let Kevin Leinum help you understand the many parts of Medicare.

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What’s the late enrollment penalty for Medicare Part D and when does it take effect?

Suppose you don’t enroll in a Part D prescription drug plan or a Medicare Advantage plan that includes Part D coverage when you are first eligible for Medicare. In that case, you may be assessed something called the Part D late enrollment penalty. The late enrollment penalty is an amount is added to your Part D premium, and once it is incurred, it never goes away. You will be assessed a late enrollment penalty if, at any point, after your Initial Enrollment Period is over, you don’t have Part D coverage or other creditable prescription drug coverage for 63 or more days in a row. The amount of the Part D late enrollment penalty depends on how long you did not have Part D or creditable prescription drug coverage. The amount is calculated by multiplying 1% of the “national base beneficiary premium” ($33.37 in 2022) times the number of full, uncovered months you did not have Part D or creditable coverage. The monthly premium is rounded to the nearest $.10 and added to your monthly Part D premium. The national base beneficiary premium can change every year, and as a result, the penalty amount can change each year. The Part D penalty takes effect as soon as you enroll in a Part D Prescription Drug plan after a break of 63 days or more. Let expert Kevin Leinum help you understand the many parts of Medicare and determine the right fit for you.

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Medicare Advantage plans can be very cost-effective, and in fact, there are plans with $0 premiums.

So how is that possible? To understand how $0 premium plans are possible, you must understand how Medicare Advantage plans are paid. There are two parts to how Medicare Advantage plans get paid. The first is the premium members pay; how the premium is depends on the benefits of the plan you purchase. It can be as low as $0, or in other cases, it can be higher. The second part is the money Medicare pays the insurance company.  Since Medicare Advantage Plans completely replace Original Medicare, Medicare pays the Medicare Advantage insurance company an amount per member based on location, health, and many other factors. It is then the Medicare Advantage insurance companies responsibility to pay for all the health care needed by that Medicare Advantage member. The payment from Medicare makes up the majority of the money the insurance company gets for each member. They then manage their members’ healthcare, negotiate lower physician and hospital costs and drug prices, and many other aspects of healthcare costs. This allows them to provide additional benefits and lower the premiums they can charge even to the point of having $0 premium plans. In addition to the premium for your Medicare Advantage plan, if it is not a $o premium plan, you will still have to pay your Medicare Part B premium and Part A premium if applicable.

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Can I use my Medicare coverage to utilize telehealth services?

If you have original Medicare, Part B will cover telehealth services, and you will have to pay a 20% coinsurance of the Medicare-approved amount for your doctor or other health care provider’s services after you pay the Part B deductible. You will have to pay the same amount for most telehealth services as if you received the service in person. Due to the Coronavirus (COVID-19) pandemic, Medicare has allowed doctors and other health care providers to use telehealth services to treat COVID-19 (and for other medically reasonable purposes) from offices, hospitals, and places of residence (like homes, nursing homes, and assisted living facilities). Medicare coinsurance and deductibles still apply; however, healthcare providers are reducing or waiving those amounts in some cases. If you are enrolled in a Medicare Advantage plan, they must, at a minimum, provide the same benefits provided under Medicare Part A and Part B, so the same telehealth services are available. Depending on the Medicare Advantage plan you are enrolled in, additional telehealth services may be available, and the out-of-pocket costs may be lower. Kevin Leinum – your local Medicare Expert – can help you understand the many parts of Medicare and determine what the right fit is for you. Give us a call to discuss the options available to you.

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We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 75 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This is a proprietary website and is not associated, endorsed, or authorized by the Social Security Administration, the Department of Health and Human Services or the Center for Medicare and Medicaid Services. This site contains decision-support content and information about Medicare, services related to Medicare and services for people with Medicare. If you would like to find more information about the Medicare program, please visit the Official U.S. Government Site for People with Medicare located at http://www.medicare.gov.

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