June 13th 2024
By Ari Parker
3 Medicare enrollment periods to know are the Initial Enrollment Period, Special Enrollment Period, and General Enrollment Period. Learn about them and other Medicare enrollment periods in this article.
By Ari Parker
Learning the ins and outs of Medicare can make you feel like you’re in a maze. Just when you think you’ve got it all figured out, you learn about another deadline or rule! Well, we’re here to help you through this journey, starting with one of the most important aspects of Medicare: the three key enrollment periods.
There are more than three Medicare enrollment periods, but we’ll go over the three tied to when you should first enroll in Medicare: the Initial Enrollment Period, Special Enrollment Periods, and the General Enrollment period first. Knowing when and what these three enrollment periods are can save you from penalties and gaps in your healthcare coverage.
Three important Medicare enrollment periods to know are the Initial Enrollment Period, Special Enrollment Period, and General Enrollment Period.
Missing your Initial Enrollment Period may mean you need to pay a late enrollment penalty.
There are also other Medicare enrollment periods to be aware of, like the Medigap Open Enrollment Period, Open Enrollment Period, and Medicare Advantage Open Enrollment Period.
Your Initial Enrollment Period (IEP) is when you first become eligible to sign up for Medicare. This window of time begins three months before your 65th birthday, includes your birth month, and lasts for three months after. In total, you have seven months to enroll in Medicare during your Initial Enrollment Period.
Here are a few tips to keep in mind when thinking about your Medicare enrollment:
Make sure to stop any HSA contributions six months before applying to enroll in Part A.
If you’ve been collecting Social Security benefits, you’ll be automatically enrolled in Original Medicare (which includes Part A and Part B).
You can enroll in Medicare on the Social Security Administration website or by calling Social Security at 1-800-772-1213 (TTY number at 1-800-325-0778).
You can delay enrollment if you qualify for a Special Enrollment Period (SEP). If you don’t qualify for an SEP and you miss your IEP, you may have to pay a lifetime fee. Learn how to avoid Medicare enrollment penalties.
Special Enrollment Periods (SEPs) allow you to enroll in Medicare if outside of standard enrollment periods, like your Initial Enrollment Period. If and when you qualify depends on your unique situation. Medicare beneficiaries most commonly sign up during an SEP if they delay retirement. In this case, they can use the Part B Special Enrollment Period to sign up for Medicare once they retire and lose their employer insurance coverage.
Other common events that may qualify you for an SEP include:
Losing Medicaid coverage
Losing coverage through a spouse’s insurance
Clerical errors in other coverage you signed up for or misleading information from other coverage you have
Important note: You do not qualify to enroll during a Part B Special Enrollment Period if you work for an organization with fewer than 20 employees. If this applies to you, you should plan to enroll during your Initial Enrollment Period.
Even if you continue to work past age 65, it may be worth comparing your employer coverage to your options for Medicare to see which is the most cost-effective and provides the most benefits. You may find that you want to drop your employer coverage and sign up for Medicare during your IEP.
You should try to avoid signing up for Medicare during the General Enrollment Period. Medicare created this enrollment period for people who missed their Initial Enrollment Period and don’t qualify for a Special Enrollment Period. In other words, it’s intended to be a backup option. Like we mentioned earlier, signing up for Medicare outside of your Initial Enrollment Period could mean paying a penalty on top of your Part B premium—unless you’re eligible for a Special Enrollment Period.
If you do miss your IEP and aren’t eligible for an SEP, you can apply for Medicare during the General Enrollment Period, which lasts from January 1st to March 1st of every year.
The Initial Enrollment Period, Part B Special Enrollment Period, and General Enrollment Period are each used to sign up for Original Medicare. So, when can you enroll in Medicare Advantage (Part C) and Part D (prescription drug coverage)?
You can join a Medicare Advantage plan for the first time during your Initial Coverage Election Period (ICEP). Before you sign up for a Medicare Advantage plan, you’ll need to first enroll in Medicare Part A and Part B. Your ICEP starts three months before you’re enrolled in Part A and Part B, and it ends on the last day of the month that both parts are effective. It can also end the last day of your Initial Enrollment Period (whichever is later).
Put more simply, the best time to join a Medicare Advantage plan is during your Initial Enrollment Period. You can also join a Medicare Advantage plan up to three months before your Part B goes into effect if you qualify for a Special Enrollment Period or enroll during the General Enrollment Period.
Keep in mind that you may want to think about the pros and cons of enrolling in a Medicare Advantage plan beforehand.
Your ICEP is also the best time to enroll in Medicare Part D. Part D is your prescription drug coverage, and an important part of your health insurance.
You can also choose to enroll in Medicare Part D or a Medicare Advantage plan during the Medicare Open Enrollment Period, which occurs from October 15th to December 7th of every year. Just know that if you don’t sign up for Medicare Part D during your Initial Enrollment Period and go more than 63 days without creditable prescription drug coverage, you will have to pay the Part D late enrollment penalty.
The best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment Period. This is a period of six months that starts after your Medicare Part B coverage begins. During your Medigap Open Enrollment Period, you have a guaranteed issue right. This means insurance carriers cannot deny you coverage or charge you more based on your health status. Outside of this period, you’ll likely need to answer questions about your health during medical underwriting. Insurance carriers could deny your application or charge you more based on your answers to medical underwriting questions.
Don’t worry—you’re not stuck with any Medicare plan for the rest of your life. Read below to learn about some ways you can switch Medicare plans.
If you want to switch between Medicare Advantage plans or prescription drug plans, you can do so during the Medicare Open Enrollment Period. The Medicare Open Enrollment Period occurs every year from October 15th through December 7th.
If you’ve enrolled in a new Medicare Advantage plan during the Open Enrollment Period that you find doesn’t work for you, you can change your coverage during the Medicare Advantage Open Enrollment Period. This period lasts from January 1st to March 31st every year.
If you have qualifying circumstances, you can switch coverage during a Special Enrollment Period. For example, you can switch plans if you moved out of your Medicare Advantage plan’s service area. See a full list of Special Enrollment Period here.
The Initial Enrollment Period, Special Enrollment Periods, and the General Enrollment Period are especially important for people new to Medicare, but there are other enrollment periods to know too. Medicare enrollment periods can be hard to keep track of, and missing a deadline can result in lifetime penalties! Call a licensed Chapter Medicare Advisor to learn when you should enroll and what coverage options work best for you. Call us at 855-900-2427 or schedule a time to chat to get started.
