While many people are aware that Medicare coverage often begins at age 65, there are a variety of other opportunities for Medicare-eligible individuals to purchase or change their coverage. It is a common misconception that once you reach retirement age, you can simply sign up for Medicare at any time. There are a wide variety of Medicare enrollment periods with which you should be familiar. These range from annual opportunities to individual- and situation-specific enrollment periods, all of which allow for different coverage purchases and changes.
The primary Medicare Initial Enrollment Period (IEP) spans a 7-month period around your 65th birthday. The IEP includes the 3 months leading up to your birthday, the month you turn 65, and the 3 months immediately following. During the IEP, you can enroll in Original Medicare (Part A and Part B). It is important to complete the enrollment process during the first 3 months of your IEP to ensure you will not see a delay or gap in your coverage. Additionally, enrolling outside of this window could mean you could be required to pay a late enrollment penalty on your Medicare Part B premiums for as long as you hold the policy.
The Medicare Annual Enrollment Period (AEP) spans from October 15th to December 7th of every year. Coverage purchased during the AEP begins January 1st of the following calendar year. The kinds of coverage in which you are eligible to enroll during the AEP depend upon your current plan structure. We encourage all of our clients to take advantage of the AEP to re-revaluate whether your coverage still meets your health and lifestyle needs.
If you missed your IEP, the General Enrollment Period (GEP) provides an opportunity for you to enroll in Original Medicare, Medicare Advantage plans, and Part D prescription drug coverage. While you may be assessed late enrollment penalties, you do not have to miss out altogether on Medicare. The GEP begins January 1st and ends March 31st of every year for Original Medicare, and runs from April 1st to June 30th for Medicare Parts C and D. If you enroll during these windows, the coverage you purchase will go into effect July 1st of the year you enrolled.
Individuals who have already enrolled in a Medicare Advantage plan have the option to change their coverage during the Medicare Advantage Open Enrollment Period (MAOEP). While you are only allowed a single coverage change during this period, it does allow for some flexibility in your coverage. Medicare Advantage members also have the chance to change their enrollment to Original Medicare plus Part D coverage within this period. Similar to the Original Medicare GEP, the MAOEP begins January 1st and extends through March 31st. It differs, however, in that you do not necessarily have to wait until July for your new plan to take effect. Rather, coverage changes requested within the bounds of this enrollment period are implemented on day one of the month following your initial request.
A Special Enrollment Period (SEP) occurs any time a policyholder or beneficiary has a qualifying life event, or for individuals who delayed enrollment in Medicare because of continued employment past the age of 65. While not a comprehensive list, qualifying events include changes to where you live, loss of coverage, opportunities to purchase alternate coverage, or if your plan sees changes in its agreement with Medicare. Not every instance that falls under these broader categories automatically qualifies you for SEP plan changes or enrollment, so it is important to consult a Medicare expert before attempting to make any changes to your coverage. Because of the wide variety of circumstances that can trigger an SEP, the window for enrollment and date your new coverage begins are also specific to your situation.
Enrolling in Medicare Part B opens a unique enrollment period known as Medicare Supplement Open Enrollment. Once your Part B coverage begins, you have 6 months from the effective date to take advantage of the guaranteed right to purchase a Medicare supplement plan. During this Medicare Supplement Open Enrollment Period, insurers cannot reject your application for coverage based on your health status. You do have the option to purchase Medigap coverage under a different enrollment period, but you will have to answer the insurance provider’s health questions. This could lead to more costly premium than if you had opted-in during the open enrollment window, or denial of coverage entirely.
You have important decisions to make when it comes to Medicare. We want to help you navigate these often-tricky enrollment periods and ensure you are receiving the perfect coverage for your situation at the best possible price. We encourage you to check out the condensed version of this enrollment period breakdown for easy reference. If you still have questions about enrolling in Medicare, we would love to provide you with a no-cost consultation! Give us a call or easily request more information through our website.
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We do not offer every plan available in your area. Currently we represent 8 organizations which offer 53 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all your options.Not affiliated with or endorsed by the government or federal Medicare program. Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP] organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal. By providing the information above, I grant permission for a licensed insurance agent to contact me regarding my Medicare options including Medicare Supplement, Medicare Advantage, Prescription Drug plans.