Breakdown of Medicare Enrollment Periods

One of the most complex components of Medicare is the variety of enrollment periods. You’ll have a unique opportunity to enroll when you’re first eligible, but there are also chances to enroll in different parts and plans – as well as change your coverage – every year.

Further, you may get an opportunity to sign up for Medicare coverage due to a life-changing event. In this article, we break down how the enrollment periods work and what you can expect.

Initial Enrollment Period

It’s important to understand that the Initial Enrollment Period, also known as IEP, is unique to each beneficiary. Additionally, it only happens once in most people’s lifetimes. Those who qualify for Medicare due to a disability before age 65 get two IEPs: one when they’re originally eligible and the second when they turn 65.

Your IEP is seven months long, starting three months before your 65th birthday and lasting through the third month after you turn 65. During your IEP window, you can sign up for Part A and Part B.

If you miss your IEP, you can enroll during the General Enrollment Period. It’s important to note that you could experience a coverage gap if you enroll during the GEP if you don’t have what Medicare considers creditable coverage. Please also keep in mind that you could face a lifetime penalty on top of your Part B premium if you lack this coverage.

General Enrollment Period

If you miss your Initial Enrollment Period, you have another chance to sign up for Parts A and B. This chance is the General Enrollment Period (GEP), which takes place from January 1 through March 31 every year. Regardless of when you sign up during this window, the effective date for your coverage is July 1.

When signing up during the GEP, there’s also a chance that you will face a Part B late enrollment penalty since you postponed enrollment. Make sure your coverage for Medicare is creditable and you’ll avoid the penalty.

Special Enrollment Period (SEP)

Life is unpredictable, and many events may prevent someone from enrolling in Medicare coverage. For those who qualify, a Special Enrollment Period allows them to drop or make changes to their supplemental Medicare coverage outside the other enrollment periods and without penalty.

Common reasons people are granted a special enrollment period include:

1. Moving to another state (Medigap)
2. Moving out of your plan’s service area (Advantage and Part D)
3. No longer being eligible for Medicaid

You can also qualify for a Special Enrollment Period of eight months for Part B. This happens when you (voluntarily or involuntarily) lose creditable coverage, such as through a group plan at an employer with 20 or more employees – which includes when you choose to retire or drop the health insurance you get through your spouse.

Medicare Supplement Open Enrollment Period

Your Medicare Supplement Open Enrollment Period is the best time to enroll in a Medigap plan because you can avoid needing to answer health questions that go through medical underwriting. Outside your Medicare Supplement Open Enrollment Period, these questions may put you in a position for an insurance carrier to deny your coverage.

This enrollment period begins the same month that you become eligible for Medicare, but you must first have Part B. While you can sign up for a Medigap plan any time of year, you’ll want to prioritize your Medicare Supplement Open Enrollment Period. If you enroll at another time, you could risk paying a higher premium and experience limited coverage options.

Medicare Annual Enrollment Period

Also known as the Annual Election Period or fall Open Enrollment, this window happens every year from October 15 to December 7. During this window, you can disenroll from or change Advantage or Part D plans. Any changes you make go into effect on January 1 of the following year. Be sure to also keep an eye out for an Annual Notice of Change (ANoC) letter from your carrier if you have either of these types of plans. You should expect to receive your ANoC in the mail each September.

Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period is for those with Medicare Advantage plans. It occurs every year between January 1 and March 31. If you’re unhappy with your Advantage coverage, this is the once-a-year window to change it. Medicare enrollees can switch from one Medicare Advantage plan to another or leave an Advantage plan to go back to Medicare – possibly picking up a Medigap plan to supplement their coverage.