It is crucial to sign up for Medicare when you are ready. Here are the facts.
Signing up on time for all the different parts of Medicare is key to getting the most out of this government-sponsored health coverage. Late penalties can lead to higher premiums. It is important that you meet your deadlines.
To better understand when to enroll in Medicare, let’s first take a quick look at the various types of Medicare coverage available.
Original Medicare includes Medicare Part A (hospital insurance), and Medicare Part B (“medical insurance”).
Medicare Advantage (also known as Medicare Part C) plans are sold by private insurers as an alternative to Original Medicare. Medicare Advantage plans can offer additional benefits such as vision and dental coverage. Medicare Advantage plans may also include Part D prescription drug coverage.
Medicare Part D prescription drug coverage is also administered by private insurers. Part D is an optional program that helps cover the cost of prescription drugs.
Medicare Supplement Insurance (also known as Medigap) plans help pay for out-of-pocket health care costs you incur with Original Medicare parts A and B.
The following information will help you understand the major Medicare enrollment periods.
Notice: Original Medicare Parts A and B will automatically begin if you turn 65 if you are already receiving Social Security benefits or Railroad Retirement Board benefits.
Initial enrollment period
Parts A,B,C, and D
The initial enrollment period lasts seven months and includes the month that you turn 65, as well as the three months preceding and following your birthday month. You can sign up for Original Medicare (parts B and A), a Medicare Advantage plan, and a Medicare Part D prescription medication plan during this period. For example, if you turn 65 in July you will have the opportunity to enroll from April 1 through October 31.
It is vital that you sign up for Medicare Part B or Medicare Part D promptly. You could face costly penalties if you don’t sign up for Medicare Part B and Medicare Part D on time. You can get exceptions if your employer offers qualified prescription drug coverage and health insurance.
Your Medicare Part A and Medicare Part B coverage will be covered if you select a Medicare Advantage plan. If you sign up for Medicare Advantage within your initial enrollment period, there will be no Part B penalties. You can switch Medicare Advantage plans at extended times by looking below. You don’t need to sign up for Part D coverage if your Medicare Advantage plan covers prescription drugs. There are no penalties for signing up during the initial enrollment period.
General enrollment period
If you miss your initial enrollment deadline, the general enrollment period is when you can sign up to Medicare Part B or a Medicare Supplement plan. This is not the same as the annual open enrollment period.
The general enrollment period is from January 1 to March 31 each year. The coverage does not begin until the first day of July in the year that you enroll. You must wait until the general enrollment period if you haven’t signed up since you weren’t first eligible. Penalties will apply. You will also be responsible for any medical expenses you have incurred during the period you were not enrolled in the general enrollment period.
Fall open enrollment period
The annual open enrollment period, which runs from Oct. 15 through Dec. 7, allows Medicare enrolled individuals to make any changes to their coverage. David Lipschutz, associate director at the Center for Medicare Advocacy, advises that it’s always a good idea “to compare coverage and assess prescription drug requirements during this time” to ensure you have the best Medicare coverage for you and your finances.
Remember that you might pay more for a supplement policy if you have Original Medicare and want Medicare Insurance (Medigap) during this time.
Open enrollment period for Medicare Advantage
If you were enrolled in a Medicare advantage plan during your initial enrollment period and the annual Medicare open enroll period, you have the option to change to another Medicare plan with or without drug coverage or to go back to Original Medicare during the three month Medicare Advantage open enrollment period that runs from January 1 through March 31. This is important for patients who find out their medications are not covered by their Medicare Advantage or MedicarePart D formularies. Patients who discover that their doctors are not part of their Medicare Advantage networks, or those who find a cheaper alternative.
These or other reasons may cause you to change your plans. However, you can only make one change during the special enrollment period. This is in contrast to the end-of-2018 open enrollment period, where you can switch between plans as many times as you wish.
Open enrollment for Medicare Supplement Insurance
This is the 6-month period that begins when you turn 65 and enroll in Medicare Part B. You can purchase any Medigap policy in your state during this period, regardless of your current health status. Insurers must charge preexisting conditions at the same rate as people in good health during this six-month Medigap enrollment.
In all but four states that allow insurers to use medical underwriting to deny coverage or charge more if you apply for Medigap coverage during the open enrollment period. If you have a preexisting condition such as heart disease, diabetes, or are in need of surgery, you could be charged more or denied coverage.
Special circumstances or a special enrollment period
If you have certain life events, you can make changes to your Medicare Part D prescription drug coverage and Medicare Advantage. You may decide to move out of the area you currently have or into an area that offers more options. Or your insurer may discontinue Medicare coverage. You should also consider: What happens if your coverage with a former employer ends?
Each circumstance will have its own requirements and time windows. For a full list of special circumstances, check this page of Medicare.gov.
