If you’ve recently joined Original Medicare or a Medicare Advantage plan, you’re probably wondering if you need to renew your membership or if it will automatically renew each year.
Depending on your circumstances, there may be situations where you shouldn’t assume that your Medicare coverage will continue.
This article will outline when and how often you need to renew your Medicare plans.
The federal Medicare program is a health insurance coverage for individuals 65 or older, disabled people and those that suffer from ESRD.
If you haven’t enrolled for Medicare coverage and don’t have a private health care plan, there are many benefits to signing up. Before you read on, check out our Guide to Enrollment to learn more about joining a Medicare plan.
If you’re already enrolled in a Medicare plan or Medicare Advantage plan, you won’t usually have to submit a Medicare renewal form or call your provider to ensure that your coverage continues each year.
But in some cases, your membership can lapse, which can have consequences for your coverage and automatic renewal.
Medicare Part A refers to inpatient treatment and hospital care and includes hospital stays, hospital treatments, and general nursing costs.
Medicare Part B relates to outpatient or general medical coverage and includes preventive treatments, doctor’s consultations, scans, and tests.
Part C/Medicare Advantage Plans are health cover plans offered by insurance companies that have a contract with Medicare. These policies cover Part A, B, and D expenses and will cover the costs for hospital care, prescription drug coverage, and doctor’s visits.
Part D Medicare plans (A Medicare Prescription Drug Plan) cover self-administered prescription drugs. For example, medications for high blood pressure, pain tablets, and antidepressants. Part D costs are covered by Medicare Advantage plans or standalone Part D plans.
Medicare Supplement Insurance, also known as Medigap, is insurance plans for people who have Original Medicare. These plans cover costs such as deductibles, coinsurance, and out-of-pocket costs. There are several plans ranging from A-N, with different benefits.
If you have a basic Medicare plan (Part A and B cover), in most cases you won’t have to do anything to renew your coverage each year.
But there are still conditions for membership renewals for both Part A and Part B that you should keep in mind.
Your Medicare Part A automatic renewal will depend on how you qualified for Medicare Part A.
If you or your spouse has paid Medicare payroll taxes for at least forty quarters (ten years), you will get premium-free Medicare Part A cover.
This will mean that:
You won’t have to pay a monthly premium when you enroll.
You can sign up at any age without having to pay a late enrollment penalty.
Your cover will renew each year automatically.
But if you or your spouse hasn’t contributed to Medicare through payroll taxes, you will have to pay a monthly premium to enroll in Medicare Part A.
It will also mean that your Part A coverage renewal will depend on your payment status.
This means that if you do not pay your monthly fees for Part A cover, your Medicare coverage will not automatically renew.
Here’s what you might expect to pay if you have not contributed towards Medicare through payroll taxes (forty quarters):
If you paid less than 39 quarters - $274.00 p/m.
If you paid less than 30 quarters - $499.00 p/m.
If you made no contributions towards Medicare - up to $499.00 p/m.
If you don’t have premium-free Medicare Part A, you will have to enroll at the age of 65 to avoid late enrollment fees.
These are usually 10% of your monthly premium, and you will have to pay it for double the length of time you weren’t enrolled.
For example, if you enrolled in a Medicare plan at the age of 68 (three years after becoming eligible), you would have to pay the penalty for six years.
Your Part B cover will renew automatically each year unless you stop paying your monthly premium.
Unlike Part A, with Medicare Part B there is no premium-free option. This means that every person who enrolls in Part B must pay a monthly premium to get coverage.
Depending on your income, you’ll pay anywhere between $170.10 and $578.30 per month for Part B coverage.
If you fall behind on your Medicare payments and your cover ends, you will be able to rejoin Original Medicare (Part A and B). But you will have to pay a Late Enrollment Fee for the period when you weren’t covered.
Late Enrollment Fees are different for Part A, Part B, and Part D coverage. Take a look at our Medicare Hub to learn more about the costs and benefits of Medicare Part A, B, and D.
Do you have any questions about Medicare or Medicare plans? PolicyScout’s trained consultants can help. Contact us at 1-888-912-2132 to get in touch with a licensed insurance agent about coverage, providers, and costs.
Medicare Advantage plans follow the same rules for renewal and enrollment as basic Medicare (Part A and B cover).
This means that your Medicare Advantage plan will automatically renew as long as you pay your premiums.
But if you stop paying your monthly premium, your provider will notify you in writing (a Notice of Non-Payment) when your coverage will end and tell you how long you have to pay the outstanding balance (this is called your grace period).
Along with the Notice of Non-Payment, your health insurance provider is also required to notify you of any changes to your Medicare insurance in your Plan’s Annual Notice of Change.
If you don’t pay your monthly premium after this and your grace period ends, you’ll automatically be disenrolled from your Medicare Advantage plan and become an Original Medicare beneficiary.
It’s important to remember that if you decide that you would like to rejoin your previous Medicare Advantage plan later, your provider might not accept your application. This can be for a number of reasons, including:
The provider has stopped offering the plan in your area.
The plan has reached its capacity limits (the number of beneficiaries allowed on the plan).
If you’re thinking about changing your plan or want to find out more about Medicare Advantage plan renewals, reach out to one of our trained consultants. Send an email to Help@PolicyScout.com or call 1-888-912-2132 to get in touch with a licensed insurance agent.
An ANOC is a letter you will receive every September if you have Medicare Advantage or a Medicare Prescription Drug Plan (Part D).
This is a notice that will inform you of any changes in your plans relating to:
Service Area Adjustments
Medicare Supplement Insurance plans (Medigap plans) are sold by private insurance companies and pay for expenses such as coinsurance and deductibles.
Your Medicare Supplement plan will automatically renew each year as long as you pay your premiums—even if you move to another state.
If you do not pay your premiums, you will be given a grace period to settle your outstanding fees.
Coinsurance amounts are costs that you will have to pay for medical services, tests, and equipment. They can be a percentage of the total cost (Part B and D) or based on the number of days that you receive treatment (Part A).
Deductibles are amounts that you have to pay before your Medicare coverage starts. These set amounts can be charged annually or for a period of treatment.
Part D Medicare plans will automatically renew as long as you pay your monthly premiums.
You won’t have to renew your policy each year, and your Part D insurance provider will notify you about any changes to your coverage and costs in your plan’s Annual Notice of Change (ANOC) letter.
Your private Medicare policies will renew automatically each year as long as you pay your monthly premiums. But certain events can lead to your subscription not being renewed.
Here are some common reasons why Medicare Advantage, Medicare Supplement Insurance Plan, or Part D (drug coverage) plans might not renew.
Your private insurance company stops providing your specific plan.
Your plan is low-performing and has received a rating of lower than three stars for three years. Medicare uses a star system to rate the quality of services that different providers offer.
Your insurance provider decides to stop offering your current Medicare plan in your area.
While these events are out of your control, you need to ensure that you are up to date with what is happening if you want to change plans during the Special Enrollment Period.
If your private Medicare plan does not automatically renew because of changes outside of your control, you will be allowed to switch Medicare Advantage plans during a Special Enrollment Period (also known as a Special Election Period).
This enrollment period allows people to join and to change Medicare plans due to special circumstances. These can include:
If your insurance company ends your Medicare plan.
If you move states and would like to change your coverage to a better option that wasn’t available.
If your employment health care coverage or insurance plan ends.
You will not have to renew your Medicare card each year. However, you will need to replace your card if it is lost, damaged, stolen, or if your details have changed.
Visit your nearest Medicare Service Center with your proof of identity to replace your card, or request a new card by visiting myMedicare.gov.
Visit our Medicare Hub to get the latest information about Medicare, Medicare eligibility, and Medicare Advantage. You’ll be able to find in-depth guides on the next enrollment period and how you can make the most of your Medicare coverage, costs, and benefits.
If you need more personalized assistance or want to find a licensed insurance agent in your area, get in touch with one of our consultants to discuss your individual needs. Send an email to Help@PolicyScout.com or contact us at 1-888-912-2132 today—we’re ready to help.