Medicare Advantage Enrollment & Disenrollment Periods
There are specific Medicare Advantage enrollment periods, including ones that allow you to enroll, switch, or disenroll.
Below, we’re going to go over all of them in detail.
Ultimate Guide to Medicare Advantage Enrollment & Disenrollment Periods
There are four enrollment periods for Medicare Advantage plans:
- Initial Coverage Election Period (ICEP)
- Annual Enrollment Period (AEP)
- Medicare Advantage Open Enrollment Period (MA OEP)
- Special Enrollment Period (SEP)
If you’re new to Medicare, you’ll have an Initial Enrollment Period that allows you to enroll in Part A, Part B, and Part D.
At the same time, your Initial Coverage Election Period will also begin, which allows you to enroll in a private Medicare Advantage health plan.
Initial Coverage Election Period
Your ICEP will begin three months before the month of your 65th birthday. It will end either the last day of the month before you enroll in Part B or the last day of the month of your IEP, whichever is later.
Examples of ICEPs
Let’s say you turned 65 on May 10th. You have both your Part A & B taking effect on May 1st. That makes your ICEP to enroll in a private Medicare Advantage plan from February 1st-August 31st. Your Medicare Advantage coverage cannot take effect before May 1st.
Another example would be if your birthday were February 27th, 2018. Since you were still working, you enrolled in Part A but decided to delay Part B due to having employer coverage.
Once you retired, you were given an 8-month Special Election Period to enroll in Part B. You join Part B with an April 1st, 2019 effective date.
The above scenario would make your ICEP window to enroll in a Medicare Advantage plan between January 1st – March 31st.
The reason your ICEP window is between the above dates is due to your Part B becoming effective April 1st, 2019 vs. you enrolling when you were first eligible.
As you can see, your ICEP can be a little confusing. That’s why it’s recommended not to attempt to enroll without the help of a licensed agent.
The general rule of thumb is when you enroll in a Medicare Advantage plan during your ICEP, it will take effect the first of the following month.
The only caveat to that is your Medicare Advantage plan cannot become effective before your Part B effective date.
ICEP When Delaying Part B
There’s a good chance you may be working past 65. Meaning, you may delay enrolling in Part B until you either retire or lose group coverage.
As stated above, in example #2, you’ll get an 8-month Special Enrollment Period upon retiring or losing employer health coverage.
It’s always recommended to sign up for Part B during the months just before retiring. This is, so you have coverage following the month you retire and don’t have any coverage gaps.
Depending on your situation, if it makes sense, you can sign up for Part B at any time while working and covered by employer group health coverage.
It’s important to understand that, along with your 8-month SEP to enroll in Part B, you’ll also have your ICEP to register in a private Medicare Advantage plan.
Medicare Advantage Enrollment Period Outside your ICEP
If you missed your ICEP or chose not to enroll in a private Medicare Advantage plan at that time, your next opportunity to join in one is during the Annual Enrollment Period.
The AEP runs annually between October 15th-December 7th. During this window, you can enroll in a Medicare Advantage plan with your effective date being January 1st.
You can also use this enrollment window to disenroll from your Medicare Advantage plan and switch back to Original Medicare.
After you disenroll from your Medicare Advantage plan, you can choose to pick up a Medigap plan and a stand-alone Part D prescription drug plan.
If you missed the AEP, your next chance to make changes is during the Medicare Advantage Open Enrollment Period.
Your Medicare Advantage Open Enrollment Period
This enrollment period is not new. It was once known as the Medicare Advantage Disenrollment Period and was discontinued back in 2010.
The Medicare Advantage Disenrollment Period was renamed and brought back in 2019. It’s now known as the Medicare Advantage Open Enrollment Period.
It runs annually between January 1st and March 31st. It allows you to make a one time change to your current Medicare Advantage plan.
Unless you’re currently enrolled in a Medicare Advantage plan, you cannot make any changes to your Medicare coverage during this enrollment period.
The Medicare Advantage OEP is not for you to enroll in a Medicare Advantage plan for the first time, but to change your current policy to another one or switch back to Original Medicare.
This enrollment window was brought back in 2019 because many Medicare Advantage enrollees did not fully understand how their Medicare Advantage policy worked.
When they realized it was not going to give them the benefits they thought it would, they were stuck with that plan for an entire year.
So, the return of the Medicare Advantage OEP gives you a second chance to make changes to your current Medicare Advantage plan if you’re unhappy with it.
Medicare Advantage Special Enrollment Periods
If you missed your ICEP, as well as the annual AEP and Medicare Advantage OEP, you may have another opportunity to enroll in a Medicare Advantage plan.
There are a few particular circumstances that allow Medicare beneficiaries to either enroll in a Medicare Advantage plan or change their current Medicare Advantage plan.
These particular circumstances give you a Special Enrollment Period. During a SEP, you can enroll in a Medicare Advantage plan outside your ICEP, the annual AEP, and the annual Medicare Advantage OEP.
Medicare Advantage “Trial Period” Special Enrollment Period
If you enrolled in a private Medicare Advantage plan during your ICEP, you’re given a “trial period.” This trial period is a 12-month window.
During this 12-month window, you have an SEP that allows you to disenroll from your first Medicare Advantage plan and go back to Original Medicare.
At this same time, you’ll have a “Guaranteed Issue Right” to enroll in a Medigap plan. This Guaranteed Issue Right will last for 63 days after you disenroll from your Medicare Advantage plan.
Trial Right After Switching from Medigap to Medicare Advantage
This same trial right also applies to beneficiaries who dropped their Medigap plan and enrolled in a Medicare Advantage plan for the first time.
In this scenario, you’ll also have a 12-month window that gives you a SEP to change your mind. Once you disenroll from your Medicare Advantage plan, you’ll have 63 days with Guaranteed Issue Rights.
However, this trial right does have some limits. You’re only allowed to enroll back into your previous Medigap plan if it’s still available in your area.
If your previous Medigap policy is no longer available, then you’re allowed to enroll in Medigap Plan A, B, D, G, K, or L.
Medicare Advantage SEPs for Beneficiaries on Limited Income
If you’re on a limited income, there are a few Special Enrollment Periods you’re eligible for.
Medicare Advantage Dual SEP
If you have both Medicare & Medicaid, you’re eligible for this SEP. This SEP will allow you to enroll, disenroll, or switch to another Medicare Advantage plan once per quarter during the first three quarters of the year.
During the 4th quarter, dual beneficiaries must use the AEP to make changes. If you lose Medicaid, this SEP will end two months after.
Medicare Advantage Low-Income Subsidy & Extra Help SEP
This SEP is for beneficiaries who are eligible for the Part D LIS/Extra Help. This Special Enrollment Period is also for those who are dual-eligible for Medicare & Medicaid.
This SEP also allows you to enroll, disenroll, or switch to another Medicare Advantage plan once per quarter during the first three quarters of the year.
This Low-Income Subsidy/Extra Help SEP will begin the month you’re found eligible for Extra Help. If you lose your Extra Help standing, this SEP will end two months after.
Medicare Advantage State Pharmaceutical Assitance Program SEP
For stats that participate in SPAPs, beneficiaries can use this SEP to sign up for switch Part D plans. This SEP can only be used once per the calendar year.
Medicare Advantage SEP that Coordinates with Part D
There are two different Special Enrollment Periods for Medicare Advantage enrollees that allow them to disenroll and enroll in a stand-alone Part D prescription drug plan.
Medicare Advantage SEP 65
If you joined a Medicare Advantage plan during your IEP, this SEP would allow you to disenroll from your Advantage plan and switch back to Original Medicare.
You can also use the Medicare Advantage SEP 65 to disenroll from a Medicare Advantage Prescription Drug plan to a stand-alone PDP.
Those who take advantage of the SEP 65 should take into consideration the out of pocket costs that come with Original Medicare and enroll in a Qualified Medicare Beneficiary Program or Medigap plan. This SEP extends your Medigap Open Enrollment Period.
SEPs When Moving to Another Service Area
The Medicare Advantage relocation SEP is for individuals who move to another service area. Usually, since many plans are specific to a county, moving gives you new plan options.
The relocation SEP window will begin the month before your move date and will last two months after you move.
FEMA Declared Weather Related Emergency or Major Disaster SEP
If a weather-related emergency or major disaster impacted your enrollment, then you’ll have a SEP to enroll, switch, or disenroll from your Medicare Advantage plan.
If you rely on the help of a family member or friend that lives in one of the areas impacted by a weather-related emergency or major disaster, you’ll also qualify for a SEP.
This SEP window will start at the time of the emergency and will continue for four calendar months after.
SEPs for Institutionalized Individuals
The Medicare Advantage Open Enrollment Period, or OEPI, is for those residing in nursing homes or other long-term care facilities.
The OEPI gives beneficiaries with Original Medicare who move into, live in, or are discharged from individual long-erm care facilities to join, switch, or disenroll from a Medicare Advantage plan.
This SEP can be used by:
- nursing homes
- rehabilitation hospitals
- psychiatric hospitals
- long-term care hospitals
The OEPI can also be used by individuals who are admitted into a Skilled Nursing Facility. It allows them to join a Special Needs Plan, or SNP, for institutionalized individuals.
This SEP window will begin the month of admission and will end two months after the individual is discharged. The OEPI may be used monthly if needed.
Wrapping Medicare Advantage Enrollment Periods Up
As you can see, there are many different Medicare Advantage enrollment and dis-enrollment windows for Medicare beneficiaries. CMS has a very long (and confusing) guide to the different enrollment windows for Medicare Advantage plans.
When making important decisions regarding your Medicare healthcare coverage, use the free help of a trusted Medicare agent. This will ensure you’re making the best decision for your situation.
Since some of the above enrollment periods only allow you to make a change one-time, don’t do it alone. You could be stuck with a plan you don’t want for an entire year.
Plus, if you run into any issues with your coverage, our Client Care Team is always here to help. Give us a call, or use our compare rates form to compare all Medicare plans available in your area now.