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Medicare Enrollment Periods


Each Medicare enrollment period offers different benefits for beneficiaries to enroll. Whether you are new to Medicare or wish to change your Medicare elections, understanding each enrollment period is essential.

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Below, we explore all Medicare enrollment periods and how you can utilize them to obtain coverage.

What is the Medicare Enrollment Period?

Medicare enrollment periods can be confusing because different enrollment periods have different dates for various purposes. There are many enrollment periods for people signing up for Medicare benefits for the first time. When you are new to Medicare, you may not need to apply for benefits. You could be automatically enrolled in Medicare coverage if you meet a few requirements.

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If you are receiving Social Security benefits when you turn 65, you will automatically be enrolled in Original Medicare. Thus, you will not need to enroll yourself in Medicare Part A and Part B. 

 If you do not qualify for automatic enrollment, you will need to utilize the Initial Enrollment Period.

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Medicare Enrollment Periods

Initial Enrollment Period for New Medicare Beneficiaries

Your Initial Enrollment Period for Medicare is a seven-month Medicare enrollment period that allows you to enroll in Medicare Part A and Medicare Part B. You will receive this enrollment period upon your 65th birthday or receiving your 24th Social Security disability check, whichever comes first.

During your Initial Enrollment Period, you can enroll in both parts of Original Medicare or opt to delay Medicare Part B. For most, enrolling in Medicare Part A is a no brainer due to its $0 monthly premium. However, if you have creditable coverage in place, it is not uncommon to delay Medicare Part B benefits.

The Initial Enrollment Period begins three months before your Medicare enrollment qualifying event, the month of, and ends three months after your qualifying event. For most, this enrollment period happens around their 65th birthday.
For example, if you turn 65 on June 1, your enrollment period begins on March 1 and ends on September 30.

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If you enroll in Medicare during the three months before your 65th birthday, your Original Medicare benefits will go into effect on the first day of your birth month. If you enroll during your birth month or in the three months following, coverage will begin on the first day of the following month.

Initial Enrollment Period for Those on Medicare Before 65

If you receive Medicare benefits before age 65 due to a disability, you will receive a second Initial Enrollment Period. This will happen when you turn 65. This is known as the Initial Enrollment Period 2.

For example, if you become eligible for Medicare at age 57 due to 24 months on disability, you will be able to enroll again at age 65 with no late enrollment penalties.

During the Initial Enrollment Period 2, you can sign up for a Medicare Advantage or Medicare Supplement plan, and a Medicare Part D plan. The Initial Enrollment Period 2 runs for the same seven-month period as the Initial Enrollment Period.

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Special Enrollment Period for Medicare

One of the most complicated Medicare enrollment periods is the Special Enrollment Period. Not all Medicare beneficiaries will become eligible for a Special Enrollment Period, and those who do will need to prove their qualification.

A Special Enrollment Period happens when you delay Original Medicare enrollment when you were first eligible with creditable coverage in place. The most common reason for delaying Original Medicare coverage is because you have employer coverage in place at the time you turned 65.

Once your employer coverage is terminated, you will receive a Special Enrollment Period to enroll in Original Medicare. If you qualify, your Special Enrollment Period will last 8 months from the termination date of your employer coverage.

Once you have enrolled in Original Medicare, you will have a 63-day Special Enrollment Period to enroll in a Medicare Part D plan. It is important to enroll in drug coverage once you lose employer benefits to avoid paying the Medicare Part D late enrollment penalty.

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Additionally, if you are on a Medicare Advantage or Medicare Part D plan and experience a life-changing event, you will qualify for a Special Enrollment Period to make a change to your plan.

These life-changing events include:

  • Moving out of your plan’s service area
  • Your plan no longer services your area
  • You move in or out of a nursing home
  • You lose or gain Medicaid coverage
  • You become approved (or lose) Extra Help benefits

If you believe you may qualify for a Special Enrollment Period, our licensed Medicare agents can help. Since the Special Enrollment Period is time-sensitive, our licensed agents will assist you in finding new Medicare coverage. Please complete our online rate form to learn more.

General Enrollment Period for Those Who Delay Medicare Coverage

Suppose you do not enroll in Original Medicare during your Initial Enrollment Period and do not have creditable coverage in place. In this case, you will need to wait until the General Enrollment Period to enroll in Original Medicare.

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The General Enrollment Period runs annually from January 1 to March 31. When you enroll during this time, your coverage will go into effect on July 1.

Keep in mind, when you enroll in Original Medicare during the General Enrollment Period, you may be responsible for paying late enrollment fees. This depends on how long you delayed Medicare benefits without creditable coverage. Creditable coverage is health insurance that provides at least equal benefits to Original Medicare. We recommend that you enroll in Medicare coverage as soon as you are eligible or lose creditable coverage to avoid paying the late enrollment penalty.

Are There Enrollment Periods for Medicare Supplement Plans?

Your Medicare Supplement Open Enrollment Period begins the 1st day of the month your Medicare Part B becomes effective. This is a six-month enrollment period that grants you guaranteed issue rights for any Medicare Supplement (Medigap) plan you wish to enroll in. However, many carriers allow you to enroll in a Medicare Supplement plan up to six-months before your Medicare Part B start date.

A Medicare Supplement plan is essential for Medicare enrollees who wish to pay as little out-of-pocket costs as possible for their healthcare coverage. Medicare Supplement plans cover the costs that Medicare Part A and Part B leave behind, eliminating the high expenses associated with Medicare coverage.

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Enrolling in Medigap during a guaranteed-issue period is important. Especially if you have pre-existing conditions that could result in denial of your policy in the future.
If you miss your Medicare Supplement Open Enrollment Period, you can still apply for Medigap coverage throughout the year. However, there is a chance the application can be denied due to underwriting.

Are there Enrollment Periods for Medicare Advantage Plans?

Once you have enrolled in Original Medicare, you can begin enrolling in additional coverage plans. One of these plans include Medicare Advantage plans.

Medicare Advantage plans are offered through private insurance companies and offer additional benefits to Original Medicare coverage. Often, these plans provide dental, hearing, vision, and drug coverage as well as gym memberships to enrollees. On the other hand, these plans tend to have high out-of-pocket costs and are more restrictive than Original Medicare.

To enroll in a Medicare Advantage plan, you will want to utilize your Initial Coverage Election Period. This enrollment period is the same seven-month period as your Initial Enrollment Period.

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If you wish to enroll in a Medicare Advantage plan it must be done during your Initial Coverage Election Period. If you miss your Initial Coverage Election Period, you may have to wait until the Annual Enrollment Period to enroll in a Medicare Advantage plan for the following year.

Additionally, if you enroll in Original Medicare during the General Enrollment Period, you will have a Special Enrollment Period to enroll in a Medicare Advantage plan.

Annual Enrollment Period for Medicare

The Annual Enrollment Period for Medicare occurs each year from October 15 to December 7. This Annual Enrollment Period allows Original Medicare enrollees to make several changes to their coverage.

These changes include:

  • Switching from Original Medicare to Medicare Advantage
  • Go from Medicare Advantage to Original Medicare
  • Switch from one Medicare Advantage plan to another
  • Enroll, change or drop your Medicare Part D prescription plan

Suppose you use the Annual Enrollment Period to return to Original Medicare from Medicare Advantage. In this case, you can then enroll in a Medicare Supplement plan to alleviate your Original Medicare out-of-pocket costs. This plan will begin on January 1 of the following year.
However, you will need to pass medical underwriting to enroll in the Medicare Supplement plan.

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Annual Enrollment Period vs Open Enrollment Period

Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period allows anyone enrolled in a Medicare Advantage plan to make a one-time change to their coverage from January 1 through March 31. This enrollment period is extremely helpful to those who were unable to change their plan during the Annual Enrollment Period. Additionally, if you are unhappy with their new Medicare Advantage plan coverage, this is your time to make a change.

During the Medicare Advantage Open Enrollment Period, you can switch Medicare Advantage plans or return to Original Medicare.

It is important to understand that this enrollment period is only for those already on Medicare Advantage. You may not enroll in a Medicare Advantage plan during this time.

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How to Get Help Understanding Medicare Enrollment Periods

It is essential to enroll in Medicare while you have a valid enrollment period. Missing these enrollment periods can lead to late penalties, lack of coverage, or denial of coverage in the future.

To ensure you enroll in the right Medicare plans at the right time, we have a team of licensed Medicare experts available to help at any step of the Medicare enrollment process. Whether you wish to enroll in a Medicare Part D plan, Medicare Advantage or a Medicare Supplement plan, we have a team of licensed Medicare agents to help you find the best plans in your area through the best carriers at the lowest cost.

To receive a free online rate comparison today complete our online rate form or give us a call today at the number above.

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Sources:

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. When does Medicare coverage start?, Medicare. Accessed June 2022.
    https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start
  2. Medicare benefits, SSA. Accessed June 2022.
    https://www.ssa.gov/benefits/medicare/
  3. Understanding Medicare Part C and D Enrollment periods, KFF. Accessed June 2022.
    https://www.kff.org/wp-content/uploads/sites/2/2012/10/11219.pdf

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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