Learn about the Medicare Enrollment Periods, such as Initial Enrollment, Annual Enrollment and Medicare Advantage Open Enrollment
Is it time to enroll? Learn more about Medicare enrollment periods
Medicare enrollment doesn’t need to be scary. Understanding Medicare enrollment will help you prepare for the best time to start receiving benefits. Certain parts of Medicare have different enrollment periods and your individual circumstances may mean you’re eligible for special enrollment periods.
Continue reading below to learn more and if you’re still unsure when you should enroll, SmartMatch licensed insurance agents can give you a definitive answer.
Explore Enrollment Periods
Initial Enrollment Period
Your Initial Enrollment Period (IEP) begins three months before your 65th birthday month and ends three months after, for a total of seven months including your birth month. This is your opportunity to enroll in Medicare Parts A, B, and D.
If you're not already receiving Social Security or Railroad Retirement Board benefits, it's essential to sign up for Medicare Parts A and B during your IEP.
Even if you're not planning to retire at age 65, you can still enroll in Medicare Parts A and B during your IEP. After retirement, you have the option to switch to a Medicare Advantage plan that offers more comprehensive coverage, such as dental, vision, hearing, critical illness, and more.
Initial Enrollment Period Timeline
The Initial Enrollment Period (IEP) is the seven-month period of time when you can enroll for the first time in a Medicare plan. It starts on the 1st day of the month that is 3 months before my birth month and ends on the last day of the month that is 3 months past my birth month.
If you're eligible for Medicare but didn't sign up when you first could, don't worry: The General Enrollment Period (GEP) runs from January 1st to March 31st each year and gives you another chance to enroll in Medicare Parts A and B.
The GEP is a yearly opportunity for those who missed their initial Medicare enrollment window to sign up. It's also a chance to enroll if you missed any special enrollment periods due to life events like losing job-based coverage.
Many people delay enrolling in Medicare Part B if they're still working and have employer-provided health insurance. While this is often a smart move, some individuals might miss their initial sign-up window or experience changes in their employment situation that make Medicare more attractive. However, you may be subject to a Part B Late Enrollment Penalty.
What To Know About Late Enrollment Penalties
If you have to buy Part A and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay this penalty for twice the number of years you didn't sign up. For instance, if you waited two years to sign up, you'll have to pay the penalty for four years.
Note: Most people qualify for premium-free Part A, so this would not apply in those cases.
The Part B late enrollment penalty is an extra 10% of the standard monthly premium for each year that someone delays enrolling in Part B after becoming eligible, unless they have a Special Enrollment Period. You will have to pay this penalty for as long as you have Medicare Part B.
The Medicare Part D late enrollment penalty occurs when you do not join a Medicare drug plan when you first get Medicare, and go 63 days or more without creditable drug coverage — coverage that's similar in value to Part D.
Medicare's Annual Enrollment Period, also known as Medicare's Open Enrollment Period or Annual Election Period, lasts from Oct. 15 through Dec. 7 each year. Changes made during this time take effect on Jan. 1 of the following year.
This period is specifically important for those with Medicare Advantage plans and Medicare Part D (Prescription Drug) plans.
Frequently asked questions about Medicare's Annual Enrollment Period
Anyone enrolled in Medicare can participate in the AEP. This includes those with Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Part D (prescription drug coverage).
Please note that if you have Original Medicare along with a Medicare Supplement plan, AEP is a good time to specifically evaluate your standalone Prescription Drug Coverage, or determine if health or budget changes mean you should evaluate a Medicare Advantage plan.
The AEP allows you to make several changes to your Medicare coverage:
Switch: Move from Original Medicare to a Medicare Advantage plan, or vice versa.
Change: Switch between different Medicare Advantage plans.
Enroll: Join a Part D prescription drug plan if you don't have one.
Switch: Change your Part D plan if you already have one.
Drop: Cancel your Part D coverage if you no longer need it.
It's crucial to review your coverage annually because plans can change. Premiums, deductibles, copays, covered services, and provider networks can all be adjusted from year to year. By reviewing your options, you can ensure you're in the plan that best meets your needs and budget for the coming year.
No, you don't have to make any changes if you're happy with your current plan. However, it's still wise to review your coverage each year to ensure it still meets your needs and budget, as plans can change their costs and benefits.
If you miss the December 7th deadline, you'll likely be stuck with your current coverage for the rest of the year. There are some exceptions, such as if you qualify for a Special Enrollment Period due to specific life events (like moving or losing other coverage). However, it's best to evaluate your coverage during the AEP to avoid potential gaps in coverage or unexpected costs.
Medicare's Annual Enrollment Period: Key Takeaway
There's no getting around it: Medicare's Annual Enrollment Period is a source of confusion and stress for many Medicare beneficiaries each year. You'll be inundated with advertisements, often leading to confusing conclusions on what you should or should not do.
That's why we recommend SmartMatch as your first call each AEP, whether you're a current customer or not. We can take the guess-work out of this time for you, and help make you confident Medicare decisions for the next year.
You may be eligible to enroll in Medicare after your IEP and outside of the Annual Enrollment Period if you meet certain criteria. These are divided into a few categories with many situations underneath; we'll explore some of the common ones now, but we recommend, for a full list, visit the Medicare.gov page at the bottom of this section.
In addition, if you believe you're in a Special Enrollment Period, a SmartMatch licensed insurance agent can help examine your situation to determine your eligibility.
You've moved.
Moving may mean that your new address isn't in your current plan's service area, or your new address may have new plan options.
In both these options, you can switch to a new Medicare Advantage or Medicare drug plan, but your timeline depends on how soon your notify your current plan.
You've lost current coverage.
Examples of this situation include leaving coverage from your employer or union (including COBRA) or you've lost creditable drug coverage.
In the first situation, you have two months to join a Medicare Advantage or Medicare drug plan for 2 months following the month your coverage ends. In the second, you can join a Medicare Advantage plan with drug coverage (MA-PD) or a Medicare drug plan.
You have other coverage choices.
This situation includes having a chance to join coverage offered by an employer or union, or you are enrolling in other drug coverage as good as Medicare drug coverage.
In the first, you can drop your current Medicare Advantage plan or Medicare drug plan to enroll in your new employer plan. In the second, you can drop your current Medicare Advantage or Medicare drug plan coverage to be enrolled in Original Medicare, or you can switch from a Medicare Advantage plan with drug coverage to one without.
Again, these are not inclusive of all scenarios in which you may be eligible for a Special Enrollment Period. For more information, visit the link below or contact your SmartMatch Licensed Insurance Agent.
There are two other periods that occur after you have enrolled in Medicare and want to make changes, and they pertain to two different aspects of Medicare: Medicare Supplement (Medigap) and Medicare Advantage.
These are called the Medigap Open Enrollment Period and the Medicare Advantage Open Enrollment Period.
Medigap Open Enrollment Period
This is a 6-month time period that begins the first day of the month you're 65 or older and signed up for Medicare Part B. Both qualifications have to be true; this often drives confusion because it often at least partially overlaps with your Initial Enrollment Period.
During this time period, you're able to purchase any Medigap policy that's available in your state.
There are two benefits: The first is that insurance companies have to sell you any policy that's available in your state. The second is that they have to charge you a standard rate. These means there is no medical underwriting, which means you can't be denied coverage and you can't be charged more because of your age or pre-existing conditions.
Medicare Advantage Open Enrollment Period
This lasts from Jan. 1 through March 31 every year, and is specifically for beneficiaries currently enrolled in a Medicare Advantage plan.
During this time period, if you're enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage Plan, disenroll from your current Medicare Advantage plan and return to Original Medicare, or join a Medicare Part D plan if you don't have one.
Agencies such as SmartMatch can't market toward this time period, so you'll have to know about it in order to make a change.
Want to learn more?
Now that you know about Medicare's enrollment periods, it's time to learn more about what plan may be right for you. Go to our next section to learn about Medicare Advantage, Medicare Supplement and Medicare Part C.
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We do not offer every plan available in your area.
Currently, we represent organizations which offer products in your area.
We do not offer every plan available in your area. Please enter your Zip Code above to see the number of plans and carriers we offer in your area.
Please contact Medicare.gov, 1-800-Medicare or your local State Health Insurance Program (SHIP) to get information on all of your options. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Not all plans offer all benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Limitations and exclusions may apply. No obligation to enroll. Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. PLEASE NOTE: Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease.
