Medicare Enrollment Periods for Original Medicare Coverage

If you aren’t receiving Social Security benefits or RRB benefits when you turn 65, you will have to sign up for Original Medicare (Medicare A and/or Part B) during your Initial Enrollment Period (IEP). This open enrollment period or initial enrollment period begins three months before your 65th birthday includes the month that you turn 65, and ends three months later.

Remember, if you miss your initial enrollment period for whatever reason, you can sign up for Medicare Part A and/or Part B during the Medicare General Enrollment Period that runs from January 1 through March 31 of every year. You may have to pay a late enrollment penalty for both Part A and Part B if you did not sign up when you were first eligible. You can also make changes to your coverage during general enrollment period.

Remember, if you miss your initial enrollment period for whatever reason, you can sign up for Medicare Part A and/or Part B during the Medicare General Enrollment Period that runs from January 1 through March 31 of every year. You may have to pay a late enrollment penalty for both Part A and Part B if you did not sign up when you were first eligible. You can also make changes to your coverage during general enrollment period.

Medicare Annual Election Period (AEP)

If you’d like to make changes to your current Medicare coverage, there are specific times when you are able to make those changes, and we call it the open enrollment period. The Annual Election Period (AEP) runs from October 15 to December 7 each year. Think of it more as a general enrollment period than an annual enrollment period. If you didn’t sign up for Medicare Advantage (open enrollment), Original Medicare, or a Medicare Prescription Drug Plan when you first become eligible (during your Initial Enrollment Period), this is your chance to make those changes (unless you qualify for a Special Election Period).

What changes can you make during the Annual Enrollment Period?

Great question about the open enrollment period! Let’s take a look at what you can do during the general enrollment period or annual enrollment period:

• Change from Original Medicare (Part A & B) plan to a Medicare Advantage Plan

• Change from Medicare Advantage open enrollment plan to Original Medicare, Part A & B

• Change from one Medicare plan to a Medicare Advantage plan to another (regardless of whether either plan offers drug coverage)

• Enroll in a Part D prescription drug plan of a Medicare Advantage open enrollment

• Change from one Medicare Advantage plan prescription drug plan to another

• Opt out of Medicare Advantage plan Prescription Drug coverage completely

Note: To enroll in Medicare, any changes you make during the AEP go into effect January 1st of the following year.

Special Enrollment Period

A special enrollment period is a designated timeframe during which certain individuals are allowed to enroll in a health insurance plan or make changes to their existing coverage outside of the typical open enrollment period. This special enrollment period can be triggered by a variety of circumstances, such as losing coverage due to job loss or divorce, moving to a new area, having a baby or adopting a child, or experiencing certain other qualifying life events. It’s important to note that the special enrollment period is not available to everyone at all times, as an open enrollment period, and eligibility requirements may vary depending on the circumstances. If you believe you may be eligible for a special enrollment period, it’s important to act quickly and take advantage of the opportunity while it lasts. Don’t wait until the next open enrollment period, as you may miss out on important coverage options and benefits that you need. So, always stay aware of the availability of a special enrollment period and take advantage of it if you are eligible.

Medicare Advantage Plans

Medicare Advantage is a type of health insurance plan that is offered by private insurance companies as an alternative to Original Medicare. Medicare Advantage plans provide all of the same benefits as Original Medicare, but may also include additional benefits like prescription drug coverage, vision, hearing, and dental benefits. Medicare Advantage plans may also have different costs, deductibles, and co-pays than Original Medicare. One of the benefits of Medicare Advantage plans is that they often offer more comprehensive coverage than Original Medicare, making them a popular choice for seniors who have complex medical needs. Medicare Advantage plans also provide a range of choices, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Private Fee-for-Service (PFFS) plans. Overall, Medicare Advantage plans are a viable option for many people seeking to supplement their Medicare coverage and access a range of additional benefits. If you’re interested in learning more about Medicare Advantage plans and whether they’re right for you, speak with a licensed insurance agent who can help you compare plans and select the best option for your individual needs.

What if I want to make a change to my Medicare Plan outside of the AEP?

Another great question! If you missed the Initial Enrollment Period for Medicare and need to make changes to your policy, you can do this during the Medicare Enrollment Period, from January 1st to March 31st each year. If you switch to Original medicare during this period, you will have to wait until March 31 to enroll in a Medicare Part D prescription drug plan. 

Medicare allows changes outside the standard enrollment periods in specific situations that are often out of the beneficiary’s control, such as Medicare ending its contract with your plan, through Special Election Periods (SEPs). Other examples of these situations include, but are not limited to, the following:

• Moving out of your plan’s service area.

• Receiving both Medicare and Medicaid benefits.

• Qualifying for Extra Help.

• Living in, moving to, or moving from an institution such as a long-term care hospital or skilled nursing facility.

It’s important to know when the different enrollment periods are to sign up for medicare to ensure you receive coverage for Original Medicare and a Medicare Advantage Plan if needed so you don’t get a late enrollment penalty. We can help you enroll in Medicare, learn about which Medicare plan is best, and whether you need a Medicare Advantage plan or not.