There are several significant Medicare enrollment periods to be aware of. Missing one of these can greatly impact both your coverage and your premium. Enrollment periods are based on your birthday and then on the type of plan you have.
When is the Medicare initial enrollment period?
Your Initial Enrollment Period is the first one to mark on your calendar. This period begins three months prior to your 65th birthday and extends to three months after your 65th birthday. However, if your birthday falls on the first of the month, your enrollment period begins one month earlier.
At this time, you can enroll in Medicare Parts A and B, as well as the additional coverage of your choice. Additional coverage could be through a Medicare Advantage or Medigap plan, as well as Part D prescription drug coverage.
If you miss this enrollment period and do not have other creditable health insurance, you could be facing late enrollment penalties.
When is Medigap’s open enrollment period?
After enrolling in Medicare Parts A and B, you have a six-month window to enroll in a Medigap plan. The 6-month window begins on your Part B effective date. For most beneficiaries, this is the only time you will be guaranteed a Medigap policy.
I missed my Medicare enrollment period.
Unless you have other creditable health coverage, you will incur late enrollment penalties if you miss your Medicare Initial Enrollment Period. You’ll incur a penalty if you delay enrollment, do not have other creditable health coverage, and you:
- Do not enroll in Part B and do not have other creditable coverage. The penalty is an additional 10% of your premium for each year you delay coverage.
- Do not enroll in Part D and do not have other creditable coverage. The penalty is an additional 1% of your premium for each year you delay coverage.
- Do not qualify for premium-free Part A. The penalty is an additional 10% of your premium and will last twice the number of years you delayed coverage.
What if I have employer coverage?
If you decide to work past the age of 65, you may choose to stay on your employer’s group health insurance policy. As long as that coverage has been deemed “creditable,” you may delay Medicare enrollment as long as you stay on that policy.
When your coverage on the group policy ends, your Special Enrollment Period begins. This period lasts for eight months, starting either the month your (or your spouse) retires or the month your coverage ends, whichever occurs first.
If your group health insurance is creditable, you will not incur a late enrollment penalty.
What is a Medicare Special Enrollment Period?
To qualify for a Special Enrollment Period, you must meet specific requirements.
If you delayed enrollment into Part B and had other creditable coverage, you will qualify for a Special Enrollment Period when the creditable coverage ends.
You may also qualify if you move out of your current plan’s coverage area. This frequently happens with Medicare Advantage and Part D plans. If this occurs, you have two months to switch to a new plan.
Other Special Enrollment Period qualifiers are related to significant life events: a marriage, divorce, death, etc.
When can I enroll in Medicare Advantage or Medicare Part D?
Otherwise, the Annual Enrollment Period occurs each fall from October 15 to December 7. During this time, you may switch from Original Medicare to Medicare Advantage, change Medicare Advantage plans, and change Part D plans.