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Medicare Enrollment

Medicare Enrollment

When you enroll in Medicare Part A and Medicare Part B is an important decision that will affect you for the rest of your life. Many factors go into this decision including your current employment and insurance coverage as well as what type of plan you may currently be enrolled in.

By Age

If you are joining Medicare because of your age and you receive your Social Security retirement benefit before you turn 65, you may automatically be enrolled in Medicare Part A and Part B. There are some restrictions to the automatic enrollment.

If you qualify for Medicare because of your age and you are not already receiving your Social Security retirement benefit, you must sign up for Medicare during your 7 month open enrollment period that begins 3 months before you turn 65, includes your birth month and extends 3 months after your birth month. Also, if you decline your Medicare benefit because you have existing medical insurance, you may be entitled to a Special Enrollment Period but only if it is based upon current employment insurance.

By Health

If you are under 65 and you are eligible for Medicare because of a disability or disease, you are automatically enrolled in Medicare in your 25th month of disability.

Medicare Enrollment Penalties

There are penalties for not enrolling in Medicare Part B and Medicare Part D when you are eligible. These are not one time fees, but are additional costs that you must pay as long as you remain on Medicare.

Enrollment Periods

You can enroll in Medicare during specific times called enrollment periods. Some enrollment periods are for people joining Medicare for the first time. Others are for people already enrolled in Medicare who want to change their coverage.

Initial Enrollment Period (IEP)

The Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. Your Initial Enrollment Period allows you to enroll in Medicare Part A, Part B, Part C, and Part D.

The specific dates for your Initial Enrollment Period are determined by the event that makes you eligible for Medicare.

  • When you are eligible for Medicare based on your age, your Enrollment Period depends on your 65th birthday. Your Initial Enrollment Period begins 3 months before your birthday and continues for 3 months after your birthday.
  • When you are eligible for Medicare because of a disability, your Initial Enrollment Period starts on the 25th month after you start receiving Social Security disability benefits.
  • When you are eligible for Medicare because you have Amyotrophic Lateral Disease (ALS), your your Medicare benefits begin the first month you get disability benefits.
  • When you are eligible for Medicare because you have End Stage Renal Disease (ESRD), and you’re on dialysis, your Medicare coverage usually starts the 4th month of dialysis treatments.

During your Initial Enrollment Period, you can:

  • Enroll in Medicare Part A, Medicare Part B, or both.
  • Enroll in a Medicare Advantage (Medicare Part C) plan (if you enroll in both Medicare Part A and Medicare Part B).
  • Enroll in a standalone prescription drug plan (Medicare Part D) unless you enroll in a Medicare Advantage plan that includes prescription drugs.

You should enroll in Medicare during your Initial Enrollment Period or you may encounter late enrollment penalties.

General Enrollment Period (GEP)

The General Enrollment Period (GEP) runs from January 1 to March 31 each calendar year. During this time, you can:

  • Enroll in Medicare Part B if you did not enroll during your Initial Enrollment Period.

You cannot enroll in Medicare Advantage (Medicare Part C) during the General Enrollment Period. When you delay your enrollment into Medicare Part B using the GEP, your initial Enrollment Period for Medicare Advantage and Part D begins on April 1st and continues through June 30th.

If you did not enroll during your Initial Enrollment Period, you may encounter a late enrollment penalty for enrolling during the General Enrollment Period.

Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP) runs from October 15 to December 7 each calendar year. During this time, you can:

  • Switch from original Medicare (Medicare Part A and Medicare Part B) to Medicare Advantage (Medicare Part C).
  • Switch your existing Medicare Advantage (Medicare Part C) plan to a different plan.

Medicare Part C and Medicare Part D plans change every year. This is your opportunity to customize your Medicare insurance to meet your changing needs.

Medicare Open Enrollment Period (OEP)

The Medicare Open Enrollment Period (OEP) runs from January 1 to March 31 each calendar year. During this time, anyone who is enrolled in a Medicare Advantage plan (Medicare Part C) can switch make the following changes.

  • Switch your existing Medicare Advantage (Medicare Part C) plan to a different plan.
  • Switch your existing Medicare Advantage plan (Medicare Part C) to Original Medicare (Medicare Part A and Medicare Part B) with or without a Prescription Drug Plan.
  • Add a Medicare Part D plan if you don’t have prescription drug coverage.
  • Switch your existing Medicare Part D plan for a different prescription drug plan.
  • Switch from Medicare Advantage (Medicare Part C) to original Medicare (Medicare Part A and Medicare Part B).

If your Medicare Advantage plan included prescription drug coverage, you can also enroll in a standalone prescription drug plan (Medicare Part D) at this time.

Special Enrollment Period (SEP)

There are many special enrollment periods that happen throughout the year. Generally, Special Enrollment Periods are triggered by changes in your home, employment, or insurance situation.

Contact Medicare by phone at 1 (800) MEDICARE or 1 (800) 633-4227 or 1 (877) 486-2048 (TTY) or visit their website at Medicare.gov for more details about Special Enrollment Periods and how to qualify for them.

Now that you understand Medicare enrollment, let’s talk about your Medicare costs.