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Understanding Medicare Enrollment Periods

If you’re looking to secure a Medicare-approved health care plan, do you know when you are eligible to enroll? Take a few minutes to understand your Medicare enrollment period, and avoid missing your deadline, or having to pay a penalty.

When You First Join Medicare – Initial Enrollment Period

At the age of 65, most individuals are automatically enrolled in Medicare Part A and Part B. As long as you are eligible to receive Social Security or Railroad Retirement Board benefits, you qualify for Medicare coverage. Everyone who has worked for at least 10 years will receive Part A benefits premium-free. You do not need to do anything at all and you will automatically be enrolled in Medicare Part A coverage.

However, Part B is not premium free and you will need to pay monthly. Like Part A, enrollment is automatic – if you choose not to accept Part B coverage, you can “opt-out”. If you are still working at age 65 and receive employer-sponsored health care, you may still enroll in Part B coverage and would need to sign up during your Initial Enrollment Period. If you choose to continue receiving coverage through work, it is acceptable to delay enrollment in Part B benefits. In this case, there is a Special Enrollment Period that typically begins when employer-based coverage ends.

Medicare Enrollment Periods

Initial Enrollment Period:

Medicare offers those who are turning 65 a 7-month period of time to enroll called the Initial Enrollment Period. Initial Enrollment begins three months prior to your 65th birthday and ends three months after you turn 65.

General Enrollment Period:

For those who miss the Initial Enrollment Period, there is a General Enrollment Period, which extends from January 1st through March 31st each year. Keep in mind, enrollment begins on January 1st for coverage that begins on July 1st.

Open Enrollment Period:

Changes can be made during this period to switch from a Medicare Advantage Plan to Original Medicare plus a Part D Plan or to switch from one Medicare Advantage Plan to another. This period is from January 1st to March 31st. Plan changes take effect the month after it is submitted.

Special Enrollment Periods:

Special Enrollment Periods are available for people to join who are undergoing special life events or circumstances that make it difficult to enroll during designated enrollment periods.

Making Changes to Your Medicare Coverage

Medicare realizes that sometimes people want to change their Medicare plan. An Annual Election Period is available from October 15th through December 7th. During this time, anyone is entitled to do the following:

If you receive Original Medicare:

Leave Original Medicare for a Medicare Advantage plan (with or without prescription drug coverage)

Join or drop Medicare Prescription Drug coverage

Switch between Medicare Prescription Drug plans

If you are enrolled in Medicare Advantage:

Switch to Original Medicare

Switch between Medicare Advantage plans with prescription drug coverage

Switch between Medicare Advantage plans without prescription drug coverage

With all changes to your Medicare plan, as long as your enrollment request is made by December 7th, new coverage begins January 1st of the following year.

 

References:

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-sign-up-parts-a-and-b/when-sign-up-parts-a-and-b.html

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html

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