Your Guide to Understanding Medicare Enrollment Periods
Medicare enrollment has different moving parts and it can be challenging to figure out what you need to do and when you need to do it. This is your guide to the Medicare Enrollment Periods. Medicare has four different types of enrollment periods: initial enrollment, special enrollment, general enrollment, and open enrollment. Read on to learn about the importance of each enrollment period, the timing of each enrollment period and the consequences of not enrolling in Medicare.
What to Know About Initial Enrollment
Understanding what happens during the initial enrollment period is vital for the purposes of planning your health coverage. You can enroll initially into Medicare up to 3 months before you turn 65. Coverage starts on the first day of your birthday month. If you decide to wait until your birth month to sign up for Medicare, you will be covered starting on the first day of the next month.
Once your birthday month has passed, you have 3 remaining months to enroll in Medicare during initial enrollment. Timing matters here. Coverage starts at different times depending on when you enroll.
- Enrolling the month after your birthday means coverage will start 3 months after your birthday month.
- Enrolling during the 2nd month after your birthday month starts coverage 5 months after your birthday.
- Enrolling during the 3rd month after your birthday month extends your coverage effective date to 6 months after your birthday month.
The initial enrollment period is important for anyone considering a Medigap plan, also known as Medicare Supplement, along with Medicare. This is generally the best time to buy the supplemental insurance plan because you must be given the plan you want regardless of previous or existing health conditions. Getting a plan is possible at other times but can be more difficult.
Who Are Special Enrollment Periods For?
Special enrollment periods are for anyone who have special circumstances or life events that cause them to lose coverage. These circumstances can include:
- Moving to a New Area Not Covered by Your Plan
- Leaving a Job or Losing Insurance Coverage Provided by an Employer, Union, or Spouse.
- You Are Able to Get Other Insurance
- There is a Contract Change with Your Current Plan
- Your Eligibility for Other Programs Changes
The rules for special enrollment do depend on your specific situation in terms of how long you have to enroll in Medicare and when. Medicare.gov has resources for these common situations and others.
When is General Enrollment?
General enrollment takes place between January 1 and March 31 every year. Everyone who enrolls in Medicare during this time period will gain coverage starting July 1 of that same year. It is the next opportunity to enroll after the initial enrollment period, if a special election period does not apply.
People who enroll during this period will be required to pay a late penalty premium for Medicare Part B, unless they had health coverage through an employer, spouse or union and qualify for a Special Enrollment Period. The late penalty is 10% for every 12-month period you are not enrolled. It is a life-time penalty. Therefore, the penalty for not enrolling in Part B goes up the longer you are not enrolled in it.
Making Changes During the Annual Enrollment Period
The Annual Enrollment Period is between October 15 and December 7 every year. It is the time of year for Medicare recipients to review their current plans and benefits and see if there are any other plan options that may suit their needs better than their current coverage. This period is particularly important as it is the only time to enroll in Medicare Advantage plans and/or Part D Drug Plans unless a special circumstance exists.
However, Medicare Advantage offers a Medicare Advantage Open Enrollment Period from January 1 to March 31 for individuals enrolled in an existing advantage plan. During this time, you may make a onetime switch to a new plan or go back to original Medicare A and B and enroll in a Part D plan.
How Do I Enroll in Medicare and What if I Have Questions?
Medicare enrollment can be completed online through the Social Security Administration (SSA) for anyone not already receiving SSA or RRB benefits. Medicare enrollment is automatic only for people receiving SSA benefits or benefits from the Railroad Retirement Board (RRB) at least 4 months prior to turning 65.
If you are planning on working after 65 and have employer benefits, you may delay enrolling in Medicare until you are ready to retire.
The Medicare option you choose depends on your individual circumstances. If you have questions about what Medicare plan is right for you or the differences between original Medicare and Medicare Advantage, visit MedicareWise. Our expert staff can help you find the right plan and will answer your Medicare insurance questions.
