Medicare Enrollment 101

When can you sign up for Medicare or make change to the coverage you already have?

Here's a summary.

Open Enrollment

Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. Open enrollment runs from October 15 to December 7 each year, with changes effective January 1 of the following year. You can:

  • Change from Original Medicare to a Medicare Advantage Plan
  • Change from a Medicare Advantage Plan back to Original Medicare
  • Switch from one Medicare Advantage Plan to another Medicare Advantage Plan
  • Switch from a Medicare Advantage Plan that doesn't offer drug coverage to a Medicare Advantage Plan that offers drug coverage
  • Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn't offer drug coverage
  • Join a Medicare Prescription Drug Plan
  • Switch from one Medicare drug plan to another Medicare drug plan
  • Drop your Medicare prescription drug coverage completely

Initial Enrollment Period (IEP)

The IEP is a 7-month period that begins 3 months before the month a person turns 65 and ends 3 months after the person turns 65. For someone under age 65 who becomes entitled to Medicare based on disability, entitlement begins with the 25th month of disability benefit entitlement. For these individuals, the IEP begins 3 months before the 25th month of disability benefit entitlement, includes the 25th month, and ends three months after. The IEP for people with ESRD and ALS varies based on their situation.

Coverage begins based on when you enroll during the IEP.  If a person enrolls in the first 3 months of the IEP, coverage begins the first month the person is eligible for Medicare. If a person enrolls in any other month of the IEP, coverage will be delayed. Disabled individuals are automatically enrolled in Medicare Part A and Part B after they have received disability benefits from Social Security for 24 months.

NOTE: In most cases, if someone does not enroll in Part B or premium Part A when first eligible, they will have to pay a late enrollment penalty. The Part B penalty is assessed for as long as the person has Part B. 

General Enrollment Period (GEP)

The GEP takes place from January 1 through March 31 of each year. Part B and Premium Part A coverage begins July 1 of that same year. The General Enrollment Period is a general time to enroll in Medicare if for some reason the person didn’t enroll within the other specified periods. Be aware that coverage will not begin until the following July 1 after enrollment, and Part B premium penalties may apply.

Special Enrollment Period (SEP) for the Working Aged and Working Disabled

Individuals who do not enroll in Part B or premium Part A when first eligible because they were covered under a group health plan based on their own or a spouse's current employment (or the current employment of a family member, if disabled) may enroll during the SEP. The individual can enroll at any time while covered under the group health plan based on current employment, or during the 8-month period that begins the month the employment ends or the group health plan coverage ends, whichever comes first.

NOTE: Individuals with ESRD are not eligible to enroll during the SEP.

Special Enrollment Period (SEP) for International Volunteers

Individuals who do not enroll in Part B or premium Part A when first eligible because they were performing volunteer service outside of the United States for at least 12 months on behalf of a tax-exempt organization and had health insurance that provided coverage for the duration of the volunteer service may enroll during this SEP.

 Source: https://www.cms.gov/medicare/eligibility-and-enrollment/origmedicarepartabeligenrol/index.html

Medicare Advantage Disenrollment Period

No discussion of enrollment periods would be complete without mention of the Medicare Advantage Disenrollment Period (January 1 - February 14), which gives people in Medicare Advantage Plans the opportunity to leave their plans and switch to Original Medicare.

If you switch to Original Medicare during this period, you'll have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.
 
What can't you do during the Medicare Advantage Disenrollment Period?
  • Switch from Original Medicare to a Medicare Advantage Plan
  • Switch from one Medicare Advantage Plan to another
  • Switch from one Medicare Prescription Drug Plan to another
  • Join, switch, or drop a Medicare Medical Savings Account (MSA) Plan

This page on www.medicare.gov explains more about specific sign-up periods during the year.~ 

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