Open Enrollment in 2020 will run from Sunday, November 1, 2020, through Tuesday, December 15, 2020, for health insurance coverage beginning on January 1, 2021. During Open Enrollment for health insurance, you may have questions about what type of health insurance plan you are eligible to participate in. There are many different options available through each state’s health insurance marketplace. Are you having difficulty sorting through your options? It can be confusing. If you are eligible for either Medicare or Medicaid, this adds another layer of complexity. One important thing to understand is that Medicare is not the same as Medicaid.

Medicare is a federal program that provides health insurance coverage to adults aged 65 and older, and also to adults under the age of 65 who have certain disabilities. Any person who falls into one of these categories is eligible for Medicare regardless of his or her income.

You may or may not be automatically enrolled in Medicare upon turning 65 years old. If you will receive Social Security benefits beginning at least 4 months before you turn 65, you will not have to sign up as you will be automatically enrolled. If you delay receiving benefits past this time, you will need to sign up to receive Medicare coverage. You can apply through the Social Security office.   

Depending on your income, you may be required to pay monthly premiums for Medicare just as you would for private insurance. It is not free to everyone.

Medicaid is a health insurance program run by both the federal government and the individual states that provides coverage to citizens with very low incomes. You can sign up for Medicaid at any time, even if it is not an Open Enrollment period, through your state’s healthcare marketplace, if you are eligible.

It is possible to be eligible for both Medicare and Medicaid, if you fall into one of the two Medicare categories for eligibility and you are also low income. If this is the case, you may be covered under both programs, and the insurance administrators will work in tandem to reduce the overall costs by applying the benefits from each program. 

This is just one of the ways we are able to help as well. We know it can be confusing to navigate, especially in light of the recent changes to New York’s Medicaid program. We encourage you to ask us your questions and reach out to us today to schedule a meeting.