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Kiss Coverage Gaps Goodbye With New 2023 Medicare Enrollment Rules

The new year is bringing a new benefit for Medicare enrollees. You may no longer need to worry about delays in enrollment that can lead to coverage gaps!

That’s great news for people facing months-long delays with their transitions. A new effort to ensure that people have access to the healthcare they need led to the change, and there are other adjustments coming that will also reduce the lack of coverage that has sometimes plagued new enrollees.

In the past, such gaps created complications for enrollees. They might have to pay for medical care from their own pockets, or they might have to skip care altogether if they couldn’t afford such costs. The new adjustment should ensure that people who need medical care can receive it, regardless of their insurance status.

Here’s a look at what the new rules, which go into effect on Jan. 1, may mean for you.

Initial Enrollment Changes

When you become eligible for Medicare at age 65, you get an initial enrollment period, which starts three months before your birthday. You have from then until three months after your birthday to enroll in Medicare coverage. Up till now, coverage generally began the month after you enrolled, but if you waited until after your birthday, you had to wait longer for coverage to begin.

The new rules will change that. Now, for everyone who signs up, coverage will start the very next month. So if you sign on to Medicare at the end of the month, your coverage will begin on the first day of the next month, the same as if you enrolled earlier in the month.

Early General Enrollment Coverage (But You May Still Have to Pay Penalties)

The new rules also loosen the guidance for signing up for coverage when you miss the initial enrollment period. Up until now, if you didn’t qualify for a special enrollment period, you had to sign up during the general enrollment period, which opens during the first three months of the year. Coverage wouldn’t actually start until July.

Unfortunately, that could lead to the long and potentially health-threatening coverage gap lasting months. So the new rules change it so you will enjoy coverage the month after you sign up. However, you may have to pay for this in the form of a late-enrollment penalty:

· If you sign up for Part B, you will pay $164.90, which is 10% of the standard premium for the 12-month period.

· If you sign up for Part D, you will pay $32.74, which is 1% of the “national base premium,” times the number of months you didn’t have Part D since enrolling.

Signing up Under Exceptional Circumstances

Finally, you may be eligible to enroll in Medicare outside of the traditional enrollment periods if you get impacted by “exceptional circumstances.” You may suddenly need care and not have the means; if you can show that, you won’t even have to pay a Part B enrollment penalty, either.

Wondering what your Medicare options are or how these changes could impact you? Contact Jay to learn more.


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