6 Medicare Enrollment Periods You Need To Know

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6 Medicare Enrollment Periods

If you’re eligible for Original Medicare, Part A, and Part B, generally you can only enroll, switch plans, or drop a plan at certain times of the year. The same is true for Medicare Advantage and prescription drug plans. This article “ 6 Medicare Enrollment Periods You Need To Know” will teach you when and what you can do. 

Have you ever wanted to make changes to your Medicare coverage or switch plans — only to realize you couldn’t because you were outside of any enrollment periods! 

Don’t be unprepared.  Here is an overview of the different enrollment periods for each type of Medicare coverage, so you can plan ahead.

Enrolling into Medicare

Most people qualify for Medicare because of age. Your first chance to sign up for Medicare is usually your Initial Enrollment Period. Most people don’t need to sign up; you’re automatically enrolled in Medicare if you’re already receiving Social Security or Railroad Retirement Board benefits when you turn 65. 

However, if you do need to manually enroll, you can do so (through Social Security) during your Initial Enrollment Period.

1. Initial Enrollment Period

The Initial Enrollment Period beginnings 3 months before your 65th birthday. It included the month of your birthday and continues for an additional 3 months after your birthday month. So, you have a total of 7 months to enroll in Original Medicare if you have not been enrolled automatically. 

Welcome to Medicare, now what?

Once you are enrolled, you will want to make the decision on how you’re going to protect yourself from the financial gaps left behind by Medicare. Most people choose a Medigap policy to cover the percentage of the bills that Medicare does not pay for. 

If you are like the 60%+ of people than you need to know about the Medigap Open Enrollment Period (OEP).

2. Medigap Open Enrollment Period (OEP)

This period begins on the first day of the month that you are both enrolled in Medicare Part B and aged 65 or over, and lasts for six months. 

During this time, you generally have the guaranteed-issue right to buy a Medigap plan of your choosing, as long as you’re enrolled in Medicare Part A and Part B and you live within the Medigap plan’s service area.

Medigap Open Enrollment Period

An insurance company may not deny you enrollment in a Medigap policy based on any pre-existing conditions* during your Medigap OEP. If you miss this enrollment period, you can still apply for a plan anytime, but you may be subject to medical underwriting. 

A Medicare Supplement insurance company might turn down your application or charge more for a health condition.

What about Advantage plans (Part C)?

Most people think that once you join an Advantage plan that you are leaving Medicare, that is not the case. You still have Original Medicare and you need to keep paying your Medicare Part B monthly premium, but now all your healthcare is being handled by the company which runs the plan. 

In return for taking care of your healthcare needs, Medicare pays that company a monthly fee. 

Once you have signed up for Original Medicare, you can sign up for an Advantage plan. The same Initial Enrollment Period of 7 months applies to Advantage plans as for Orignal Medicare. 

What If I miss the Initial Enrollment Period?

Sometimes life just flies by and we don’t even notice how fast it goes. If you miss your Initial Enrollment Period, you might have to wait a while before you can sign up again. You will have to wait for the General Enrollment Period. 

3. General Enrollment Period (GEP)

If you miss the Initial Enrollment Period, your next chance to enroll in Medicare is the General Enrollment Period, from January 1 to March 31 each year. You can sign up for Medicare Part A and/or Part B during this time. Your coverage will start on July 1st of that year. 

Once I'm all signed up, when can I make changes?

AEP

The Medicare Annual Enrollment Period – AEP for short – is a set time each year for changing your Medicare coverage choices if you choose to. AEP runs from October 15 to December 7. New coverage choices go into effect on January 1.

The specific actions you can take during AEP depend on your current coverage. Let’s break it down based on the coverage you have. 

I currently have Original Medicare (Parts A & B)

  • Join a Medicare Advantage plan (Part C) with or without built-in drug coverage. Note that you may be charged a penalty if you do not currently have other creditable drug coverage.
  • Join a stand-alone Medicare prescription drug plan (Part D). A penalty may apply here as well if you do not currently have other creditable drug coverage.
  • Make no changes and your current coverage will renew as is.

I currently have a Medicare Advantage plan (Part C)

  • Switch from your current Medicare Advantage plan to another Medicare Advantage plan with or without built-in drug coverage.
  • Drop your Medicare Advantage plan and go back to Original Medicare.
  • Join a stand-alone Medicare prescription drug plan if you go back to Original Medicare or if you switch to a Medicare Advantage plan that does not include drug coverage.
  • Drop Medicare prescription drug coverage completely. Note that you may be charged a penalty if you decide you want drug coverage again later.
  • Make no changes and your current coverage will renew as is.

I have Original Medicare (Part A & Part B) and a drug plan (Part D).

  • Join a Medicare Advantage plan (Part C) with or without built-in drug coverage.
  • Switch from your current Medicare prescription drug plan to another Medicare prescription drug plan.
  • Drop Medicare prescription drug coverage completely. Note that you may be charged a penalty if you decide you want drug coverage again later.
  • Make no changes and your current coverage will renew as is.

Don’t get confused by all these different enrollment periods, If you have questions about anything relating to this article or any general questions about Medicare, don’t hesitate to call me directly on my cell phone. My name is Daniel and my cell number is 727-777-3661. You can also visit us online at www.LocalMedicareServices.com to schedule an appointment.

What If I don't like the plan I chose?

Unhappy with your Medicare Advantage Plan (Medicare Part C), you have options?

4. Medicare Advantage Open Enrollment Period

Each year, there’s a Medicare Advantage Open Enrollment Period from January 1 – March 31. During this time, if you’re in an Advantage Plan and want to change your health plan, you can do one of these:

  • Switch to a different Medicare Advantage Plan with or without drug coverage
  • Go back to Original Medicare and, if needed, also join a Medicare Prescription Drug Plan
MAOEP

If you switch Medicare Advantage Plans or go back to Original Medicare with or without a Medicare drug plan, your new coverage will start the first day of the month after your new plan gets your request for coverage. 

Keep in mind, if you go back to Original Medicare now, you may not be able to buy a Medicare Supplement (Medigap) policy.

Remember, Medicare Advantage Open Enrollment Period ends March 31.

Life has its own plans...

5. Special Enrollment Period – Qualifying Life Events

People who already have Medicare may qualify for a 2-month Special Enrollment Period with certain qualifying life events. This Special Enrollment Period lets you switch to a different Medicare Advantage or Part D prescription drug plan.

You may qualify for a 2-month Medicare Special Enrollment Period in the following situations:

  • You move out of your plan’s service area.
  • Your plan closes, stops serving the area where you live, significantly reduces its provider network or your plan consistently receives low Medicare star ratings.
  • You want to enroll in a 5-star plan at any time or drop your first Medicare Advantage plan within 12 months of enrolling.
  • You move into or out of a qualified institutional facility, like a nursing home.
  • You are enrolled in or lose eligibility for a qualified State Pharmaceutical Assistance Program.
  • You have Medicare financial assistance such as Medicaid, a Medicare Savings Program or Extra Help, or you gain or lose eligibility for any of these.
  • You enroll in or leave the Program of All-Inclusive Care for Elderly (PACE).
  • You gain or lose eligibility for a Special Needs Plan.

Some situations not listed here may qualify for a Special Enrollment Period as well.

6. Special Enrollment Period – Working Past 65

For people who work past 65 and qualify to delay Medicare with creditable employer coverage, there is an 8-month Special Enrollment Period that allows you to enroll in Part A (if you haven’t yet), Part B , Part C and Part D without late penalties.

This Special Enrollment Period is tricky though. Why? Because while you have the whole 8 months to get Parts A & B, you only get the first 2 months to enroll in Part C or Part D without penalty. 

If you enroll after the two-month mark, you’ll face late enrollment penalties for Part D (regardless of whether you end up with a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage).

To qualify for the Part B Special Enrollment Period, you must have creditable employer or union health coverage. 

Your Special Enrollment Period will begin eight months after your employer coverage ends or you leave your job, whichever happens first.

If you have questions about anything relating to this article or any general questions about Medicare, don’t hesitate to call me directly on my cell phone. My name is Daniel and my number is 727-777-3661. You can also visit us online at www.LocalMedicareServices.com to schedule an appointment.

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Daniel Vujinovic

Daniel Vujinovic

Daniel Vujinovic has been a licensed Insurance Agent since 2012. He started working in the corporate insurance world at first to get his feet wet. After about a year in corporate, he decided that he can help more people as an independent agent who can offer more companies and products. As he started growing his book of business, Daniel and his wife Shannon decided to open LocalMedicareServices.com and continue growing a local presence in his community.

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