Medicare’s 4 Enrollment Periods

Hello, this is Will Hardy with ManTalk Radio. We are all about breaking down the walls of race and denomination. Your chosen Truth Network Podcast is starting in just a few minutes. Enjoy it, share it, but most of all, thank you for listening to the Truth Network Podcast. Today's Finishing Well Show is pretty exciting. For me, because I love the idea of learning new stuff.

Yeah, I really do. And so I actually just this is one of those shows. I was completely ignorant of what we're going to talk about today. It's Medicare's for enrollment periods. So I'm guessing everybody like me had heard all about one, you know, that started October 15. Was it October 15 through December 7? Yeah, a day that wouldn't live in infamy.

And I thought if you didn't do it by then, it was all over Katie bar the door till next year. But we have secrets for, you know, really cool information along those lines. But on a spiritual line, I was thinking, you know, in First Timothy where it says all God, all scriptures God breathed. And there's a line in there that has always intrigued me. It said that the scripture is able to cut between soul and spirit.

Now, that's a pretty fine line. And I don't know how much time you thought about and something that I because honestly, John Eldridge's prayer always talks about praying for your soul, praying for your, you know, spirit, but also praying for your heart and praying for your intellect. And so just trying to make those cuts, like what's the difference between your heart and what's the difference between your soul and your spirit and your heart and your intellect?

Because you might have heard a lot of people say that one of the longest distance in the world is between your heart and your intellect. So, you know, just to show at times I struggle with relationships, I have a family member, you might find this surprising that annoys me. Hopefully she doesn't listen to this show. How did you know? It's a she.

I didn't say if it was a boy or a girl. But anyway, this particular family person annoys me. And you may have heard, you know, Jesus talk about that what makes a man unclean comes out of his heart. So often, you know, certain adjectives about this family member float into my mind about how I feel about her and how annoying I am. Well, that stuff's coming out of my heart.

It really is. But it floats into my intellect, which then decides, well, I need to avoid her at all costs right now. But, you know, then you've got a soul. Well, my soul really loves this person. It really does.

I really do love this person. However, my heart flows things out. My mind does things with that information. And then, you know, here comes my soul. And I love the 23rd Psalm where it says that, you know, he makes me lay down in green pastures, leads me beside still waters. And he says, he's going to restore my soul. Well, my soul gets heartbroken over things like the election results and those kind of things. And my soul really is suffering. But it's interesting by spending time with God, then as my soul gets, you know, there, then that revives my spirit. See, so the Word of God is coming in and it's reviving my spirit that makes me want to engage more, that affects my intellect and comes back and helps my heart.

And how is that for a description of it? But I don't think… Are you more nice to her? At times.

At times. I'm working on it. You know, we're doing what we can do.

That's good. And so what we're getting at is that it's helpful to know this information and decide for yourself what is your heart, what's your soul, what's your spirit, you know, what's your intellect, how does that work out in your life and, you know, where does the work need to be done and when does that work need to be done is all critical part of planning, right? And so in planning for your Medicare situation, understanding these four enrollment periods becomes a big deal.

Well, it is. And, you know, my business, Medicare is a foundation for us. You know, I sat on a course years ago of being, you know, America's Medicare expert, long-term care and Medicare expert. And I think we've done a pretty good job of that. I mean, we have a bunch of very sharp young people who are also investment and financial experts. And they've really been trained mostly. There's no place to go to school to become a Medicare expert.

It just, it doesn't exist. It's certainly, there's plenty of places to go to school to become a financial expert like we've become CFPs. But we've put the same studying and the same research and the same knowledge and put it into practice in the Medicare business. And so we, you know, when you really think about it, people receive Medicare differently. I mean, whether they're on disability or not. People, whether they continue to work past 65 or whether their spouse works past 65 and they can get dependent benefits. People are veterans and they can access the veteran services. You know, there's a downside to that.

And then in the modern era, you've got really two distinct routes that you need to make a decision on. Are you going to go the Medicare Part C Medicare Advantage? Get your Medicare from like Humana or UnitedHealthcare or Aetna or WellCare or one of those companies? Or are you going to stay on Original Medicare from the government?

And are you going to purchase a private supplement to go along with that? We've studied this stuff and we think it's really through our practice. We don't just sit here and read books on Medicare, but it's just people come to us with problems and situations and then we research them and we solve them to the best of our ability.

So what we're talking about today is the enrollment periods of Medicare. And I think most of you are going to be familiar with the annual period, which just happened because the airways are just littered with these commercials and, you know, Joe Namath was on one of them. I don't know if you ever saw that, Rob. Certainly the number of you have seen that.

Oh, I have seen them. I've gotten emails and I've gotten texts and I've gotten phone calls now. All about that. There's got to be some money in this for the companies, some big money or they wouldn't be spending all that money just worrying you about it for seven, eight weeks.

I mean like 50 times a day. But anyhow, that's over with. So a lot of folks really don't know and haven't known exactly what you can and can't do during that October 15th, December 7th annual enrollment period. But you can do just about anything with your Medicare during that period, but you've got to do it during those seven weeks.

And most folks would assume that that's it. If you don't get it done during that period, you can't do it. And really, we can't do much between December 1st and January 1st, but there's a whole new period that starts and it's called the open enrollment period. And it's January 1st to January, excuse me, to March 31st. So it's three months. It's a little longer. And you can do some things during this period.

Well, let me just outline what they are. First of all, for this period of three months, this open enrollment period, January 1st to March 31st, you need to already be on a Medicare Advantage plan. So if you're not on a Medicare Advantage plan now or effective on January 1st, then there's nothing about this period that's going to be of benefit to you. Yeah, and I would also say that we're not advocating that you get on a Medicare Advantage plan unless that works for you just because you don't make the enrollment period.

That doesn't have anything to do with it. But if you are on a Medicare Advantage plan, a whole new season opens up January 1st. So there's some things you can do with that Medicare Advantage plan. So one of them would be you can change to a different company or a different provider. So if you're on Humana and you want to move to something else, you can consider all of them and you could move to UnitedHealthcare. Or if you were on UnitedHealthcare and you want to go to Aetna, I mean, so you can move one time during this period. And part of the reason you may want to do that in this period of time, but, you know, you got a phone call from Humana or whatever.

You saw Joe Namath and you called and, man, this is awesome. But the first time you went to the emergency room, you saw something you wouldn't have seen if you had a Medicare. Sure. And so you're – Well, you can't – we're not on that now. So we're on – you can go Medicare Advantage to Medicare Advantage so you can go from like plan to like plan, different companies. The only reason I was saying that is because that's one of the reasons you may not want to be on a Medicare Advantage plan in the open enrollment period. But if you're there and you all of a sudden saw this huge deductible that you didn't realize completely or there was some other issue, like your doctor wasn't on that in their list of doctors or something along those lines, this is the perfect opportunity right then.

That's the second thing you can do. So if you're on a Medicare Advantage plan on January 1st, you can elect to go back to original Medicare. So you can leave Part C and go back on Parts A and B original Medicare. Okay. And then now you're not getting your Medicare from Humana or UnitedHealthcare or Aetna.

You're going to be getting it directly from the government. Okay. So, yeah. So just take me, for example, although I didn't choose a Medicare Advantage plan, but had I done that, right, and I came in January 1st and said, ooh, this was what I thought I signed up for, and I got this big huge payment I owe the hospital or whatever the situation may be that disappointed me, then I can go off of. You can go backwards to, or not backwards, but you can undo your Medicare Advantage election, go back on original Medicare, and now you're going to need to apply for a Medicare supplement.

Right. And you're going to have to answer health questions when you apply for that Medicare supplement. Now, these aren't as hard as, you know, I scare people, preexisting conditions, all that. There's a lot of people that have some pretty serious stuff wrong with them that we're still able to get on a Medicare supplement.

So I don't want that to scare you away from at least investigating. Now, there's some people that we just can't get them on any Medicare supplement policy, just period. But it's all the more reason, from my perspective, to make sure you have somebody helping you with this, and you just don't jump off your Medicare Advantage program before you research, wow, can I get a supplement, what would that be, all those kind of things.

Well, you actually want to apply for the supplement in my book and get it issued. Then you want to dump the Medicare Advantage plan. And the way you dump the Medicare Advantage plan is you would enroll in a Part D plan, because you're going to need one of those two, because you used to have that part of your – and that's guaranteed issue. With the Part D being your drug. Your drug plan, yeah, a Part D plan. And when you do that, that will automatically disenroll you.

So we know how to do all this stuff. So you really can do two things during this OEP, or January 1st to March 31st, is you can switch from one Medicare Advantage plan to another Medicare Advantage plan. Perhaps you want their benefits, their network of doctors, whatever the deal is.

That's number one. Number two, what you can do is you can leave your Medicare Advantage plan system, the Part C system, go back to A and B, original Medicare, but before you do that, apply for a supplement and get it issued. Then do that, and then we can also sign you up for a Medicare Part D drug plan. Wow, you can see there's a whole lot here.

We got to maybe one and a half of the four that we're going to talk about. So we got so much more. You can find out all about a lot of this stuff, which I wasn't even that familiar with these, is in Hans' book, The Complete Cardinal Guide to Planning for and Living in Retirement. It's all there at cardinalguide.com, as well as ways to order the book or download this chapter, which is on Medicare. So we'll be right back with a whole bunch more of Medicare.

That's cardinalguide.com. Welcome back to Finishing Well with certified financial planner, Hans Scheil, and today's show, Medicare's four enrollment periods. And so we've talked a little bit, but it'd be a good time to review what are all four of them. Okay, so you got annual enrollment period, AEP, October 15th to December 7th. You can do most things or all things Medicare. You can make changes during this period of time. Consider all your alternatives.

You can make several changes. Okay, we just finished that. Now we're entering the open enrollment period, or we just entered it, which is January 1st to March 31st. Are there 31 days in March? Okay, good. I got that right just by luck.

I never could memorize those. So you got three months, and during those three months, we were just going over the end of the last show. You can do two different things. You can do, you have to be on a Medicare Advantage plan to have this enrollment period be of use to you.

So if you're on a Medicare Advantage Part C plan and you want to change it to another Medicare Advantage plan with a different company, with different benefits, and then it possibly could have different networks of doctors, a different drug plan is associated with it. There's a lot of reasons that you would want to do that. We're not necessarily encouraging you to do that.

We're just, you would have the option during this period of time to make a change of like to like is really what it amounts to. That's the first thing. The second thing you can do is that you can leave the Medicare Advantage Part C system and go back to original Medicare Parts A and B. But I would suggest before you do that, you're going to need a Medicare supplement. And you can apply for the Medicare supplement before you leave your Medicare Advantage plan, get it issued, and then we'll help you do that. And then you've got to add on a Part D plan. So those are the two things you can do during open enrollment, which is what we're in now. Now there's two more periods, and one of those is called the SEP or the Special Election Period.

And what the Special Election Period is something special has happened to you, is unique to you. Either you've moved or there's been a hurricane and affected your county and you couldn't change your Medicare plan. Yeah, and you can see examples why that would be necessary because a big part of Medicare Advantage, if you've chosen that type of Medicare, is a network of doctors. So you had doctors in your area, you lived in Oklahoma City, and all of a sudden you moved to Sandusky, Ohio, and you've got a whole different ballgame.

So they give you this special time since you've moved in order to do that. Or if a hurricane or some other major catastrophe happened in your area, it too could wipe out a hospital or all sorts of things that would make you have a need to have a Special Enrollment Period for Medicare Advantage. There's a whole bunch of rules floating around this. Again, we're getting back to the Medicare experts thing where we, you know, we've, I mean, we don't claim to be right 100% of the time.

So, I mean, no experts are, but we know more about this than most people that are in our business. And we, you know, everybody's situation is different. And sometimes we've really got to almost create one of these Special Election Periods. We've got to get somebody to, like if you move into a nursing home or you move into an assisted living. So that qualifies you to, for a Special Election Period. And there's even a special group of plans that now open up for you because you're a resident in a senior living facility or a nursing home.

And so there's just around this Special Election, just by the word special, it's, there's a whole list of things that qualify you for that. And then the fourth one is the IEP or the Initial Election Period. And what that means is that's the first time you're going on Medicare Part B, okay? Which some people start A at 65, but they don't start B because they're still working. And then they wait until, you know, 67 or 68 when they retire and go off their group insurance. Then their IEP or Initial Election Period is moved around their date of when they went on Part B. For most people that go on Medicare at 65, the Initial Election Period or IEP is right around their birthday.

So I don't want to get into the details on that because you wouldn't be able to repeat it anyhow. So there's four election periods that can go on. Two of them happen according to the calendar and then two of them happen around something that is special to you, which is your first time you're going on Medicare or you've had something special happen in your life that causes you to need a Special Election Period. Now, during three of them, you can do anything, you can change anything regarding Medicare. But this one that we're in now, the OEP, there's only limited things that you can do and that you have to be on a Medicare Advantage plan.

So I don't expect people to memorize this. I just I think that if you're going to utilize any of these election periods, that it's best to get in touch with a professional and have somebody help you with this that actually knows all the rules. Yeah, because if you watch TV regularly or even any more with your texts or whatever, all you're ever going to hear about is the one that happens from October 15th through December 7th, because that's the only one they're allowed to, according to law, advertise. Right. That they can advertise that they have these services only during the, they call that open enrollment, right? No, it's annual enrollment.

That's okay. It's so confusing. It is confusing. It's annual enrollment. The annual enrollment period, which I guess is October to December, is the one that they're allowed to advertise, but you don't hear about the special one because people aren't advertising about it. Let's say a little prayer and thank the Lord that the only time they can advertise and come after you for this is during that fall time of the year.

Can you imagine if we had this stuff going year-round? Me as a marketer and a seller of this stuff, when I said this is basic to our business, this is how we meet people. So I would certainly like that. And our ads don't look like everyone else's ads. We actually give them some education and people tend to like our ads. But I'm just talking about for my own personal, I mean, I don't want to watch those ads all year long. No, I certainly don't. And it's actually against the law or against the regulation for me to promote the open enrollment period, which we're in now, where you could just change Medicare Advantage to Medicare Advantage, or you could leave Medicare Advantage.

I have to wait for you to call me. And I'm not so much promoting that now because we're running an educational radio show here, but we don't send out flyers or mailers or emails or anything promoting that because it's against the regulation. The government just wants you to be able to do it.

They just don't want anybody telling you about it. But another big one that's there that people don't promote is that initial election period, right? Right. And so I would have never known in a million years, there would be no way that I would have known that I could begin that process in July. My birthday was in October.

Right. And I was totally hooked up because as soon as you go to the website, I was able to apply for and get – I had my Medicare card weeks before I was on Medicare. I figured out the Medicare supplement I was going to do. I figured out the drug plan I was going to do. And as it turned out, one of those things got botched, not by you guys but by the insurance company.

And so I never got the cards. Really? Yeah. And so I called Tom and I'm like, Tom, I got my card from my Medicare supplement and I got my card from my drug plan, but I never got my actual Medicare card. And I think that's kind of critical. And he goes, well, yeah.

Well, you can go to dah, dah, dah. And so he helped me get my actual Medicare card even though I got the email saying you're all set up and this is – but no card came, no card came, no card came. And so he ended up helping me go back and get that stuff done. But it was all the more reason that, number one, that's critical that you start that because there can be fines, right, if you don't start Part A when you're supposed to.

Part A and Part B and – yeah. I mean, plus you're not going to be insured. I mean, it's critical that you get that stuff done. You can do it online now. But then for them to do all that, confirm all that, and then they'll send you the card, this is Medicare we're talking about or the insurance company? It was my Medicare card. The one that came from Medicare.gov. The red, white, and blue one. Right.

The one that has that number on it. Yeah. Getting them to send another one is like trying to get another Social Security card or something. I mean, you just – it's like getting a passport or something. It was not easy.

But that's what I'm saying. I'm glad I did it in July because I realized – because if I'd have waited until the first of October, you know, and as it turned out, and you know that that's about the time I chopped off the animal finger. And so here I was meeting all this stuff and I had it. You know, I was totally prepared with all my cards and whatever because we had time. You weren't necessarily happy going in there. No, but I – But you were fulfilled. I mean, you were protected. That's a good word. Yeah, I was protected.

But, you know, I hear horror stories all the time of people that are my age. Oh, man, I'm paying these fines and the fines come out of your Social Security forever. Or penalties as they call them, yeah. They call them penalties.

Excuse me. They don't call them fines. Yeah.

And you know what? They're lifetime penalties. Right. Once they start these, they never go away until you die.

Right. They're taking a certain amount out of your Social Security check. I've got people that have been on penalties. They're 85 and they've been on penalties for, let's say, 15 years or something because they did something late. And they're still paying it and they see it, you know, every month or they see it every year that it's just right there.

And they can be on Part D, late enrollment, and they can be on Part B, late enrollment, either or both. And they really make people angry. Yeah. You can see why. I mean, I can understand that they would need some amount of money when they were, you know, for two or three years or whatever. But you're talking about some guy who's now in his 90s or he's in his 80s.

I'm sure I could find one in their 90s. They bring it up every year. You know, we're calling them.

We're redoing their drug plan. And we listen to them. And, you know, again, I tell them that my job is not to make you like this. Okay. That's not my job. And I have to tell myself that all the time because I can launch into trying to make somebody happy about something they're angry about. And it's not my job. My job is just to explain it to you and try to make it the best that we can possibly make it. That's what my job is.

And then I'm just going to leave you with, I mean, you know, you got what you got. Those penalties anger people. So one more time, the four R. AEP, annual enrollment period.

That just happened and just finished. What we're in now, open enrollment period, OEP. The SEP, which is special enrollment period, which can be any first of the month of the year, all 12 different dates.

And it's based upon something that happened to you, some special situation like moving, a disaster, your spouse dying, losing group insurance. I mean, there's just all kinds of things that could create a special enrollment period. And then the IEP, which is the initial enrollment period, which is the time when you first go on to Medicare. And then in each of these periods, there are certain things you can do and there are certain things you can't do. Now, where there's a lot of confusion is your Medicare supplement policy. A lot of folks think that they can only change that during one of these special periods. You can change your Medicare supplement policy or Medigap policy 365 days a year. It has nothing to do with the federal government other than they dictated the standardized policies.

That's it. And they basically dictate Medicare. It's a state government thing. And the open or the enrollment period for Medicare supplements are continuous.

And why that matters is if you're paying a high premium for your Medicare supplement insurance and it's been going up and going up, you may want to consider changing that to one that's less expensive. And you can do that any time of year. This time of year would be a great time. So just give me a call. There you go. It's all at cardinalguide.com.

That's cardinal. Don't forget the guide. And then.com where you'll find Hans' book, The Complete Cardinal Guide to Planning for and Living in Retirement, where you've got the seven worry chapters that all are free downloads where you can get the whole book with all this information in. As well, you know, these shows, Finishing Well, or the podcast page at finishingwell.com. I mean, excuse me, at cardinalguide.com. Just look for the radio show, Finishing Well, and you can get a podcast of all sorts of shows along this, all kinds of resources, materials, because we really feel, Hans and I both do, that the more information you have, right, the better your intellect in this case, you know, would inform your heart what kind of decision you need to make.

And that would be good for your soul, which then will engage your spirit to engage God and enjoy your life. Thank you for listening. Thank you. Or to get Hans' book, go to cardinalguide.com. If you have a question, comment, or suggestion for future shows, click on the Finishing Well radio show on the website and send us a word. Once again, that's cardinalguide.com. Cardinalguide.com. This is the Truth Network.