Did you think there was just one time to choose and enroll into a Medicare plan? Actually there are various Medicare enrollment periods!
The Initial Enrollment Period (or IEP), is the seven months around your Medicare birthday. It starts three months before you turn 65 and ends three months after your birth month. This is the time when you can be safely applying for Medicare without a late penalty. Your Medicare starts the month after you enroll!
The General Enrollment Period is January 1 through March 31, with Medicare starting the month after you apply. If you’ve stayed on your employer group health plan and never got around to applying for Medicare at all, this is time only time of year after age 65 that you can apply for Parts A and B, or just Part A if you have Part B all by itself.
If you already have your Part A from applying previously when you turned 65 and now want to go on Medicare, you have a special time to apply of your own choosing. Warning: You must be in a plan before the start date of your new Medicare Part B or you’ll have to wait for the next AEP!
Annual Enrollment/Election Period (AEP)
Ah, the Fall! It’s when summer is blazing out and your mailbox is filling up with Medicare mail from various carriers! This is your clue that the Medicare Annual Enrollment Period is right around the corner. (That and Joe Namath on the TV . . . .)
Also known as AEP, this is the time from October 15th to December 7th every year when you can change Medicare plans:
- Change or enroll in a Prescription Drug Plan
- Change Medicare Advantage Plans
- Return to Original Medicare
- Enroll in a Medicare Advantage Plan (if on Original Medicare)
The last plan standing on December 7th is the plan you will have on January 1st.
The Open Enrollment Period is January 1 through March 31st of each year. This is when you can:
- Switch to a different Medicare Advantage Plan
- Drop your Medicare Advantage Plan and return to Original Medicare Part A and Part B
- Sign up for a stand-alone Medicare Part D Prescription Drug plan (if you return to Original Medicare)
Did you make a mistake choosing your Medicare plan last Fall? You can still choose . . . better! The Open Enrollment Period is when you can choose a different Medicare plan one time, then you're "locked in" to your plan for the rest of the year.
Medicare Special Enrollment Periods (SEPs)
Dual-Eligible Special Needs Plans (D-SNPs): For those on Medicare and Medi-Cal (Medicaid for all you non-Californians), you have a chance to change in or out of your Dual-Eligible Special Needs Plan (D-SNP) four times a year – one time per quarter if you’re so inclined.
Chronic Special Needs Plans (C-SNPs): For those who have chronic medical conditions like heart disease, emphysema, kidney disease, diabetes, etc. there are Chronic Special Needs Plans (C-SNPs). If you discover you have one of these conditions, you are entitled to change any time during the year to a C-SNP because they plans tailored toward the special needs of people with these conditions. For example, a diabetes C-SNP may include certain injected insulins at $0 copay, whereas the same company may offer a heart plan to a diabetic and the insulin would be a minimal copayment.
Institutional Special Needs Plans (I-SNPs): Another type of plan that benefits from a SEP are Institutionalized Special Needs Plans (I-SNPs for those living in nursing homes).
Other SEPs: There are other reasons for SEPs, such as moving out of your current plan service area, acquiring or losing a Low-Income Subsidy (LIS) where the Feds cover some drug costs, coming off of incarceration, or if FEMA has declared a natural disaster in your area, preventing you from selecting a new plan. If you have an unusual situation, check here to see the Special Situations and proper forms.
Pay Attention! These situations DO NOT qualify for a Special Enrollment Period:
– Your COBRA or retiree coverage ends;
– You missed your 8-month window to sign up when you stopped working or lost job-based coverage;
– You have or lose your “Obamacare” coverage;
– You have End-Stage Renal Disease (ESRD). (If you have ESRD, don’t worry, you will get Medicare! Click here for a deeper dive.)
Are You Helping Someone Else?
If you are helping your parent, family member, or someone you are providing care for, you may be the one making decisions for someone else with Medicare. You can get the Medicare authorization form by clicking here.
Still have Medicare enrollment questions? Contact me here!
