Medicare Enrollment Periods
There are several key time-periods when you can enroll in Medicare, and each of those periods has specific rules for applying, affecting when your coverage will begin. Understanding when you can enroll and the best time to do so is an important part of your Medicare experience. It can save you from making costly mistakes.
Contact Us to Help You Navigate Your Medicare Options
Roman Brokers Insurance in Mesa , AZ represents a wide range of Medicare plans and options. We are dedicated to helping you develop a Medicare strategy that best suits your needs. No one strategy is best for everyone.
Roman Brokers Insurance compares companies and plans for the best possible combinations of quality, cost, coverage and compatibility. A licensed, insured, independent agent will walk you through the process and give a detailed explanation of the differences in each plan. Contact Roman Brokers Insurance today at 480-834-7447. We can provide guidance at no cost and no obligation to you!
1. Initial Enrollment Period
The Initial Enrollment Period (IEP) is the first time you can sign up for Medicare. You may join Medicare Parts A, B, C and D during this period. Typically, the time frame for your IEP is:
- The 3 months before your 65th birthday,
- The month of your birthday, and
- The 3 months after your birthday.
Your coverage will start no sooner than your month of you 65th birthday. So, if your birthday is in July, your Initial Enrollment Period begins April 1 and ends October 31.
If you miss this period, you will have another enrollment period later, but you may have to pay more. You also could be left without health coverage. Learn about Part B late enrollment penalties and Part D late enrollment penalties.
When does my Part B coverage begin?
For example: if you turn 65 in May, then your IEP is from February to August. If you enroll in Part B during:
- February, March or April, your coverage would begin May 1 (your birth month)
- May, your coverage would start June 1
- June, your coverage would start August 1
- July, your coverage would start October 1
- August, your coverage would NOT start until November 1
You can see that signing up early is usually best!
If your birthday happens to fall on the 1st day of any month, your coverage will begin on the 1st of the month prior to your birth month. In other words, you can enroll 4 months before your birth month.
Mrs. Munoz is currently eligible for Medicare, and her Initial Enrollment Period ended on May 31, 2017. She doesn’t have prescription drug coverage from any other source. She didn’t join by May 31, 2017, and instead joined during the Annual Enrollment Period (AEP) that ended December 7, 2019. Her drug coverage was effective January 1, 2020.
When does my Part D drug coverage begin?
Similar to enrolling in Part B, the start date of your Part D Prescription Drug coverage depends on when you enroll.
In the example above, you turned 65 in May. Your IEP for Part D would be the same 7-month period centered around your 65th birthday. Your IEP is from February to August. Keep in mind that Part D coverage cannot start before your Part A and/or B begins. If Medicare Part A and/or B are effective, and you enroll in Part D during:
- February, March or April, your coverage will be effective May 1
- May, your coverage begins June 1
- June, your coverage starts July 1
- July, your coverage starts August 1
- August, your coverage starts September 1
2. Special Enrollment Period
A Special Enrollment Period (SEP) can be used when you qualify to delay your enrollment in Medicare Parts A, B, C & D. These SEPs are only available for specific situations.
Special Enrollment for Parts A and B
You are eligible for a Special Enrollment Period (SEP) to enroll in Parts A and/or B:
- Any time you are still covered by the employer or union group health plan through you or your spouse’s current or active employment, OR
- During the 8 months following the month the employer or union group health plan coverage ends, or when the employment ends (whichever is first).
- See more about employer coverage and Medicare here.
If you miss your special enrollment period, you may have to pay a lifetime late enrollment penalty when you join.
If you are under 65, disabled and working (or you have coverage from a working family member), the Special Enrollment Period rules also apply as long as the employer has more than 100 employees.
Special Enrollment for Parts C and D
You may have waited to enroll in a Medicare Advantage plan (also called Part C) or a Prescription Drug plan (Part D) if you were working for an employer with more than 20 employees when you turned 65, and had healthcare coverage through your job or union, or through your spouse’s job. The SEP for a Medicare Advantage plan (Part C) or Part D prescription drug coverage is 63 days after the loss of employer healthcare coverage:
- SEP for Medicare Advantage Part C (you must already be enrolled in Parts A & B): Enroll during the 63 days after the employer or union group health plan coverage ends, or when employment ends (whichever is first).
- SEP for a prescription drug plan Part D (you must already be enrolled in Part A and/or B): Enroll during the 63 days after you or your spouse’s employer/union or Veteran’s Administration coverage ends, or when employment ends (whichever is first).
Certain events trigger other SEPs for Part D plans. For example, you can switch plans if:
- You move out of the plan service area, OR
- You lose credible drug coverage from your employer, OR
- You gain or lose Medicaid eligibility, OR
- You have a chronic condition and you wish to enroll in a Special Needs Plan designed to serve people with your condition, OR
- You dropped a MediGap plan to enroll the first time in a Medicare Advantage plan and you are still in your “trial period,” OR
- You enter, leave or live in a nursing home, OR
- Your plan changes and no longer serves your area, OR
- You get Medicare Extra Help to reduce your Medicare prescription drug costs.
3. General Enrollment Period
If you miss your Initial Enrollment Period (IEP) or your Special Enrollment Period (SEP), you will get another chance to enroll in Medicare. You can sign up for Medicare Parts A & B between January 1 and March 31 each year. Your Medicare coverage would begin on July 1 of the same year.
It is important to note that if you need to buy Part A, you must also enroll in Part B at this time.
The downside to missing your IEP or SEP is that you will be likely to incur lifetime late enrollment penalties for both Part B and Part D. Learn more about the Part B late enrollment penalty and Part D late enrollment penalty.
4. Annual Enrollment Period
The Annual Enrollment Period (AEP) – sometimes called the Annual Election period or Open Enrollment Period – occurs each year from October 15 to December 7. During AEP, if you:
- Have Medicare Parts A & B, you can enroll in a Medicare Advantage plan (Part C).
- Have Medicare Part C, you can switch back to Parts A & B.
- Have or enroll in Medicare Parts A or B, you can join, drop or switch a Part D prescription drug plan.
- Have Medicare Advantage (Part C), you can enroll in a different Part C plan.
If you change coverage during the AEP, your coverage will start January 1 of the following year.
5. Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment Period (OEP), from January 1 through March 31, provides an additional opportunity to change your Medicare Advantage plan outside the Annual Enrollment Period (AEP), which is from October 15 through December 7.
There is also an individualized Medicare Advantage Open Enrollment Period for new Medicare beneficiaries with both Medicare Parts A and B who enroll in a Medicare Advantage plan during their initial coverage election period. These individuals have three months after initial coverage begins to switch Medicare Advantage plans. During Medicare Advantage OEP, beneficiaries have a one-time opportunity to either:
- Switch to a different Advantage plan, OR
- Switch from a Medicare Advantage plan to Original Medicare and a stand-alone Part D prescription drug plan.
Even if you just enrolled in a plan during the Annual Enrollment Period (AEP), you may want to re-evaluate your choice during the first 3 months of coverage. Here are a few reasons to consider changing plans during OEP.
This enrollment period does NOT allow for Part D changes for individuals enrolled in Original Medicare (Parts A and B).
6. Medigap Open Enrollment Period
Buying a Medicare Supplement (Medigap) policy during your 6-month Medigap open enrollment period allows you to buy any Medigap policy sold in our state without answering health questions, even if you have health problems that might otherwise disqualify you. The Medigap OEP automatically starts the month you turn 65 or older AND you are enrolled in Medicare Part B.
If you apply for Medigap coverage after your OEP, you will not be guaranteed the issue of a Medigap policy if you don’t meet the medical underwriting requirements, unless you qualify for a special “guaranteed Issue” situation.
If you have Parts A & B (Original Medicare) and a Medigap policy, you should weigh your decisions very carefully before switching to a Medicare Advantage plan . You may not qualify again for a Medigap plan in the future if you decide to switch back.
Contact Us to Help You Navigate Your Medicare Options
Roman Brokers Insurance in Mesa, AZ represents a wide range of Medicare plans and options. We are dedicated to helping you develop a Medicare strategy that best suits your needs. No one strategy is best for everyone.
Roman Brokers Insurance compares companies and plans for the best possible combinations of quality, cost, coverage and compatibility. A licensed, insured, independent agent will walk you through the process and give a full explanation of the differences in each plan. Contact Roman Brokers Insurance today at 480-834-7447. We can provide guidance at no cost and no obligation to you!