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 on the first day of the month in which you’re both 65 or older and enrolled in Medicare Part B. 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
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.
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. 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.
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
If you find yourself enrolling in Medicare Part A and/or Part B during the GEP, January 1 – March 31 each year, you’ll face two problems:
- 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.
If you are enrolling in Part B during the GEP, you can also join a Medicare Advantage plan during that time as well. However, just like your Part B coverage, your Medicare Advantage Plan may not start until July 1. In addition, you can also enroll in a Part D drug plan. The enrollment period for Part D is from April 1 – June 30, with coverage starting 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 this 6 month period without answering any health questions. This period begins on the first day of the month you’re both 65 and enrolled in Part B.
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, not annual
- There are many enrollment periods with Medicare. Don’t confuse this enrollment period with the one that occurs in the fall, 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. The only 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).