Missed Medicare open enrollment? You may have options

Missed Medicare open enrollment?  You may have options
Barry Klitsberg, Nassau County Medicare Counselor, Family and Children’s Association (FCA) Credit: FCA

Medicare is a federally run health insurance program for people who are 65 years of age or have collected Social Security Disability for 24 months. It is also available for individuals with permanent kidney failure or Lou Gehrig’s Disease.

Each year Medicare gives participants the opportunity to modify their health care plan during Open Enrollment season, which runs from October 15th through December 7th.

When January rolls around, there are always some Medicare beneficiaries who despite their best intentions neglected to switch plans during Open Enrollment or didn’t know about Open Enrollment. This generally means that beneficiaries will have to stay with their current enrollment for 2024.

Exceptions to Open Enrollment Limits

There are, however, exceptions to the Open Enrollment rule. Medicare beneficiaries who are in a Medicare Advantage Plan (HMO or PPO) and didn’t change their plan by December 7 may switch Medicare Advantage plans between January 1 and March 31, 2024. If you get your prescription coverage through the plan, you can also switch to a different advantage plan or drop your plan and return to original Medicare. Please note, if you return to the original Medicare, you must also switch to a new drug plan. If you prefer, you can also sign up for a Medicare supplement (Medigap) after your return to original Medicare.

If you are enrolled in the New York State Elderly Pharmacy Insurance Coverage Program (EPIC) you are also entitled to change your drug plan (or Medicare Advantage Plan) once a year outside of any enrollment period. This helps people whose doctors have left a plan network during the year and need to find a new plan that will cover their doctors.

Another option for low-income seniors who receive extra help from Social Security to lower drug costs is the ability to change your drug plan once every calendar quarter for the first 9 months of each year. Additionally, this program lowers your drug plan premium and your out of pocket costs at the pharmacy.

How to apply for Medicare

If you are not yet collecting Social Security, you have to apply for Medicare during the three month period before your 65th birthday. You may apply for Medicare by calling the Social Security Administration at 1-800-772-1213 or on-line at: https://www.ssa.gov/medicare/. If you are already collecting Social Security, you will receive your Medicare card automatically in the mail.

Free help available through FCA

If you don’t have ready access to a computer or otherwise need assistance, Family and Children’s Association (FCA) can help guide you through the process with free help available by calling the Nassau County Health Insurance Information Counseling and Assistance Program (HIICAP) at 516-485-3754. One of our counselors will be happy to assist you. HIICAP is a free service that has trained counselors who can provide you with unbiased expertise on what Medicare plan can best meet your individual needs. HIICAP counselors can also help you switch plans, in many cases over the phone. In person appointments are also available.

FCA can help. Answers to your Medicare questions are just a phone call away.


Barry Klitsberg is an assistant health insurance information counseling and assistance coordinator at FCA in Garden City and an Aging Services Program Specialist at US Department of Health and Human Services.    


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