Medicare Enrollment Periods can be confusing.
If you miss your enrollment periods, you could end up paying late enrollment penalties.
Millions of people pay Medicare penalties every year because of missed enrollment periods. I don’t want that to happen to you.
Confused about your Medicare coverage options? Watch our free video: How to Find the Best Medicare Coverage Without Paying More Than You Need To…
Initial Enrollment Period
The Initial Enrollment Period, or IEP, is a seven month window around the month in which you turn 65. For most people, it starts three months before your birth month and runs through three months after your birth month.
There is an exception. If your birthday is the first day of the month, your Medicare coverage starts the month before your birth month, and that moves your Initial Enrollment Period too.
Here are a couple examples:
If your birthday is April 20, your IEP starts January 1 and lasts through July 31.
If your birthday is Feb 1, your IEP starts October 1 and lasts through April 30.
What can you do during your Initial Enrollment Period?
You can enroll in Medicare Parts A and B. With very few exceptions, most people should enroll in Part A when they become eligible.
Medicare Part B is a different story. The video linked here explains whether you should consider delaying Medicare Part B enrollment if you are going to continue working and have employer group health coverage.
Your group health plan will be able to tell you whether you can safely delay Medicare Part B enrollment without penalty and whether your group plan’s drug coverage is considered creditable coverage by Medicare.
Those two things are very important to learn before you turn 65. If your group coverage is creditable coverage, you won’t have to worry about late enrollment penalties from Medicare in the future.
If you apply for Medicare Parts A and/or B during your IEP before the first day of your birth month, your Medicare coverage will be effective the first day of your birth month.
First day of the month birthday people, remember this is all pushed forward a month for you. I’m not going to give that disclaimer for every example for the sake of space, so if you were born on the first day of the month, just keep in mind that all of this is slightly shifted.
Unless you have a good reason, don’t delay this enrollment. Medicare punishes people who enroll later in their Initial Enrollment Period.
If you wait to enroll until the month you turn 65, your coverage will start the first day of the next month. If you apply one month after you turn 65, your coverage will start two months after you apply. And if you wait until two or three months after your birth month to apply, your coverage will start three months after you sign up.
Also during your IEP, you can enroll in a Medicare Advantage plan or a standalone Part D plan and a Medicare Supplement, also known as Medigap plan.
You can’t enroll in all of these plans. In most cases, you will choose either a Medicare Advantage plan that includes Part D drug coverage or a Medicare Supplement and a standalone Part D plan.
Medicare Advantage and Part D plans have the same enrollment windows.
If you apply up to three months before your Medicare effective date, your Medicare Advantage or Part D coverage will start on the first day of your birth month. If you wait until the month of your birth or later, your Medicare Advantage or Part D coverage will start in accordance with your Medicare coverage.
Medigap or Medicare Supplement plans have different rules.
You can apply for a Medigap plan up to six months before you are eligible for Medicare. The Medigap coverage will be effective the first day of your Medicare Parts A and B coverage.
Medicare Supplements also have a different window after your Medicare coverage is effective. The first six months that you are age 65 or older and have Medicare Part B are your Medicare Supplement Open Enrollment Period. This is a one-time enrollment period only used for purchasing Medigap plans.
During this period, you can purchase any Medicare Supplement sold in your state without having to answer health questions. You can’t be charged a higher rate by the insurance company.
For instance, during this enrollment period, tobacco users qualify for non-smoking rates. And the Medigap company can’t impose any pre-existing condition delays.
General Enrollment Period
If you miss your Initial Enrollment Period, your next chance to sign up for Medicare Parts A and B is during the General Enrollment Period, which runs every year from January 1 through March 31 and your coverage becomes effective on July 1.
If you went without creditable coverage from another source, enrolling during the General Enrollment Period will add late enrollment penalties for both Medicare Part B and Part D.
The Part B late enrollment penalty is an additional 10% of the Part B premium added to what you pay every month for each 12 month period you went without coverage.
In 2022, if you delay coverage by 12 months, that means you’ll owe an extra $17.01 on top of the $170.10 Part B monthly premium.
The Part D penalty is explained in the video linked here. That can really add up too.
If you enroll in Medicare Parts A and B during the General Enrollment Period, you will be able to use your Medicare Supplement Open Enrollment Period which runs for six months from the first day of your Part B coverage, and you will be able to enroll in a Medicare Advantage or Part D plan at that time. All plan coverage will be effective July 1.
For Part D coverage, whether in a standalone plan or through a Medicare Advantage plan, you will have a late enrollment penalty added to your premium every month if you did not have other creditable drug coverage.
Annual Enrollment Period
Next, we have the Annual Enrollment Period. Between October 15 and December 7 every year, you can change your Medicare Advantage or Part D plans. Any changes made during the AEP will be effective January 1.
The AEP can be complicated, so the video linked here explains in detail what changes you can and can’t make during that enrollment period.
Medicare Advantage Open Enrollment Period
Next up is the Medicare Advantage Open Enrollment Period. This is an annual period that runs from January 1 through March 31 and is only for people who are already enrolled in a Medicare Advantage plan.
During this time, you can switch Medicare Advantage plans or leave your Medicare Advantage plan and return to Original Medicare. If you do that, you have the right to purchase a standalone Part D plan.
However, you may not have a guaranteed issue right to purchase a Medicare Supplement. State laws vary, but you will want to look into your Medicare Supplement options before disenrolling from your Medicare Advantage plan if you are considering doing so.
Special Enrollment Periods
Those are all of the regular enrollment periods. There are also Special Enrollment Periods. You qualify for these based on changes in your life.
If you leave your employer’s group health coverage, move to a new address, become eligible for Medicaid or lose Medicaid eligibility, lose your current coverage through no fault of your own, and so on, you may qualify for a Special Enrollment Period.
Special Enrollment Periods give you at least two months, and sometimes longer, to make enrollment changes in Medicare itself and Medicare plans.
There’s a lot of variation in the Special Enrollment Periods depending on exactly what your situation is. This link explains the most common Special Enrollment Period situations: https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods but if you have questions not answered there, give us a call, and we can help you sort out what Special Enrollment Period you may qualify for.
Special Enrollment Periods can be triggered anytime during the calendar year because they are based on changes in your life, not a set schedule.
All the enrollment periods can be confusing, but you don’t have to keep track of them alone. We’re here to help you work through Medicare confusion to make sure you don’t miss any enrollment periods and avoid late enrollment penalties.
If you have questions or would like advice about your specific situation, please feel free to give us a call at 877-312-1414 or schedule a free, no obligation Medicare Plan Consultation.
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