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Medicare's Open Enrollment Period in Illinois Has Started

Tuesday, 18 October 2016 10: 00
Written by Joni B. Bailey
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On October 13, the Illinois Department on Aging put out a press release to announce the start of the Medicare open enrollment period to Illinois residents.  This is a very important period for seniors in Southern Illinois.  


Here are some frequently asked questions I receive about Medicare as a Southern Illinois Disability attorney. 

What does "open enrollment" mean?

Open enrollment means that people who are eligible for Medicare can do the following things:

  • Adjust Medicare Advantage or Medicare prescription drug coverage;
  • Change from original Medicare to a Medicare Advantage plan (or vice versa);
  • Switch between Medicare Advantage plans;
  • Join a Medicare Prescription Drug Plan;
  • Switch existing drug plans; or
  • Drop Medicare prescription drug coverage.

The open enrollment period will close on December 7, after which time those looking to do any of the above will have to wait until the end of next year.

What is Medicare and who is eligible?

Medicare is our country's health insurance program for people age 65 and older, those who have a special condition (such as permanent kidney failure or Lou Gehrig’s disease), or those who have a disability.  Even if you are not 65 yet, if you are currently receiving Social Security Disability benefits, you are eligible for Medicare.

If you have filed a Social Security Disability Insurance claim and it has been approved, your earliest Medicare entitlement month is 29 months after the month your disability began but no sooner than 12 months after the month that you filed the Social Security Disability claim.  For example, if you filed for Social Security Disability benefits this past June, the soonest your Medicare coverage would go into effect is starting in June of next year. 

Who should take action during this open enrollment period?

Some people think you have to be drawing retirement benefits to be eligible for Medicare at 65.  This is false.  Even if you are still working, you can qualify for Medicare if you are 65 or older.  In fact, if you are eligible, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.  So, if you are 65 or older and you either have no insurance or the plan offered through your employer is poor, you should take this opportunity to enroll for Medicare.

Recently in Southern Illinois, area coal miners were dealt a huge blow as Alpha Natural Resources declared bankruptcy.  Writing from my perspective as a Southern Illinois Social Security Disability attorney, I published an article on my website in response detailing how coal miners under the age of 65 who are losing health insurance benefits can qualify for Medicare if they are able to win a Social Security Disability claim.  You can read that article here:  Coal Miners Left in the Dark – How to Qualify for Medicare Before Age 65

In general, if your family relied on a spouse's insurance coverage and that spouse has recently lost that coverage, that spouse should enroll for Medicare during the open enrollment window, provided that they are either 65 or older, have a special condition, or are currently receiving Social Security Disability benefits.

How do I go about enrolling for Medicare?

First, you can use the free calculator at Medicare.gov to determine your eligibility:

https://www.medicare.gov/eligibilitypremiumcalc/

If you are eligible for Medicare, you can visit this page and scroll down to find the link to an online application.

You can also apply over the phone by calling 1-800-772-1213 from 7 a.m. to 7 p.m. Monday through Friday.  Or, visit your local Social Security office. (Remember to call first and make an appointment!)

Confused?  That's normal!  The Illinois Department of Aging offers free counseling assistance through the Senior Health Insurance Program (SHIP) for Medicare-eligible individuals and their caregivers.  Counselors are in place to help seniors understand their Medicare benefits, choose the best option, and complete their enrollment.  This assistance is available year-round, but is most timely during the open enrollment window.

For more information about the SHIP counseling service, visit this link:  https://www.illinois.gov/aging/ship/Pages/default.aspx

Joni Beth Bailey is a Southern Illinois Social Security Disability representative.


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