Would Medicare Open Enrollment Exist Under Medicare for All?

We’ve been thinking a bit about which of the more annoying pieces of Medicare might stick around if Medicare for All legislation is passed. Among them: Annual open enrollment and “Initial Enrollment Periods,” or IEPs.

First, some basic information. It’s currently Medicare open enrollment season, which runs from October 15 until December 7 each year. This is a time when many older Americans think about their past, current, and future healthcare needs. Many American seniors sign up for the coverage they need during their personal Initial Enrollment Period, which runs from three months before they turn 65 until three months after their birthday. The Open Enrollment Period is a time when seniors who missed either IEP can find a plan, but it is also a time when seniors can change their coverage to better accommodate new or predicted needs.

This begs the question: Under Medicare for All, would we still have these unnecessarily complicated sign-up processes? Like so much of healthcare legislation, it would depend on which pieces of Medicare our representatives prioritize.

Currently, Medicare covers most of the basic costs for healthcare, but many still pay extra for something called “Medicare Advantage.” These plans are approved public-private partnerships that offer supplemental care to seniors, like treatments for chronic illnesses and certain over-the-counter drugs.

Most older Americans enroll in Medicare parts A and B, but medically complicated Americans typically sign up for Medicare bundles. This often includes:

  • Medicare Part A (hospital insurance)
  • Medicare Part B (medical insurance)
  • Medicare Part C (supplemental health care)
  • Medicare Part D (drug coverage)

These different plans provide a constellation of coverage. For example, while Medicare Part B will cover urgent care visits, you’ll need Medicare Part D to pay for any resulting prescription drugs. This means that, while most Americans can get through the door of a medical service provider, they’ll often need to cover at least some type of cost on their own.

In an ideal world, Medicare for All would scrap this nonsense and provide free, open health care, regardless of an individual’s needs. But, before we get there, a partially subsidized single-payer system is the more likely scenario. It’s possible that the first iteration of Medicare for All automatically enrolls all Americans in something similar to Parts A and B, but residents are still required to pay monthly premiums (or out of pocket) to access services normally provided under Parts C and D. If this is the plan our representatives choose to pursue, we’ll continue to see annual Open Enrollment Periods until drug coverage and supplemental care is recategorized.