Congratulations, you’ve turned 65 and qualify for Medicare! Now what?
Your calendar is full of important dates: a loved ones’ birthday, your wedding anniversary, meetings, Doctor appointments and more. These and other important moments you’ll want to make sure to remember, but how about when you can sign up for a Medicare plan? The timeframe for enrolling in a Medicare plan is called the “enrollment period”. There are many different enrollment periods, but not all are relevant to you.
Here are the 6 enrollment periods you should know:
1. Initial Enrollment Period
The Initial Enrollment Period (IEP) is when you initially become eligible for Medicare. Now you can enroll in a Medicare plan. You have a seven-month window around the month you turn 65 to first sign up for a Medicare plan. This seven-month period consists of the three months before your birth month, your birthday month and three months following your birth month. During this time, you can:
- Enroll in Medicare Parts A & B
- If you are receiving Social Security benefits, you will automatically be enrolled into Medicare Parts A & B with effective dates that are the first day of the month you were born. If you were born on the 1st of the month, your start date will be the 1st of the month prior. You should receive your Medicare card about 3-months prior to your birth month.
- If you are not receiving Social Security benefits, then you need to register and signup on Medicare.gov or call your local Social Security office to schedule a meeting with a representative. You want to start this process about 100 days prior to your birth month.
- Enroll in a stand-alone Medicare prescription drug plan (Part D)
- Enroll in a Medicare Supplement plan
- Enroll in a Medicare Advantage plan (Part C)
WARNING: If you miss the initial enrollment period and don’t sign up for Medicare Parts A, B or Part D when you’re first eligible, your coverage may be delayed, or you could face lifetime penalties later when you enroll and that may end up costing you more. (Refer to #2 below)
People under 65 may be Medicare eligible with certain disabilities, end-stage renal disease (ESRD) or ALS (also called Lou Gehrig’s disease).
2. General Enrollment Period
During the General Enrollment Period, if you are currently enrolled in a Medicare Advantage plan, you can switch to another Medicare Advantage plan or switch to Original Medicare. During this period, you can only make the switch one time. The timeframe for the General Enrollment Period is from January 1 – March 31.
If you missed your IEP window, you could also sign up for Part A and/or Part B between January 1 and March 31. If you sign up during the General Enrollment Period, your coverage will begin on July 1. You may be subject to penalties.
3. Annual Enrollment Period
The Annual Enrollment Period (AEP) for Medicare is from October 15 through December 7. During this period, anyone can make changes to their coverage and enroll in a Medicare plan each year. These changes can include:
- If you have Original Medicare, you can switch to a Medicare Advantage plan
- If you have a Medicare Advantage plan you can switch to Original Medicare.
- You can switch from one Medicare Advantage plan to a different Medicare Advantage plan.
- You can join or drop a Medicare prescription drug plan.
If you elect a replacement plan in this Annual Enrollment Period, your new coverage will begin at the start of the following year on January 1st.
4. Special Enrollment Period
This Special Enrollment Period (SEP) is one of the more complicated Medicare enrollment periods. Not every Medicare beneficiary will be eligible for this SEP and for those that do qualify they will have to prove their qualification.
During the SEP, you may join, switch, or drop a Medicare Advantage or prescription drug plan outside the basic enrollment periods. To qualify for an SEP, certain events must occur that require you to change your coverage. Common scenarios include:
- The most common one is when your employer-provided plan ends.
- Your plan no longer is available in your area.
- You lose or gain Medicaid coverage.
- You move out of your plan’s service area.
Rules vary depending on what changes you can make and when you can make them. Please visit Medicare.gov for more details.
5. Medicare Supplement Open Enrollment Period
If you want to supplement Original Medicare coverage to help offset the additional costs, you can sign up for a Medicare Supplement Plan. Your Medicare Supplement Open Enrollment Period begins the month your Medicare Part B becomes effective.
That point starts a six-month enrollment period that grants you guaranteed issue rights for any Medicare Supplement plan (Medigap) you wish to enroll in. Guaranteed issue rights mean you cannot be declined because of your health. If you enroll outside this period, you may be required to answer health questions and may be denied coverage.
6. Medicare Advantage Open Enrollment Period
This period is very similar to the General Enrollment Period. This window remains open from January 1 through March 31. It allows individuals enrolled in a Medicare Advantage plan to make a one-time election to:
- Go to another Medicare Advantage plan with or without prescription drug coverage
- Go back to Original Medicare. You’ll also be able to enroll in a Medicare prescription drug plan.
Unlike the General Enrollment Period, your new coverage will start on the first day of the month, following the month you picked your new plan. If you elect to leave your Medicare Advantage plan and go back to Original Medicare, you can add a Medicare Supplement plan. Be aware: Unless you’re still within the six-month Medicare Supplement Enrollment Period, most insurance companies will require you to answer medical questions to qualify for coverage, and your coverage may be denied.