Explaining the Different Enrollment Periods for Medicare

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Explaining the Different Enrollment Periods for Medicare

By Daniel Petkevich

Feb 3, 2023

Don't Miss Your Window: Your Guide to Medicare Enrollment Periods

The Medicare enrollment periods are complicated. But it's important to stay informed and up-to-date on the enrollment periods to avoid penalties or coverage gaps.

Have more questions about Medicare?

What are the Different Medicare Enrollment Periods?

Medicare

is a federal health insurance program in the United States that provides coverage for people 65 or older, certain younger people with disabilities, and people with

End-Stage Renal Disease (ESRD).

If you’re eligible for Medicare, there are several enrollment periods when you can

coverage or make changes to your existing coverage.

The six different Medicare enrollment periods include the following:

Initial Enrollment Period
General Enrollment Period
Annual Enrollment Period
Open Enrollment Period
Medigap Open Enrollment Period
Special Enrollment Period

Medicare Enrollment Periods

Let's look at each of the enrollment periods.

1. Initial Enrollment Period

If you're about to turn 65 and are newly eligible for Medicare, this is your gateway to start receiving your Medicare benefits. If you have a disability, end-stage renal disease (ESRD) or

ALS

(also called Lou Gehrig’s disease), you may be eligible for Medicare even before you turn 65.

The Initial Enrollment Period (IEP) is a seven-month window that enables you to enroll in Medicare if you're about to turn 65, still working, and not yet getting social security or railroad benefits.

If you're already receiving social security or railroad benefits, you'll be automatically enrolled in Medicare Parts A and B.

The IEP depends on your date of birth

If your birthday falls on the first of the month, it begins 4 months before your birth month and extends until 2 months after your birth month; otherwise...
It begins 3 months before your birth month and extends until 3 months after your birth month

For example, if your birthday falls in February, your IEP starts in November and ends in May. But if your birthday is on the 1st of February, your IEP begins in October and ends in April.

During your IEP, you can:

Enroll in Original Medicare (Part A and Part B)
Enroll in Medicare Part D (Medicare prescription drug plan)
Enroll in Medicare Part C (Medicare Advantage Plan)

Failing to enroll during this 7-month Initial Enrollment Period may result in a monthly late enrollment penalty for as long as you have Part B coverage. In addition, you may incur a Part A penalty if you have to pay a Part A premium.

Initial Enrollment Period

‎

2. General Enrollment Period

The General Enrollment Period runs from January 1st to March 31st and is the time you can enroll in Medicare Part A and B if:

You missed enrolling in Medicare during your IEP
You don't qualify for a Special Enrollment Period

If you're enrolling in Medicare during the General Enrollment Period, your coverage will begin the following month after you sign-up (Starting January 1, 2023).

You may incur late penalties for the duration of your enrollment in Medicare if you don't enroll in time. So, in addition to paying your regular premiums for Part B (and Part A, if applicable), you'll also have to pay a late penalty as long as you remain enrolled in Medicare.

3. Annual Enrollment Period

If you're unhappy with your current plan, you can change your existing Medicare coverage during the

Annual Enrollment Period (AEP)

. The AEP extends from October 15th until December 7th.

During this period, you can:

Switch from Original Medicare to a Medicare Advantage Plan — or vice versa
Switch from one Medicare Advantage Plan to another Medicare Advantage Plan
Switch from Medicare Advantage Plan to Medigap Plan
Switch from one Prescription Drug Plan to another
Enroll in Medicare Part D
Unenroll from a Prescription Drug Plan

If you switch your existing plan or enroll in a new plan during the AEP, your coverage will begin on January 1st.

If you're happy with your current plan, your plan will automatically renew on January 1st.

As a Fair Square Medicare client, you can rest assured that we will review your coverage and costs yearly during AEP to ensure you're not paying too much.

4. Open Enrollment Period

If you're currently enrolled in a

Medicare Advantage Plan

but are unhappy with its coverage, Medicare offers a one-time opportunity to switch your plan during the Open Enrollment Period (OEP). This period runs from January 1st until March 31st.

During the OEP, you can:

Switch from one Medicare Advantage Plan to another (with or without drug coverage)
Unenroll from your Medicare Advantage Plan and return to Original Medicare
Enroll in a prescription drug or Medicare Part D plan if you're returning to Original Medicare

But, during this period, you can't:

Switch from Original Medicare to a Medicare Advantage Plan
Join a Medicare drug plan if you're in Original Medicare
Switch from one Medicare drug plan to another if you're in Original Medicare

If you make any changes to your Medicare coverage during the OEP, the new benefits will begin the following month.

Note: If you enrolled in a Medicare Advantage Plan during your IEP, you can

switch to another Medicare Advantage Plan

(with or without drug coverage) or return to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare.

General, Open and Annual Enrollment Periods

‎

5. Medigap Open Enrollment Period

If you plan to supplement your Original Medicare coverage with a Supplemental Plan or a

Medigap Plan

, the best time to do this is during the Medigap Open Enrollment Period.

The Medigap Open Enrollment Period is a 6-month window that starts from the month you turn 65 and have Medicare Part B and ends 5 months after your birth month. For example, if your 65th birthday falls in February, your Medigap Open Enrollment Period begins in February and extends until July.

During the Medigap Open Enrollment Period, you'll typically get better pricing and a wider choice of Medigap plans, regardless of your health status. You can purchase any plan offered in your state without undergoing medical underwriting.

Note: if you choose to enroll in a Medigap plan outside your Medigap Open enrollment period, insurance companies may use medical underwriting to decide whether to accept your application (and how much to charge you for the plan) unless you have

guaranteed issue rights

Medigap Open Enrollment Period

‎

6. Special Enrollment Period

Medicare beneficiaries may be able to make changes to their existing Medicare health and drug coverage outside the regular enrollment periods if they qualify for the

Special Enrollment Period.

You're eligible for the Special Enrollment Period if:

You move to a different location
You lose your current coverage
You have a chance to get other coverage
Your plan changes its contract with Medicare
The state you live in grants SEPs

During the Special Enrollment Period, you can join, switch or drop a Medicare Advantage Plan or a Prescription Drug Plan.

Medicare Enrollment Periods Are Complicated

Understanding different Medicare enrollment periods helps you make informed decisions about your healthcare coverage, so you have the peace of mind that comes with knowing you're covered. Taking advantage of your Medigap Open Enrollment Period allows you to choose any plan, even if you have pre-existing health conditions.

Failure to enroll in Original Medicare or a prescription drug plan at the right time can result in unnecessary penalties.

Fair Square Medicare

is here to help. Call us at 1-888-376-2028 if you have any additional questions about Medicare enrollment periods. Our experienced health insurance advisors have helped hundreds of Medicare beneficiaries make informed decisions by selecting the right plan for their needs and budget.

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Explaining the Different Enrollment Periods for Medicare

Don't Miss Your Window: Your Guide to Medicare Enrollment Periods

Have more questions about Medicare?

What are the Different Medicare Enrollment Periods?

1. Initial Enrollment Period

2. General Enrollment Period

3. Annual Enrollment Period

5. Medigap Open Enrollment Period

6. Special Enrollment Period

Medicare Enrollment Periods Are Complicated

Stay Up to Date on Medicare!

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