You have multiple opportunities to sign up or “enroll” in Medicare or change your current Medicare coverage. The four main enrollment periods are the initial enrollment period, a yearly general enrollment period, a yearly open enrollment period, or a special enrollment period.
Medicare coverage is broken up into 4 Parts. There are different enrollment opportunities for each Part of Medicare coverage. For more information about the parts of Medicare coverage, visit the Quick Guide to Medicare – Extended.
Your first enrollment period for Medicare is your initial enrollment period (IEP). Preparing for your IEP can prevent problems down the line, since signing up for coverage after this period ends can result in penalty fees. You’ll first be eligible for Medicare when:
|Eligible for an IEP
|When Benefits Begin
|65+ receiving SSA Benefits
|1st day of month you turn 65
|Under 65 w/a disability (auto enrolled)
|After receiving SSDI for 24 months
|ALS (auto enrolled)
|First month disability begins
When people sign up for Medicare, they often get what’s called “Original Medicare,” which refers to Part A & B. Part B is an extra cost, but includes coverage for things besides hospitalization and prescription drugs. If you have other health insurance coverage, you may want to decline Part B, but it is important to understand the rules and weigh your options carefully. Keep in mind:
If you have paid into Medicare through FICA employment taxes, you will likely be automatically enrolled in Medicare Part A. If you want Medicare Parts B, C, or D, or you would like a Medigap plan, you have to choose to enroll in this coverage. If you miss your Medicare IEP, you will pay a late enrollment penalty when you sign up for Part B and Part D.
Enroll in Medicare by contacting Social Security at ssa.gov or 1-800-MEDICARE.
If you miss your initial or a special enrollment period, you can also enroll in Medicare during the general enrollment period (GEP). For Parts A and B, the GEP lasts from January 1 to March 31 every year, and your coverage will take effect the month after you enroll. If you want to also pick up a Part D prescription drug plan, the GEP lasts from April 1 to June 30 every year, and your coverage will take effect July 1. If you signed up for Part A and/or B in the GEP, then you can also decide to move to a Part C Medicare Advantage Plan during the GEP that lasts from April 1 to June 30 every year, and your coverage will take effect July 1.
|General Enrollment Period
|When Benefits Begin
|January 1- March 31
|1st day of month following the month you enroll
|Part A, B, D
Unfortunately, if you enroll in Medicare coverage during a GEP after missing your initial or a special enrollment period, you may have to pay a late enrollment penalty for the rest of your life.
Each year she will pay an additional ~$55 in Part D penalties. 15 years = $825 in penalties.
Usually, if you decide not to enroll in Medicare during your IEP, you may have to pay a penalty when you enroll later. In some cases, you may qualify for a special enrollment period, or SEP, to avoid paying the penalty for late enrollment. These are times when you may qualify for a SEP for your Part C or Part D Plan
SEPs can vary by the type of coverage you would like to enroll in:
Generally, changes made during SEPs are effective the first day of the month following the month you choose your plan, if you choose your plan between the 1st and 15th. If you wait until the 16th or later in the month, your plan will take effect the first day of the second following month.
|Special Enrollment Period
|8 months after your retirement or EGHP coverage ends
|Part A & B, Part C or D
|6 months after your Part B effective date
During the OEP, you can check to make sure that your current Medicare coverage still works for you and compare your options. The OEP runs from October 15 to December 7, each year. You should consider your prescription drug costs, monthly premiums, “network” (or covered doctors, hospitals, and pharmacies), and “formulary” (list of covered drugs) when comparing plans.
Changes that you can make during the OEP, include:
Changes made to your coverage during the OEP will take effect January 1 of the new year.
|Open Enrollment Period
|When Benefits Begin
|October 15- December 7
|Part A & B, Part C, Part D
If you are enrolled in Medicare coverage, you should receive an “evidence of coverage” (EOC) document each year. The EOC is an important document to help you understand your Medicare plan. It provides an overview of your current coverage, including what your plan covers and how much you pay. Usually, this document arrives during the fall, so you can use it to prepare for the open enrollment period beginning October 15.
For more information on Medicare options, enrollment periods, late enrollment penalties, and how Medicare interacts with other types of health insurance coverage:
Last updated: 1/2023
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