NEED HELP WITH MEDICARE?
WLS Insurance Agency is your Massachusetts Insurance Broker, making the process simple and convenient for individuals, families, small groups, and Medicare clients.
Are you within three months of turning 65?
Are you 65 or older and losing your health care coverage from your employer?
It may be time to enroll in Medicare!
Our licensed insurance agents can answer your questions on enrolling in Medicare Parts A & B. They can explain the enrollment process and the forms that need to be submitted to Social Security (by visiting a Social Security office, through a phone appointment, by mailing or faxing, or completing an application online). They can also review what your options are for additional medical and prescription coverage beyond Medicare Parts A & B.
If you’re 65 or older, you can enroll online for Parts A and B, or Part A only. You can delay Part B if you’re already covered through an employer group health plan.
If you’re under age 65, you may be eligible for Medicare if you have permanent kidney failure or if you receive Disability benefits.
If you are aged 65+ and leaving your employer group health plan coverage , you will also need to submit the CMS-L564 form: Request for Employment Information. If you have difficulty getting the L564 form completed, you may be able to submit other forms of documentation (such as pay stubs, income tax returns, or receipts showing health insurance premium deductions or payments; W-2s reflecting pre-tax medical contributions; health insurance cards with an effective date; or explanation of benefits paid by employer group health plan).
You have a window of opportunity to sign up for Medicare Part B if you are losing employer-group health coverage that begins three months before you retire; while you have additional time to enroll in Medicare Part B after you leave employer group coverage, you do not want to wait to enroll!
SIGN UP FOR MEDICARE PART B ONLY
Part B helps pay for your basic healthcare services. If you already have Part A, you can add Part B during specific enrollment periods.
It’s important to sign up promptly to avoid gaps in coverage or late enrollment penalties. Your coverage generally begins the first day of the month after you sign up.
When you’re ending an employer group health plan
If you’ve been covered by an active employer group health plan (either yours or your spouse’s) since turning 65, and it ended within the last 8 months, you can enroll in Part B without any penalty. This is considered a “Special Enrollment Period.”
WHAT ARE OPEN ENROLLMENT DATES TO KNOW?
ConnectorCare Plans: Open enrollment is November 1 through January 23.
Health insurance through work: Enrollment periods are set by your employer (typically in fall)
Medicare: Annual Enrollment Period (AEP) is October 15 to December 7 every year. Initial Enrollment Period (IEP) is around age 65
Medicare Advantage: Annual Enrollment Period (AEP) is January 1 to March 31 every year.
MassHealth: Enroll anytime
Dual Eligible Special Needs Plans (DSNP): Enroll anytime
WHAT IF I MISSED THE DEADLINE FOR OPEN ENROLLMENT?
If you need coverage during a time when annual open enrollment isn’t available and you have not experienced a Qualifying Life Event, you can buy short term health insurance. Short term health insurance can fill health care needs for short amounts of time.
INDIVIDUAL SHORT-TERM HEALTH INSURANCE
RESOURCES & USEFUL LINKS
MassHealth
ConnectorCare
Medicare
Medicare Advantage
Health Safety Net
MassHealth For Seniors
SNAP
WIC
CSMP
Travel
TAFDC
MassGrant
FAFSA
MASFA
MBTA
EAEDC
MSPs
Frail Elder Waiver
PCA
Rental Assistance
Auto
Home
Small Business
HEAP
Flood
Open enrollment is the time of the year where consumers can buy a new health insurance plan or change their current plan through the Health Connector or directly through the insurance carrier. If your employer doesn’t offer health insurance or you cannot afford the plan offered by your employer, you can apply for individual insurance through the Massachusetts Health Connector. If you qualify for subsidized health insurance (i.e. MassHealth, ConnectorCare or Health Safety Net) or have experienced a qualifying life event, you do not need to wait until open enrollment to apply for coverage.
Depending on your income and if you have a change in your household (including marriage, having children, and more), you may be able to apply for health insurance outside of Open Enrollment – you can always check in with our HelpLine for more information. However, we recommend enrolling in insurance during Open Enrollment if possible.
Note: This is different than employer-sponsored insurance. If you receive health insurance through your job, you should ask your employer for more information about your options and their open enrollment period.
In Massachusetts open enrollment for plans on the Massachusetts Health Connector is annually from November 1st to January 23rd. This open enrollment timeframe only applies to Massachusetts.
You can see what insurance plans are being offered, see how much financial assistance you are eligible for, and enroll in a health insurance plan on the Massachusetts Health Connector website: https://www.mahealthconnector.org/
Shop around to see what plans have your doctors and medications at the prices you are looking for!
Massachusetts residents who need health insurance coverage can visit MAhealthconnector.org to complete an application and explore available coverage and plans.
In-person assistance with the application and plan selection is available at more than 50 “navigator locations” around the state, where trained staff help find health insurance for people in more than 30 languages.
Residents can find a navigator in their community by clicking the “Help Center” button at the top of the Health Connector’s homepage.
Even if you already have health insurance, it’s still a good idea to confirm that your information is correct before 2023 and to compare your options to make sure that your health plan is still affordable to you. It’s possible that your premiums have changed from last year, so you should double-check now. You can choose to stay with your same plan if it’s still available or shop for other options.
It’s also important to update your information to the Massachusetts Health Connector whenever you have a change to report, including changes in income and changes in your household size or address. This information determines the level of financial assistance you will receive to help you pay for insurance, so make sure your information is up-to-date before choosing a plan.
Outside of the open enrollment period, you need to experience “qualifying event” such as a change in your household size (getting married, divorced, having a child, etc.), a change in income, or a loss of your current insurance in order to get most private insurance. However, if you are eligible for certain health care plans such as MassHealth, Health Safety Net, or ConnectorCare, you can apply at any time of the year. You can check what plans you qualify for on the Massachusetts Health Connector.
If you’re unsure if you can get insurance outside of open enrollment, you can check with our HelpLine at (800) 215-2454
Partly due to actions on the federal level, health insurance costs are increasing throughout the country, including in Massachusetts.
If you see an increase in the price of your insurance, you may be able to find a lower-cost option on the Massachusetts Health Connector, or you can buy a health care plan directly through an insurance company.
However, if you qualify for lower-cost plans through the Massachusetts Health Connector, your costs probably won’t be increasing, and they may even go down – many people qualify for lower-cost plans, so be sure to explore your options!
You can visit the Massachusetts Health Connector to create an account, apply for insurance, and learn what low-cost options are available to you.
You are eligible for lower-cost plans based on your income level and household size. These income limits change annually, so you may be eligible for a lower cost plan this year even if you weren’t in the past. Check the options available for you on the Massachusetts Health Connector website or call our HelpLine at (800) 215-2454 if you are unsure about your eligibility for lower-cost plans.
You should explore the plans available through the Massachusetts Health Connector. Although some plans are increasing in price, other plans may still be affordable for you. By switching to a different plan, you may have lower costs. You can compare all your options on the Massachusetts Health Connector website.
If the plans available to you on the Massachusetts Health Connector still seem too expensive, you can also contact insurance companies directly to see if they are offering lower-cost plans that aren’t available on the Massachusetts Health Connector’s website.