Medicare Enrollment Periods
There are certain times when eligible beneficiaries may enroll in the different parts of Medicare. Some Medicare enrollment periods occur during a certain time period on an annual basis, while others may vary depending on your eligibility details (your birthday may be one example). Read below for information about enrolling in Original Medicare (Part A and Part B), Medicare Advantage (Medicare Part C), Medicare Part D Prescription Drug Plans, and Medigap plans.
Medicare Part A Enrollment
Medicare Part A coverage is one of the two parts of Original Medicare, which is offered through the government to those who qualify. Many individuals are automatically enrolled in Part A and will receive their red, white, and blue Medicare cards in the mail three months before they become eligible. If you're already receiving Social Security or Railroad Retirement Board retirement or disability benefits, you're typically enrolled into the program automatically the month that you qualify for Medicare. For example, if you turn 65 on May 9th and you're receiving Social Security benefits, you'll be enrolled in Medicare automatically on May 1st. If you're not automatically enrolled:
- You can enroll in Part A during your Initial Enrollment Period (IEP), which typically begins three months before the month you become Medicare-eligible and lasts for seven months.
- If you miss your IEP, you can sign up during the General Enrollment Period, which runs from January 1st through January 31st each year. You may have to pay a late-enrollment penalty.
- In certain situations, you can sign up for Medicare during a Special Enrollment Period. You usually don't have to pay a late-enrollment penalty if you're eligible for a Special Enrollment Period.
Medicare Part B enrollment
Medicare Part B is the other part of Original Medicare.
In general, enrollment periods for Medicare Part B (including automatic enrollment) are the same as with Medicare Part A, above. Some exceptions are:
- Some beneficiaries decide to delay Part B enrollment -- for example, you might do this if you're covered through a current employer-based health plan. If you qualify for automatic Medicare enrollment, you'll receive instructions about delaying or "opting out" of Part B during your IEP (described above).
If you delay Part B enrollment because you're covered by an employer's plan, you may qualify for a Special Enrollment Period to enroll in Part B without a penalty when the employer-based coverage ends. There may be other situations when you can qualify for a Special Enrollment Period.
- If you live in Puerto Rico, even if you qualify for automatic enrollment in Medicare Part A, you need to sign up for Medicare Part B. You may want to do so during your IEP to avoid possible late-enrollment penalties.
If you're not automatically enrolled in Medicare Part B, you may enroll in Part B during your Initial Enrollment Period (IEP), described above. If you miss this enrollment period, then you may have other options for enrolling in Part B, such as the General Enrollment Period described above, but you may have to pay a late-enrollment penalty. You might not have to pay a penalty if you qualify for a Special Enrollment Period.
Medicare Advantage (Medicare Part C) enrollment
Beneficiaries that are already enrolled in Original Medicare, Part A and Part B, may decide to get their Medicare benefits through a Medicare Advantage plan, available from private, Medicare-approved insurance companies. You can typically enroll in a Medicare Advantage plan during certain times:
- Initial Coverage Election Period (ICEP): If you enroll in Medicare Part B when you are first eligible for Part B, your ICEP to enroll in a Medicare Advantage plan will be the same as your Medicare Part B Initial Enrollment Period, which begins three months before you are first eligible for Part B and lasts for seven months. If you delay your enrollment in Part B and later enroll using the General Enrollment Period or a Special Enrollment Period, then your ICEP will be only the three months before the month your Medicare Part B goes into effect.
- Annual Election Period: This election period occurs annually from October 15 to December 7, and you have the option of enrolling in, switching, or dropping Medicare Advantage plans during this time. Your coverage changes will take effect January 1 of the following year.
- Special Election Period: Under special circumstances, such as moving or losing other coverage, you may qualify for this election period, during which you may be able to enroll in, disenroll from, or switch Medicare Advantage plans.
- Medicare Advantage Disenrollment Period: If you want to return to Original Medicare, you can drop your Medicare Advantage plan during this period, which runs from January 1 to February 14 each year. The only other change you can make during this time is to enroll in a stand-alone Medicare Part D Prescription Drug Plan.
Medicare Part D Prescription Drug Plan enrollment
Qualifying beneficiaries have the option of receiving their prescription drug coverage through a Medicare Part D Prescription Drug Plan. There are certain times you may enroll in such a plan, including:
- Initial Enrollment Period: This enrollment period begins three months before the month that you become Medicare-eligible, and lasts for seven months. During this time you may enroll in a Medicare Part D Prescription Drug Plan of your choosing.
- Annual Election Period: Every year from October 15 to December 7, you may enroll in or change your prescription drug. Your coverage changes will take effect January 1 of the following year.
- Medicare Advantage Disenrollment Period: You can enroll in a Medicare Part D Prescription Drug Plan during this period if you want to drop your Medicare Advantage plan and return to Original Medicare. This period goes from January 1 to February 14 each year.
Medicare Supplement enrollment
If you qualify to enroll in a Medicare Supplement (Medigap) plan, the best time to enroll may be during your Medigap Open Enrollment Period (OEP). This period begins on the first day of the month that you are both enrolled in Medicare Part B and aged 65 or over, and lasts for six months. During this time, you generally have the guaranteed issue right to enroll in a Medigap plan of your choosing, as long as you're enrolled in Medicare Part A and Part B and you live within the Medigap plan's service area. An insurance company may not deny you enrollment in a Medigap policy based on any pre-existing conditions during your Medigap OEP. If you miss this enrollment period, you may be subject to medical underwriting.
If you miss your Medigap Open Enrollment Period, in most cases you won't get it again. However, there are certain situations when you may have guaranteed issue rights to enroll in a Medigap plan.
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Last Updated Date: 11/5/2016