There are specific times of the year when you can enroll into a Medicare Advantage or Prescription Drug Plan. Supplement Plans are not subject to these rules.
Your enrollment into Medicare can be tricky to understand. I say that because not everyone gets Medicare at the same time of their lives. Many people will get Medicare when they turn 65 but many others will wait because they are still working.
The Initial Enrollment Period (IEP) is for those who choose to get their Medicare at age 65. IEP consists of a 7-month period. Lets break it down:
- IEP starts 3 months before the month you turn 65
- Includes the month you turn 65
- Ends 3 months after the month you turn 65
|If you join||Your coverage begins|
|During the 3 months before you turn 65||The first day of the month you turn 65|
|During the month you turn 65||The first day of the month after you ask to join the plan|
|During the 3 months after you turn 65||The first day of the month after you ask to join the plan|
Annual Enrollment Period (AEP). When: October 15 through December 7.
Anyone with Medicare Part A & B, can enroll into, or change their existing Medicare Advantage or Prescription Drug Plan. Changes take effect on the first of January, the following year.
- Change from Original Medicare to a Medicare Advantage Plan.
- Change from a Medicare Advantage Plan back to Original Medicare.
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
- Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
- Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
- Join a Medicare Prescription Drug Plan.
- Switch from one Medicare drug plan to another Medicare drug plan.
- Drop your Medicare prescription drug coverage completely.
Open Enrollment Period (OEP). When: January 1st through March 31.
If you are already in a Medicare Advantage Plan, you can make one change between Advantage Plans or swap from an Advantage plan back to Original Medicare.
Once again, I feel like Medicare is looking out for you. I like to explain it this way. Medicare understands that you may have “Buyers Remorse” with the Advantage Plan that you have chosen during AEP. To protect you, you have the option to change plans or drop the plan and return to Original Medicare.
If you did not enroll into an Advantage Plan, you cannot use OEP to enroll now. That ship has sailed.
You may be eligible to enter an Advantage Plan if you have Medicaid or certain medical conditions. People receiving Low Income Subsidy or Extra Help may be able to enroll between January and September.
Special Enrollment Period (SEP). Life sometimes gets in the way of life. There are many events in life that may qualify you for a Special Enrollment Period. I’m going to touch on a couple but there are many more. Please call me or use the contact form to send me a message if you have a question.
|You move out of your existing Medicare Advantage Plan area. You have a 2 month SEP. Those two months depend on when you notify Medicare of the move, contact me for more details.|
|You move into or out of a skilled nursing facility, psychiatric facility, rehab hospital, or long-term care facility. This SEP lasts for as long as you’re living at the facility or for 2 months after you move out|
|You move out of a jail. I’m joking a little but you cannot collect Medicare while incarcerated. When you are released from jail, you have a 2 month SEP.|
|If you lose Medicaid, you have a 3 month SEP.|
|If you loose health insurance from an employer or a union, through no fault of your own, you have a 2 month SEP. Please call me or use the contact form if you are are Medicare eligible and losing your employer insurance.|
|You have Medicare and you gain eligibility for Medicaid or the Federal Extra Help Program. This is known as DUAL/ LIS status. Enrollment is limited to once a quarter during the first three quarters of the year. Example: Jan – Mar, Apr – Jun, or Jul – Sep but not Oct – Dec. Please call me or use the contact form if you have Medicare or Extra Help.|
|If you have a CHronic Special Need such as Diabetes, Congestive Heart Failure, or Cardiovascular isssues, you may quality for a SEP. Thes periods typically run throughout the year. Please call me or use the contact form if you have a chronic condition.|
|Medicare Advantage Plansare assigned 1 to 5 Stars in a rating system. 5 Star plans are not common but they allow you a change to change your existing Advantage Plan. This period runs one time between Dec 8 and Nov 30 of each year.|