You can only enroll in Medicare or make changes to your Medicare during certain times of the year. In this blog post we review these enrollment periods, so you can make the most of them.
First, it’s important to know when to sign up for Medicare for the first time.
Some people are automatically enrolled in Medicare Parts A and B—for example, if you are already collecting Social Security retirement benefits. Other people need to actively enroll during certain times of the year. There are three times you can enroll in Medicare for the first time.
Your first enrollment period is the Initial Enrollment Period, or IEP. Your IEP is a seven-month period. It includes the three months before your 65th birthday month, the month of your 65th birthday, and the three months after your 65th birthday month. If you enroll during the three months before your 65th birthday month, your Medicare will start on the first day of your birthday month. If you enroll later in your IEP, your Medicare will start on the first day of the month after you enroll.
If you miss your IEP, you may have to wait for the General Enrollment Period, or GEP, to enroll in Medicare. The GEP runs from January 1 through March 31 of each year. Your Medicare starts the first day of the month after you enroll. When you enroll during the GEP, you may have to pay a premium penalty. It increases for each 12-month period you could have had Medicare but were not enrolled. That premium penalty will usually apply for as long as you have Medicare.
If you miss your IEP, you may be eligible for a Special Enrollment Period, or SEP, to enroll in Medicare. SEPs are periods of time outside normal enrollment periods when you can enroll in Medicare. You may be eligible for an SEP to enroll in Medicare if:
You have health coverage from current work or had this coverage within the last eight months
You lost Medicaid
You are in an area affected by a disaster or emergency
You were recently released from incarceration
You missed an enrollment period because of misinformation from your employer or health plan
You experience other exceptional circumstances
Regardless of which enrollment period you use to enroll, you will contact the Social Security Administration (SSA) to enroll in Parts A and/or B. You can call 800-772-1213, visit your local Social Security branch, or go online to www.ssa.gov.
Note that if you qualify for premium-free Part A, you can enroll in it at any time once eligible. You do not need to wait for certain enrollment periods and will not owe a premium penalty for signing up late. If you enroll in Medicare Part B or premium Part A during an SEP, you will not owe a premium penalty for that part of Medicare.
Once you are enrolled in Medicare, it may be helpful to know when you can make changes to your Medicare.
If you have a Medicare Advantage Plan, you can make one change to your coverage from January 1 through March 31. This time is called the Medicare Advantage Open Enrollment Period. The changes you make become effective the first of the following month. Remember that this enrollment period is only for people who already have a Medicare Advantage Plan.
Whether you have Original Medicare or Medicare Advantage, you can make changes every fall, from October 15 through December 7. This time is called Medicare’s annual Open Enrollment Period. You can join a new Medicare Advantage Plan or a new stand-alone prescription drug plan. You can also return to Original Medicare from a Medicare Advantage Plan. Whatever changes you make become effective on January 1.
Finally, you may be able to change your Medicare coverage outside of these periods if you are eligible for a Special Enrollment Period. Earlier in this article, we discussed SEPs that allow you to enroll in Medicare Parts A and B. There are other SEPs for people who already have Medicare but want to make changes outside of the normal enrollment periods for making changes. These other SEPs are usually triggered by life circumstances. Here are some examples of when you might qualify for an SEP to switch to a different Medicare Advantage or Part D plan:
You move out of your plan’s service area
You qualify for Extra Help, the federal cost assistance program for people with limited income and assets
You qualify for Extra Help, the federal cost assistance program for people with limited income and assets
You want to disenroll from your first Medicare Advantage Plan during your trial period, which is the12 months after your Medicare Advantage coverage first started
If you think you may qualify for an SEP, contact your local SHIP. Use our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
To use an SEP or make changes to your coverage during any of these periods, you can call Medicare at 1-800-MEDICARE (1-800-633-4227).
Still have questions?
Your SHIP is here for you! You can contact your SHIP for any other Medicare-related questions or concerns you have. SHIP counselors are government funded to provide trusted, unbiased Medicare counseling at no cost to you. (Depending on your state, your SHIP may go by another name.) User our online SHIP Locator or call 877-839-2675 (and say “Medicare” when prompted) to find your local SHIP.
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