Medicare General Enrollment Period: What You Need to Know

Between January 1st and March 31st every year, Medicare has its General Enrollment Period (GEP). Think of this time as your make-up time for Medicare enrollment, if you missed your chance to sign up when you were first eligible.

During this time, if you didn’t enroll during the Initial Enrollment Period, this is your second opportunity to join Medicare.

All coverage will begin on July 1st, no matter when you enroll or what part of Medicare you choose. This is one of the many reasons why you should sign up for Medicare when you first become eligible to do so.

General Enrollment Period Facts

You can enroll during the Medicare General Enrollment Period only if you didn’t enroll in Medicare when you were first eligible and you’re not eligible for a Special Enrollment Period.

During the GEP you may enroll in Part A, Part B or both at this time. Coverage will start July 1st the same year of enrollment.

A late enrollment penalty might be added to your monthly Part B premium. Although, you might be eligible to enroll in a Part C or a Part D for a July 1st effective date.

Another reason to sign up upon eligibility is to avoid paying the Part B monthly late enrollment penalty. The late enrollment penalty is 10% of the standard Part B premium cost for each full year enrollment is delayed.

What does this mean? This is a lifetime penalty; for the entire duration of having Part B coverage, you’ll pay the penalty.

However, there are two exceptions to this penalty policy in which the Part B penalty will be waived:

1. You’re eligible for a Medicare Savings Program
2. You’re eligible for Medicare because of disability, you were responsible for premium penalties and later turned 65

General Enrollment Period and Medicare Savings Programs

If you originally declined Part B during your Initial Enrollment Period (IEP) because the premium cost was too high, you’re not alone. Although, you’ll want to take advantage of the Part B General Enrollment Period.

If you didn’t qualify for premium-free Part A, you might have opted to not enroll during your IEP because the premium cost for Part A is even higher than Part B.

You still have options available; not everyone can afford the cost of coverage and that’s understandable.

Medicare has at least 3 of the Medicare Savings Programs to cover the Part B premium resulting in protection from a Part B penalty.

QMB to get Part A

Prior to becoming eligible for Medicare Savings Programs, you must first be enrolled in Part A.

As previously mentioned, the majority will get Part A when they’re first entitled. If you don’t have it, the Qualified Medicare Beneficiary Program (QMB) covers the Part A premium.

To enroll in Part A, you must do so at the Social Security Administration District Office.

If you’re enrolling in Part A but only if QMB will cover your premium amount, tell your SS claims representative you want “conditional enrollment”. This will ensure that if you don’t get QMB, your Part A enrollment won’t still go through.

General Enrollment Period, QMB, and Part A

Most states across the country have the Part A “conditional enrollment” procedure available any time of the year.

However, there are states that limit this option only during the General Enrollment Period, including:

• Alabama
• Arizona
• California
• Colorado
• Illinois
• Kansas
• Kentucky
• Missouri
• Nebraska
• New Jersey
• Mexico
• South Carolina
• Utah
• Virginia

General Enrollment Period and Medicare Part D

When you enroll in either Parts A or B during the General Enrollment Period, you’ll also get a related Part D Special Enrollment Period to choose a drug coverage.

You can enroll in a Medicare drug plan during April through June; your coverage will begin July 1st. All other parts of Medicare you joined during the Medicare General Enrollment Period will also begin on this date.

The first time you’re eligible for Medicare when you turn 65, the Initial Enrollment Period is when you should enroll to avoid penalties. IEP is a 7-month period where you should sign up for Part A and/or Part B.

The 7-month period includes:

• Three months prior to your 65th birthday
• 65th birthday month
• And the 3 months following your 65th birthday

If you aren’t enrolled automatically and you’re eligible, you may sign up for free Part A at any time during or after your Initial Enrollment Period begins. The start date of coverage will be determined when you sign up.

For those who must buy into Medicare, you may only sign up during a valid enrollment period.

Should you decide to wait until the month of your 65th birthday to enroll, coverage for your Part B will be postponed. This might cause a slight gap in your coverage.

Other Medicare Enrollment Periods

After you’ve enrolled in Medicare, you’ll have the option to change place one time a year, during the fall Medicare Open Enrollment period; this period runs from Oct. 15th – Dec. 7th annually.

Sometimes beneficiaries are eligible to change plans outside of the Open Enrollment Period. This is most likely during a Special Election Period.

Medicare’s Special Enrollment Period gives beneficiaries a chance to change plans under certain circumstances.  Such as if you were to move; you may also qualify for a SEP for Part A and Part B if you’re serving in a foreign country, as a volunteer.

Remember, we’re here for you! If you have any further questions about Medicare’s General Enrollment Period, please contact a Medicare agent to help.