Medicare Open Enrollment

Medicare open enrollment is the time when you can enroll in Medicare.  Medicare Part A, B, C, D, and Medigap have different enrollment period dates.  Below we will review all the Medicare open enrollment dates and attempt to provide every detail and answer in the simplest way possible. When in doubt go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Basic Enrollment Dates For Medicare

Missing an enrollment period can mean higher costs for the rest of your life.  To be safe make sure everything is in place during the 7 month period surrounding your 65th.  Getting Parts A&B will automatically qualify you for enrollment in Parts C, D, and Medigap.

• In general, you can enroll in Part A&B during your Initial Enrollment period which is the 7 months surrounding your 65th birthday.  If you don’t enroll during your Initial Enrollment Period you can end up paying more for part B for life.  (Other Part A&B dates are: General Enrollment Period Jan 1st – Mar 31)

• In general, you can enroll in Part C Medicare Advantage and Part D Prescription drug coverage during your Initial Enrollment period which is the 7 months surrounding your 65th birthday.  If you don’t sign up for Part D or Medicare Advantage, or have other “creditable drug coverage”, you can end up paying more for Part D for life. (Other Part C dates are: the Annual Election Period Oct 15 – Dec 7, and the Special Disenrollment Period Jan 1st – Feb 14.)

• In general, you can get a Medigap policy during your 6-month Medigap open enrollment period which starts the month you’re 65 and enrolled in Medicare Part B.  If you miss your enrollment window insurers can deny you Medigap.

ADVICE: If you are newly eligible for Medicare, in general, be safe and get yourself Part A&B.  Also get Part C with a drug plan or Medigap and part D.  You are better off scaling back coverage than paying late fees for not signing up.

Medicare Open Enrollment Period Dates

Initial Coverage Election Period:  The 7 months surrounding your 65th birthday including the 3 months before your 65th birthday, the month of your 65th birthday, and three months after your 65th. When you turn 65, you will automatically be enrolled in Medicare Part A and Medicare Part B if you are receiving benefits from Social Security or the Railroad Retirement Board.  If not you HAVE TO sign up during your Initial Coverage Election Period or you may pay more!  You’ll need Parts A&B to enroll in any supplemental Medicare coverage like Part C, D, and Medigap.  So for almost everyone the choice is simple, sign up for Medicare during your initial coverage election period.

NOTE: Once you have Medicare Part A&B you don’t have to re-enroll each year.  You’ll only re-enroll if you switch to Medicare Advantage or drop Part A or B and want to switch back.

General Enrollment Period: If you miss your Initial Enrollment Period, you can sign up between January 1 through March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.  As a rule of thumb, don’t miss your initial coverage election period.

Special Enrollment Period: If you or your spouse (or family member if you are disabled) is currently working and you are covered by a health insurance through an employer or union, you will have a Special Enrollment Period when your coverage ends. There is also a Special Enrollment Period for international volunteers if you are serving as a volunteer in a foreign country.  You’ll also qualify for special enrollment if:

  • You move.
  • You’re eligible for Medicaid.
  • You qualify for Extra Help with Medicare prescription drug costs.
  • You’re getting care in an institution, like a skilled nursing facility or long‑term care hospital.
  • You want to switch to a plan with a 5-star overall quality rating. Quality ratings are available on Medicare.gov.

Annual Election Period: The Annual Election Period is October 15 through December 7.  Coverage begins January 1st the following year. During the Annual Election Period can change your Medicare or prescription drug coverage.

Special Disenrollment Period: From January 1 through February 14 you can leave a Medicare Advantage plan and switch to Original Medicare.

If you are confused, that means you are human.  When in doubt go to Medicare.gov to get help and choose plans.  They have really done a great job providing the tools you’ll need to shop smart and one of the only official resources for Medicare information.  See the Medicare.gov open enrollment PDF for detailed information on Medicare enrollment periods.

Initial Coverage Election Period Facts

Enrollment periods for Part A&B are pretty straightforward for most of us, but how those dates interact with supplemental coverage can be confusing.  Let’s cover some quick facts to answer those unanswered questions.

• In general you can enroll in Part A&B during your Initial Enrollment period which is the 7 months surrounding your 65th birthday.

• In general you can enroll in Part C Medicare Advantage and Part D Prescription drug coverage during your Initial Enrollment period which is the 7 months surrounding your 65th birthday, the Annual Election Period Oct 15 – Dec 7, and then disenroll during the Special Disenrollment Period Jan 1st – Feb 14.

• In general you can enroll in Medigap during the 6-month period following you turning 65 and getting Part B.

• If you are turning 65 and you are in your initial coverage election period you can sign up for an Advantage Plan (with or without drug coverage) or a Medicare Prescription Drug Plan during your initial coverage election period.

• Your friends who signed up for a Medicare Advantage Plan or Part D Drug Coverage during the October 15 through December 7 Annual Election Period had birthdays that placed their Initial Enrollment Periods and Annual Election Periods at the same time or they already had Parts A&B before this years Annual Election Period.

• If you are getting Part B for the first time you can sign up for an Advantage Plan (with or without drug coverage) or a Medicare Prescription Drug Plan during your initial coverage election period. , but must due so between Between April 1–June 30.

• If you are newly eligible due to a disability you can sign up for an Advantage Plan (with or without drug coverage) or a Medicare Prescription Drug Plan during your initial coverage election period.  during your Initial Enrollment Period.

• If you already had Medicare due to disability, but now you turned 65, you can sign up for an Advantage Plan (with or without drug coverage) or a Medicare Prescription Drug Plan during your initial coverage election period and change plans.

• If you don’t enroll in part D during your Initial Coverage Election Period you have 63 days to enroll.  If you miss the window you may forever pay more for your Part D Drug Coverage due to a “late enrollment penalty” unless have “other creditable prescription drug coverage”, or you get “Extra Help”.

• If you don’t get Part B during your initial enrollment period you can end up paying more for life for that too.  However some COBRA, employer based plans, union plans, and more can affect this.  Check with your employer and Medicare.gov for specifics.

Simple and Quick Medicare Advice

Here are some simple and quick Medicare tips for getting the right coverage:

• Medicare Part A&B are also called Original Medicare. There is only one choice and are Public options offered by the Government. Medicare is optional, however Unless you have other coverage that replaces Part B and you know you won’t miss your enrollment window, because of this we strongly suggest you get Parts A&B during initial enrollment.  A is free, B has a premium.  If you miss your enrollment window for B you can pay more for life.

• Medicare Part C, D, and Medigap supplement what Original Medicare doesn’t cover.   They are all private plans with many options, while regulated by the Government, they are created by for-profit private companies.  Signing up for these is optional.

• The above being said, if you don’t sign up for the supplemental Parts C, D, and/or Medigap you don’t get a second chance in some cases and in other cases you will pay more for life.

• Given everything above to be safe you should get Original Medicare Parts A&B during your initial enrollment and then before your enrollment windows close get either Part C with drug coverage or Medigap with Part D.  Medicare isn’t the only insurance type where overbuying makes sense.  Once you have a plan you can switch it, but if you don’t get a plan you could miss once-in-lifetime opportunities for affordable quality coverage.

Shopping For Medicare Plans During Open Enrollment

Ready to choose a Medicare Plan?  We suggest you make your first stop Medicare.gov’s plan tool.  There you can enter information about your income, the Medicare Parts you already have, your drugs, and healthcare needs and the tool will help you shop for and compare plans.  call 1-800-MEDICARE (1-800-633-4227) for help.

Original Medicare Enrollment Overview

When you enroll in Original Medicare you’ll get Medicare Part A (Hospital Insurance) which covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care and Medicare Part B (Medical Insurance) covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Learn more about how Medicare works here.

How to Enroll in Original Medicare

To enroll in Medicare simply go to ssa.gov and sign up online. Medicare enrollment for Part A and Part B takes less than 10 minutes. You can also enroll in Medicare by visiting your local Social Security office or by calling Social Security at 1-800-772-1213. TTY users should call TTY 1-800-325-0778, or if you worked for a railroad, call the RRB at 1-877-772-5772.

The best time to enroll in Medicare is during your initial enrollment period which typically starts 3 months before you turn 65 (more information below).

No matter how you complete the Medicare enrollment process your results will be the same, you’ll get a card sent to you that shows that you now have Medicare Part A and Medicare Part B (which you can drop if you want). Keep reading to find out about the enrollment process for supplemental insurance options like Medicare Advantage (Medicare Part C), Medicare Prescription Drug Coverage (Medicare Part D), or Medigap (Part A through N).

If you have Medicare Part A (Hospital Insurance) or Medicare Part C (Medicare Advantage), you’re considered to have “minimum essential coverage” and won’t owe the fee for not having health insurance in 2014. 

Choosing Between Part A, Part B, or Both

Enrolling in Medicare Hospital Insurance (Medicare Part A) is a no brainer. Most folks age 65 or older are eligible to get Medicare Part A for free, assuming they have worked and paid Medicare taxes long enough. There is little reason not to follow the enrollment process below starting 3 months before your 65th birthday.

Enrolling in Medicare Medical Insurance (Medicare Part B) is a little tricker. Part B comes at a monthly premium and higher income seniors may pay more for it. You aren’t required to keep Part B, but if you don’t want it you’ll need to follow the Part B disenrollment process below.

Part A counts as minimum essential coverage (you won’t owe the fee for not having health insurance) so you’ll want to keep that, but some may want to drop Part B (Part B includes a monthly premium) in favor of other coverage (like coverage through work or a union). Please be aware you can’t get a supplemental policy unless you have both Part A and Part B.

Supplemental Medicare Plans Overview

Supplemental Medicare Plans include Medicare Advantage (Medicare Part C), Medicare Prescription Drug Coverage (Medicare Part D), or Medigap (Part A through N). Each have their own benefits and are designed to better cover medical needs and costs by “filling the gaps” in coverage. All supplemental plans are sold by private companies who are authorized by Medicare. Please see our sections on Medicare Advantage, Medigap, and Supplemental Health Insurance for more details.

How to Enroll in Supplemental Medicare Plans

To Enroll in Supplemental Medicare Plans like Medicare Advantage (Medicare Part C), Medicare Prescription Drug Coverage (Medicare Part D), or Medigap (Part A through N) you’ll shop through a private insurer who is authorized by Medicare. Most major brokers and providers are authorized to sell supplemental Medicare plans, you can either use Medicare.gov or your choice of broker, agent or provider to find the right plan for you. Please keep in mind that some supplemental plans can offer the same coverage and benefits at different costs, so it pays to shop around.

Each supplemental Medicare plan has it’s own enrollment periods. See below for specific Medicare Advantage enrollment periods, Medigap enrollment periods, and Part D enrollment periods. If you enroll outside of your initial enrollment period you may be subject to higher premiums and your supplemental plan may not be guarantee issue (you can be denied coverage!)

If you need coverage beyond Original Medicare you’ll want to shop for a Medigap or Medicare Advantage Plan. Both of these pair with Prescription Drug Plan (Part D), although Advantage Plans usually include drug coverage.

When Can I Enroll In Medicare?

You can enroll in Medicare during the 7 month period surrounding your 65th birthday. This 7 month period is called an initial enrollment period and comprises the 3 months before you turn 65, the month you turn 65, and the 3 months after. Aside from folks turning 65 Medicare is also offered to certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Aside from your initial enrollment period there are two other annual enrollment periods where you can change plans. If want a supplemental plan your initial enrollment period for that is 60 days after you successfully enroll in Part B. Get the details in the next section “Medicare Enrollment Peroids”.

Medicare Enrollment Periods

Original Medicare has an initial enrollment period and then two annual enrollment periods where you can switch your plan. Medicare Advantage, Part D, and Medigap also have their own enrollment rules. Let’s take a look at how Medicare enrollment works:

Original Medicare (Part A and Part B) Enrollment

For most people, the initial enrollment period for Medicare Part A and Part B starts 3 months before their 65th birthday and ends 3 months after their 65th birthday. After initial open enrollment there are two open enrollments each year where you can switch your plan or add to it. The first general enrollment period goes from January to March with coverage starting July 1st.

Medicare Advantage Enrollment

Individuals who have Medicare Part A and Part B may enroll in a Medicare Advantage plan during the Annual Election Period (AEP), the second enrollment period, which lasts from October 15 through December 7. Individuals who were eligible for Medicare Part A or enrolled in Part B as of the effective date of coverage can enroll in a Part D plan or switch Part D plans during this time. Individuals can also enroll in a Part D plan if they had qualified for a Special Election Period (SEP).

In addition, beneficiaries have from January 1 through February 14 to disenroll from their plan and return to traditional Medicare. A Medicare Advantage enrollee, however, cannot switch from his or her existing Medicare Advantage plan to a different plan during this period.

Medicare Part D Enrollment

Medicare Part D Enrollment Uses almost the exact same enrollment periods and rules as Medicare Advantage.

If you decide not to join a Medicare Prescription Drug Plan when you’re first eligible, and you don’t have other creditable prescription drug coverage, or you don’t get Extra Help, you’ll likely pay a late enrollment penalty.

You can get more details on Medicare Part D Enrollment and Medicare Advantage Enrollment here.

Medigap Enrollment

Your Medigap Open Enrollment Period 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 (Medical Insurance). If you choose to buy a Medigap plan outside of your Medigap Open Enrollment Period there’s no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements.

What If I Don’t Want Medicare Part B?

If your Medicare hasn’t started yet, there are 2 ways to drop Part B:

  1. If you were automatically enrolled in both Part A and Part B and sent a Medicare card, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums.
  2. If you signed up for Medicare through Social Security, contact Social Security.

Learn more about whether you should get Part B.

How to Sign Up For Medicare and Supplemental Medicare Plans

Whether you want Original Medicare, just Part A, just Part B, or want to shop for supplemental options your first step is always the same. Let’s take a look at the Medicare sign up process below:

1. Everyones first step will be signing up for Original Medicare (Part A and Part B) the moment they are eligible (3 months before your 65th birthday). To consider supplemental Medicare plans you’ll need to enroll in Parts A and B first. To sign up for Original Medicare follow the steps below.

You can sign up for Original Medicare (Part A and Part B) online in under 10 minutes online, by visiting your local Social Security office, by calling Social Security at 1-800-772-1213. TTY users should call TTY 1-800-325-0778, or if you worked for a railroad, call the RRB at 1-877-772-5772.

Click here to sign up for Medicare Online.

2. Once you have Original Medicare you’ll have the option to customize your health plan. Your choice will be between Medicare Advantage, a Medigap Policy, and Medicare Part D. You’ll need to sign up through a private company. Remember you cannot have an Advantage Plan and Medigap plan, and you can’t get Part D if your Advantage Plan offers drug coverage.

3. Once you decide what direction you want to go with your supplemental Medicare insurance you’ll want to find a broker, agent or provider authorized to sell supplemental policies to help you choose the right plan for you based off your specific needs.

Confused about Medicare? Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Learn more about Medicare and the Affordable Care Act.

 

Understanding Medicare Enrollment
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