Medicare Open Enrollment

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with end-stage kidney disease. If you qualify for Medicare, you can review your health insurance options during Medicare Open Enrollment.

Some people choose to receive their Medicare benefits through a Medicare Advantage health plan. If you're considering Medicare Advantage, pay attention to whether you are choosing a plan that includes your current providers and hospitals at Atrium Health.

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Key dates for Medicare Open Enrollment:

During Open Enrollment, newly eligible and existing Medicare patients can review coverage options and choose to:

• Switch from Original Medicare to Medicare Advantage (or vice versa)
• Change from one Medicare Advantage plan to another
• Add or change Medicare prescription drug plans
• Make no changes to current Medicare coverage

Original Medicare vs. Medicare Advantage

Learn about the 2 types of Medicare programs and what makes Medicare Advantage different.

Original Medicare

Original Medicare is the traditional Medicare program, where the government pays directly for the healthcare services you receive. You can go to any doctor or hospital that takes Medicare in the U.S. and buy supplemental coverage to help pay out-of-pocket costs.

Original Medicare includes:

• Part A (inpatient/hospital coverage)
• Part B (outpatient/medical coverage)

You can add:

• Part D (prescription drug coverage)
• Supplemental coverage / Medigap

Medicare Advantage

Instead of Original Medicare, you can get your Medicare benefits from a Medicare Advantage Plan, also known as Medicare Part C. Medicare Advantage bundles the coverage you get under Original Medicare and can include additional benefits.

Medicare Advantage includes:

• Part A (inpatient/hospital coverage)
• Part B (outpatient/medical coverage)

Most plans also include:

• Part D (prescription drug coverage)
• Extra benefits (routine dental, hearing and vision care)

Learn more about Medicare

Which plans include Atrium Health Navicent providers in their networks?

AHN Medical Center, AHN Peach, AHN Baldwin, AHN Rehabilitation Hospital*

• Anthem Blue Cross Blue Shield of Ga - HMO/PPO
• ChoiceCare (Humana) - HMO/PPO/PFFS
• Coventry (Aetna) - HMO/PPO
• Clover Health - PPO
• Clear Spring Health (EON Health) - HMO/PPO
• Georgia Health Advantage - Limited to Institutional Special Needs Only
• Humana - HMO/POS/PPO/PFFS
• Pruitt Health Premier - HMO Limited to Institutional Special Needs Only
• United Healthcare - HMO/POS/PPO (includes Care Improvement Plus and AARP plans)
• WellCare - HMO (Access, Liberty, Premier, Prime and Value plans)

*Always check with your insurance company to confirm in-network status with a healthcare provider.

Why choose a plan that includes Atrium Health?

If you already have an Atrium Health doctor or hospital you prefer, you may want to pick a plan that includes them. This lets you continue seeing them, while better managing your healthcare costs. In addition to your doctor and hospital, you get seamless connection to Atrium Health's vast care options. A few highlights include:

• Unmatched, world-class care from over 53 specialties in more than 50 facilities throughout the region
• Nationally-verified Level I-designated Trauma Center and a four-time Magnet Designated hospital for nursing excellence worldwide
• Primary care from the region's preferred provider, including family medicine, internal medicine and women's health
• The region's largest network of behavioral health and substance use services
• Convenient on-demand care options, like urgent cares and video visits
• Peace of mind that when you get care from Atrium Health, you can more easily keep your out-of-pocket costs down

Frequently asked questions about Medicare Advantage

• What is Medicare Open Enrollment?

  • Medicare Open Enrollment is also known as the Annual Enrollment Period or AEP. During the enrollment period, newly eligible and existing Medicare patients can review Medicare coverage options and:

    • Switch from Original Medicare to Medicare Advantage, or vice versa
    • Change from one Medicare Advantage plan to another
    • Add or change Medicare prescription drug plans
    • Make no changes to current Medicare coverage

• Which Medicare Advantage plan should I enroll in?

  • After comparing the benefits offered by the various plans, consider enrolling in a Medicare Advantage plan that lets you continue getting care from your preferred Atrium Health doctors and hospitals.

• How do I join a Medicare Advantage Plan?

  • Not all Medicare Advantage Plans work the same way. Before you join, take the time to find and compare Medicare health plans in your area. Once you understand the plan's rules and costs, there are several ways to join:

    • Use Medicare's Plan Finder.
    • Visit the plan's website to see if you can join online.
    • Fill out a paper enrollment form. Contact the plan to get an enrollment form, fill it out, and return it to the plan. All plans must offer this option.
    • Call the plan you want to join. Get your plan's contact information.
    • Call 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048.
    When you join a Medicare Advantage Plan, you'll have to give this information:
    • Your Medicare number
    • The date your Part A and/or Part B coverage started
    This information is on your Medicare card.

    Don't give personal information to plan callers

    Medicare plans aren't allowed to call you to enroll you in a plan, unless you specifically ask to be called. Also, plans should never ask you for financial information, including credit card or bank account numbers, over the phone.

    No one should call you without your permission or come to your home uninvited to sell Medicare products. Call 1-800-MEDICARE to report a plan that does this. Learn more about how to prevent Medicare fraud and abuse.

• How do I know if my Medicare Advantage health plan includes my Atrium Health doctor?

  • Before enrolling in any Medicare Advantage health plan, you can confirm that your Atrium Health doctor is participating in the plan. You can do this by:

    • Calling the health plan to verify that your preferred Atrium Health doctor and hospital are in-network.
    • Calling your doctor's office at the beginning of Open Enrollment to see which Medicare Advantage plans are in-network.
    • Visiting Medicare Plan Finder to help you understand the Medicare Advantage health plan options in your county, as well as see which doctors and hospitals are in-network.

• Do I have to renew my plan?

  • If you're happy with your existing Medicare coverage, there's no need to do anything during Medicare Open Enrollment. But it's always good to check that your current plan is still available and that you can continue to see your preferred doctors and hospitals.

• What should I do if I need to see a doctor before my new Medicare Advantage coverage begins?

  • You can continue to see your preferred doctor until your new coverage begins.
    As always, if you have a medical emergency, go to the closest emergency room. Atrium Health hospitals provide services to all patients seeking treatment for an emergency medical condition, regardless of their health insurance plan or ability to pay for emergency services.

• Where can I get more help in selecting a Medicare Advantage plan?

  • You can contact the Senior Health Insurance Information Program (SHIIP). They list available Medicare Advantage plans by county. Call them at 855-408-1212 or visit their website. You can also talk to your local health insurance agent.

• What if I sign up for a plan that doesn't include my preferred Atrium Health doctors or hospitals?

  • If you sign up for a Medicare Advantage plan during Medicare Open Enrollment and your needs change, you may not have to wait until next fall to switch plans.

    However, if you signed up for Medicare Advantage during the regular Open Enrollment period, you can elect to switch health between January 1, 2022 through March 31, 2022.