Medicare enrollment Periods
What is a Medicare Enrollment Period?
Enrolling into Medicare can be frustrating and confusing for some people. We get a lot of the same questions about Medicare enrollment periods. When can I sign up? Will I get a penalty if I don’t sign up right away? Who do I contact to get signed up? Do I get more than one Medicare enrollment period?
Usually enrollment is a simple process but for each person there is a different enrollment period that fits their situation. Getting in touch with a professional before you turn 65 is the best place to start. If you would like to go over your specific scenario you can call us at 866-319-5886 and we will be happy to help you figure it all out. You can also send us a written request HERE.
There a few different enrollment periods for those in Medicare. You will be either in your Initial Enrollment Period, the Medicare Open Enrollment period or a Medicare Special Enrollment period. There is a lot of confusion when it comes to which applies to each individual. Below we will go over each period and how it applies to Medicare beneficiaries. Understanding the differences will help you avoid unnecessary costs and possible penalties that most people are unaware of when first entering Medicare.
Initial Medicare Enrollment Period
Your Medicare Initial Enrollment Period (IEP) is a very important period and is one that every person will get the opportunity to use one time. Your Initial Enrollment Period is a seven month window that starts three months before the month of your 65th birthday, the month of your birthday and the three months after.
Here is an example of this window. If you turn 65 April 15th, your Initial Enrollment Period will be from January 1st until July 31st.
There is one exception to this rule. If you are born on the 1st of any month your IEP will start on the first of the previous month. So if you were born on December 1st, your IEP will start on August 1st and go until February 28th. This is because your Medicare will start on November 1st.
Your Initial Enrollment Period is when you can enroll into Original Medicare Part A and Part B. You can also enroll into a Medicare Advantage Plan ( Part C) and/or a Medicare Part D drug plan during this time. You can enroll into either a stand alone Part D drug plan or get your drug coverage through a Medicare Advantage Plan (Part C). Enrolling into a plan during the IEP will help you avoid late enrollment penalties.
Once you have Original Medicare’s Part A and B, you also have the option to enroll into a Medicare supplement to help cover the costs that are passed on to you after Medicare has paid its portion of the bill. Sometimes this is called the “gap” in Medicare benefits and supplement plans are also referred to as “Medigap” plans for this reason.
There is a Medicare Supplement Open Enrollment period for those who would like to purchase a Medigap plan. During this period you will not have to go through underwriting or answer any health questions to be approved. Your current health conditions will not have any impact on your monthly premiums either. This period starts the first day of the month that you turn 65 or enrolled into Medicare Part B and will last for 6 months.
Again, if your birthday is on the first of the month your open enrollment period will start the first day of the month before your birthday. This will also be when your Medicare Part A and B will start as well.
What Happens if I Miss My Initial Enrollment Period?
Missing your Initial Enrollment Period when you don’t have other creditable coverage could cause you some headaches. Creditable coverage would be if you had coverage through an employer or union plan still. Without that coverage you could be looking at the following consequences:
- If you don’t enroll into Part B during your IEP you will have to pay a late enrollment penalty for as long as you have Medicare coverage. This is a 10% penalty for every 12 month period you should have had it but didn’t.
- If you do not sign up for Part B during your IEP you will not able to enroll until the next General Enrollment Period. Your coverage will not start until July 1 of that year.
- If you miss enrolling into a Part D drug plan during this time you may also have to pay a penalty as well for as long as you have Medicare coverage.
You can go can go here to find more about the Part B Penalty or here to learn about the Part D penalty and how it is applied.
What Is Creditable Coverage?
Many people choose to work beyond their 65th birthday and opt to maintain their employer or union coverage. When you do this you can delay your enrollment into Part A and/or B. Once you decide to retire you can sign up for Part A and B with a Special Enrollment Period (SEP). This applies to people working for employers with 20 employees or more. You will get a Special Enrollment period that will last 63 days to sign up for Part A and/or B without a penalty.
What Is The Medicare General Enrollment Period?
For those who have missed their IEP and don’t have a Special Enrollment Period, you can sign up during the General Enrollment Period (GEP). This period runs from January 1 thought March 31 each year.
Enrolling during this time is not the same as enrolling during your IEP and will not help you avoid any late enrollment penalties.
Although you will enroll into Original Medicare during this time frame your coverage will not start until July 1st.
This period only allows you to enroll in Part A and B of Medicare. You will not be able to enroll in a Medicare Advantage Plan or Part D drug plan until the Annual Enrollment Period (AEP) which is October 15th through December 7th. Anything you sign up for during the AEP will not start until the 1st of the following year.
Medicare Annual Enrollment Period (AEP)
The Annual Enrollment Period (AEP) runs from October 15 to December 7 every year. This period is specifically Medicare Parts C and D, which is Medicare Advantage and prescription drug plans. Any plan you enroll in during this time will start on January 1 of the following year.
During this time you can switch back to Original Medicare or change to a different Advantage plan. You may also enroll into a Medicare Part D prescription drug plan or switch to a different Part D plan.
The AEP is not time designed to switch your Medigap plan. Medigap plans may be switched at any time but you will want to contact an agent if you are looking for a new Medigap policy to go over your options. If you have questions about this we will be happy to help and you can call us at (866) 319-5886.
Annual Enrollment Period VS. Open Enrollment Period
Many times we have customers with Medigap plans that believe the Annual Enrollment Period applies to their plan. You may switch your Medicare supplement at any time of the year. The Annual Enrollment Period does not apply to Medigap policies. If you would like to change your Medigap plan you may do so but will have to answer health questions and go through underwriting.
If you have a Medigap plan the best course of action is to first talk with an agent to figure out what your options are given your own personal circumstances. The Annual Enrollment Period is for Medicare Advantage Plans and Part D Prescription Drug Plans.
Medicare Enrollment Period Summary
Simply put, the best time for someone to enroll into a Medicare Supplement Plan is during your Initial Enrollment Period. This would start 90 days before your Part B effective date.
Enrolling during your Open Enrollment Period is the best time to enroll because you are able to select any available plan and will not have to undergo any health questions or underwriting to be approved. Your current and previous health conditions have no effect on you getting the plan you have chosen for yourself.
Once your Open Enrollment Period is over you will no longer be able to automatically qualify for a Medigap plan. You will have to go through the underwriting process where you may or may not be approved.
If you are someone who has had health issues in the past it would be in your best interest to make sure you apply for a Medigap plan during your Open Enrollment Period. Doing so will more than likely save you significant amounts of money down the road in health care costs.
If you still feel like you have questions that need to be answered just give us a call at (866) 319-5886 and we will be happy to help in any way we can.