Medicare Enrollment

There are several different medicare enrollment periods, which makes the process confusing.  The definitions of each enrollment period are below.  Following this are more detailed explanations of each of the them.

• Initial Enrollment Period (IEP) – 7 month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65.  This period marks the first time most people are eligible for Parts A and B.
• Special Enrollment Period (SEP) – A period of time after your IEP when you may have a chance to sign up for Part A and/or Part B without paying a late enrollment penalty.  It’s available if you were covered under a group health plan during your IEP and didn’t sign up for Part A and/or Part B.
• General Enrollment Period (GEP) – If for some reason you missed the IEP and didn’t qualify for a SEP you can sign up for Part A and/or B each year from January 1 – March 31.  NOTE: You may be subject to late enrollment penalties.
• Annual Enrollment Period (AEP) – Every year between October 15 and December 7 anyone with Original Medicare can join, switch or drop a Medicare Advantage Plan or a Part D plan.
• Medicare Advantage Open Enrollment Period – January 1 – March 31 each year; allows those people that already have a Medicare Advantage plan to switch plans or go back to Original Medicare.  Note this period used to be called the Medicare Advantage Disenrollment Period (MAPD).
• Medicare Supplement Open Enrollment Period – 6 month period that begins from your Part B start date.  During this time, you can’t be denied a Medigap policy or charged more due to health problems.

Initial Enrollment Period

You will be automatically enrolled in Part A and Part B if you are receiving Social Security benefits when you turn 65.  You will receive your Medicare card in the mail 3 months before your 65th birthday.

If you are not receiving Social Security as you’re nearing 65, then you’ll need to sign up for Medicare during your Inital Enrollment Period, or IEP.  It is advised you contact Social Security 3 months before you turn 65.  You can do this a few different ways:

• •   Apply online at https://ssa.gov/benefits/medicare
  •   Visit your local Social Security office
  •   Call Social Security at 1-800-772-1213

Should you delay enrolling in Part B?

You may consider opting out of Part B if you have creditable health coverage from your employer at the time of your IEP.  If you do not opt out, your monthly Part B premiums will be deducted from your Social Security Benefits.

Part D enrollment

The IEP is the best time to enroll in a stand alone Part D prescription drug plan (PDP).  A Part D plan is paired with a Medicare Supplement, or Medigap, plan to complete your Medicare coverage.

Medicare Supplement enrollment

Note the Medicare Supplement Open Enrollment Period overlaps the IEP, so this is an important time to remember. It’s important because it’s the only time you can get Medigap coverage with no medical underwriting.  The exception to this is when you have a guarantee issue right.

Medicare Advantage enrollment

If you choose to replace Original Medicare with a Medicare Advantage plan, then the best time to do this is during your IEP.  A vast majority of these plans include prescription drug coverage, which means you don’t need a stand alone PDP.

Special Enrollment Period

A Special Enrollment Period is an opportunity to enroll in Part A and/or Part B after your IEP.  It’s available if you were covered under a group health plan from your or your spouse’s employer (20+ employees) during your IEP and you chose to delay enrollment.  You can continue to delay enrolling in Part B as long as you have creditable coverage.

You can enroll in Part B using a Special Enrollment Period during the following times:

• During the 8 month period that begins the month after employment ends or the coverage ends, whichever comes first
• Anytime you’re still covered by the group health plan

General Enrollment Period

You may be forced to enroll in Medicare Part A and/or Part B during the GEP, which runs from January 1 – March 31 each year.  This can happen if you failed to enroll in Part B during your IEP (the 7 months around your 65th birthday) or any subsequent SEP (if you delayed enrollment due to having employer coverage).

There are two issues you need to be aware of after enrolling in Part B during the GEP:

1. •   Your coverage may not start until July 1
   •   You will likely pay a late enrollment penalty

The late enrollment penalty for Part B is an additional 10% of your monthly premium for every 12 months you could have had Part B.  You will have to pay this as long as you have Part B.

You can also join a Medicare Advantage or a stand alone Part D drug plan after you enroll in Part B during the GEP.  You can do this from April 1  – June 30.  Your coverage will start on July 1.

 Annual Enrollment Period

During the AEP, October 15 – December 7 each year, you can make changes to your Medicare Advantage plan or Part D prescription drug plan.  The coverage will go into effect on January 1.  The following changes are possible:

• • Change from Original Medicare to a Medicare Advantage plan – or vice versa
  • Switch Medicare Advantage plans
  • Join, switch or drop a Part D prescription drug plan

Medicare Advantage Open Enrollment Period

During this time period, January 1 – March 31, you are allowed to make one change to your Medicare Advantage plan and possibly to your Part D prescription drug plan.  You can do one of the following:

• • Switch Medicare Advantage plans
  • Disenroll from your Medicare Advantage plan and return to Original Medicare.  You can then join a stand alone Part D drug plan

You are NOT allowed to do the following:

• • Switch from Original Medicare to a Medicare Advantage plan
  • Switch from one Medicare prescription drug plan to another
  • Join a Medicare prescription drug plan if you’re in Original Medicare

Medicare Supplement Open Enrollment Period

You are eligible to enroll in any Medicare Supplement, or Medigap, plan during the Medigap Open Enrollment Period without answering any health questions.  For a vast majority of people, there is only one Medigap Open Enrollment Period.  This period begins on your Part B start date and ends 6 months later.  Most people will be 65 years or older during this period.

However, some people will have a Medigap Open Enrollment Period before age 65.  This happens if they qualified for Medicare because of a disability.  These people will actually have two Medigap Open Enrollment Periods.  The first one will start on their Part B start date and end 6 months later.  Their second Medigap Open Enrollment period will start in the month they turn 65 and end 6 months later.

To learn more about what Medicare Supplement coverage can do for you, see Medigap.

If you have delayed enrolling in Part B due to having employer health coverage, then your Medigap Open Enrollment Period starts when you sign up for Part B.

Keep the following helpful facts in mind:

• This is a one time 6 month period (exception noted above), not an annual period
• There are many enrollment periods in Medicare.  Don’t confuse this enrollment period with the one that occurs in the fall every year, the AEP (see above)
• If you happen to miss enrolling in a Medigap policy during this time you can still enroll anytime in the future.  However, an important difference being you will have to undergo medical underwriting.  This involves answering health questions and listing your prescription medications (unless you have a guarantee issue right), which means you may be denied coverage.