Navigating Medicare Open Enrollment

Open enrollment ahead road sign

The 2021 Medicare open enrollment period opens October 15 and runs through December 7, allowing every Medicare beneficiary to make changes to their plan coverage. Any changes to your coverage will be effective January 1, 2022.

After the open enrollment window closes, plan changes can only be made after a qualifying life event.

Medicare is available to everyone age 65 and older and their spouses, and everybody who is eligible for Social Security Disability Insurance. Thanks to the tireless work of ALS advocates, people diagnosed with ALS who already qualify to receive SSDI benefits are immediately eligible for Medicare as well. That makes Medicare open enrollment an important window of time for the ALS community.

Navigating the world of health care and insurance, especially Medicare, can be complicated and overwhelming.

There are two main components to Medicare – Part A, which broadly covers things like hospital visits, hospice care and skilled nursing facilities, and Part B, which broadly covers things like doctor’s visits, home health services, durable medical equipment and some hospital outpatient services. Part B includes a monthly premium.

Medicare beneficiaries have the option to receive their Medicare benefits through private health insurance plans. These private insurance options are authorized by Medicare Part C, which is also called Medicare Advantage.

In order to help people with ALS navigate the system, The ALS Association has partnered with the Patient Advocate Foundation. Connecting ALS recently asked Courtney Jones, senior director, case management for the Patient Advocate Foundation for some tips to help. The full episode will be available Thursday.

“It's really important that individuals start to think about the Medicare coverage and what that will look like in 2022, carefully reviewing their current Medicare coverage and noting any upcoming changes that they may have to any, treatments or therapies, any tests or medications that they have, decide if their current Medicare coverage will meet their needs for the year ahead,” she said.

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Woman in headset

According to data from the ALS Focus survey program, the challenges of understanding medical insurance coverage creates a substantial level of stress for people living with ALS. But you don’t have to navigate the Medicare open enrollment period by yourself.

Access the ALS Medicare Resource Line to talk to Medicare experts who can help you pick the coverage that is right for you.

Comments

Submitted by: Jennifer L. on Fri, 10/15/2021

How do we know if you qualify? I am 45 years old , have ALS but was a stay at home mom so I have very few years of working.

Submitted by: Jennifer L. on Fri, 10/15/2021

I am 45 years old and have ALS. I was a stay at home Mom so I have very few years of working outside the home. How does one know if they qualify?

Submitted by: Williamsic W. on Mon, 10/18/2021

Usually I don't learn article on blogs, however I wish to say that this write-up very forced me to take a look at and do it! Your writing style has been amazed me. Thank you, very nice post.

Submitted by: Christine H. on Sun, 11/14/2021

You don't have to qualify for SSDI to get Medicare. I have long term disability through my employer. I don't qualify for SSDI because my employer didn't take out SS taxes from my pay. I did pay Medicare taxes. I had to argue with SS about it, and I was approved for Medicare. ALS and ESRD are automatic qualifier.

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