One of the most popular Medicare Enrollment opportunities starts October 15 each year. While commonly known as the Medicare Open Enrollment period, it’s also called the Annual Election Period. You might be surprised to know there are four other enrollment periods that are equally as important.
While all five enrollment periods may not apply to your current situation, it’s important to have an understanding of when they take place. If you miss an enrollment opportunity, there can be penalties and waiting periods.
Our Medicare Enrollment – What You Need To Know article will explain the important details and information you’ll need to understand.
Initial Enrollment Period
The Initial Enrollment Period (IEP) is a 7 month window of time that you can first sign up for Part A and/or Part B.
Beginning 3 months before the month you turn 65. It includes your birthday month and ends 3 months after the month you turn 65.
In other words, you can enroll during the 7-month period that:
- Begins 3 months before the month you turn 65
- Includes the month you turn 65
- Ends 3 months after the month you turn 65
NOTE: Your Medicare coverage start date will be delayed If you decide to enroll in Part A and/or Part B during your birthday month or during the last 3 months of your Initial Enrollment Period.
When will your coverage begin?
The start dates of your coverage have been simplified under the BENES Act of 2020.
- First 3 Months: If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, your coverage starts the first day of your birthday month.
- If your birthday month is on the first day of the month (for example: May 1st), your coverage will start the first day of the prior month (ex: April 1st).
- If you enroll during the last 3 months of your IEP, then your coverage will begin the 1st day of the month following the month of enrollment.
Medicare Part A and the Initial Enrollment Period
Many people receive Part A (hospital insurance) for free. This happens if you or your spouse paid enough Medicare taxes while working. If you want Part A, sign up for it during the Initial Enrollment Period.
If you have to buy Part A, you must do it during your Initial Enrollment Period. If you don’t, your monthly premium may go up 10% every 12 months you didn’t have the coverage in place.
The higher premium stays in place for twice the number of years you could’ve had Part A, but didn’t sign up.
Medicare Part B and the Initial Enrollment Period
Most people ARE NOT automatically enrolled in Part B. It’s really, really, important to pay attention to this enrollment period.
If you don’t sign up for Part B when you are first eligible, you may have to pay a late enrollment penalty for as long as you have Part B.
Your monthly premium for Part B may go up 10% for each full 12 month period that you could’ve had Part B, but didn’t sign up for it.
Exception to the rule…
If you are still covered under group employer health insurance, you can delay enrolling in Part B. You won’t be penalized if you enroll after losing group coverage. Once group coverage ends, you have eight months to sign up for Part B without a penalty.
Medicare Part C and the Initial Enrollment Period
You can sign up for a Medicare Advantage Plan during your Initial Enrollment Period.
If you don’t sign up during the Initial Enrollment Period, you have to wait until the Annual Election Period (October 15 – December 7) to sign up.
Signing up during the Annual Election Period means your coverage will begin on January 1.
Medicare Part D and the Initial Enrollment Period
Likewise, you can sign up for your Part D (Prescription Medicare Drug Plan) when you first become eligible for Medicare.
If you don’t sign up during the Initial Enrollment Period, you have to wait until the Annual Election Period (October 15 – December 7) to sign up. Which in turn means your coverage will begin on January 1.
Also note, that not signing up for Part D when you are first eligible could result in a penalty.You will receive financial penalties if you have gone for more than 63 days without other drug coverage. And, if you had drug coverage, it must be considered as good as Part D.
General Enrollment Period
Let’s say for some reason you didn’t sign up for Part A (if you have to buy it) and/or Part B during your Initial Enrollment Period. You then decide later to enroll. If you’re not eligible for Special Enrollment, your only opportunity is during the General Enrollment Period. This runs between January 1 – March 31 each year.
And, even if you sign up on January 1, coverage doesn’t begin until July 1 of that year.
In addition, you may have to pay a higher premium for late enrollment.
Special Enrollment Period
With many people employed beyond age 65, this enrollment period is particularly important. Especially if you or your spouse are still working and covered under an employer sponsored health plan.
If you didn’t sign up for Part B when you were first eligible because you’re covered under a group employer health plan, you can sign up for Part A (if you need to buy it) and/or Part B:
- Anytime you’re still covered by the group health plan.
- During the 8 month period that begins the month after the employment ends or the coverage ends, whichever happens first.
The good news is that most people eligible for Special Enrollment don’t pay a late enrollment penalty.
Medigap Open Enrollment
This is a one and done opportunity. Don’t let it slip away! It lasts for 6 months and begins on the first day of the month in which you’re both 65 or older and enrolled in Medicare Part B.
During this period of time, an insurance company can’t use medical underwriting to determine if you can buy a policy with them.
Regardless of your current or past health problems, Medigap companies can’t refuse to sell you any Medigap policy it offers. They also cannot charge you more for a Medigap policy than they charge for someone with no health problems.
However, once the Medigap Open Enrollment period ends, it’s done. Moving forward you have to answer health questions on the Medigap application.
If you can’t pass medical underwriting, insurers can refuse to sell you a policy. That’s why it’s SO important to take advantage of this opportunity!
Annual Election Period (aka Open Enrollment Period)
This period of time can be very confusing because of all the advertisements you see on TV, on Facebook, in your email, and mailbox.
It runs from October 15 – December 7 each year and pertains to Part C (Medicare Advantage Plans) and Part D (Medicare prescription drug) plans.
Don’t be confused by the term Open Enrollment Period.
If you want Medigap during this time period, that’s fine, but if it’s not YOUR Medigap Open Enrollment period, you have to go through underwriting.
That’s because Medigap isn’t a government subsidized program like Part C (Medicare Advantage) and Part D (Medicare prescription drug).
This period of time is used to change your Medicare Part D plan coverage for the following year (if you want).
If you have a Medicare Advantage Plan, this is the period of time to change coverage for the following year (if you want).
Thank you for reading our article Medicare Enrollment – What You Need To Know. At REMEDIGAP, we provide the tools you need to make informed decisions about your Medicare benefits. We’re happy to work with you at your comfort level. Many people prefer to ask questions without picking up the telephone. We understand. That’s why we offer several contact options. So, whether you have many questions or none at all, we tailor our approach to meet your needs.
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Joann Quinn is the Chief Compliance Officer and Cofounder of REMEDIGAP. She is a licensed Medicare agent in 47 states. Her main role is to provide essential resources and tools to educate eligible individuals on Medicare. Joann provides helpful Medicare education to thousands of viewers with our popular REMEDIGAP YouTube channel. With expertise in Medicare Supplement, Medicare Advantage, and Medicare Part D, Joann is a highly knowledgeable and sought after Medicare insurance professional.