In this article
- 1 Don't Miss Your Window
- 2 Your Guide to Medicare Enrollment Periods
- 3 What are the Different Medicare Enrollment Periods?
- 4 1) Initial Enrollment Period (IEP)
- 5 2) General Enrollment Period (GEP)
- 6 3) Annual Enrollment Period (AEP)
- 7 4) Open Enrollment Period (OEP)
- 8 5) Medigap Open Enrollment Period
- 9 6) Special Enrollment Period (SEP)
- 10 Ready to Start the Conversation?
Don't Miss Your Window
Your Guide to Medicare Enrollment Periods
Medicare enrollment periods are complicated. But it is important to stay informed and up-to-date on the enrollment periods to avoid penalties and coverage gaps.
What are the Different Medicare Enrollment Periods?
There are six different Medicare enrollment periods. Take a look at each below.
1) Initial Enrollment Period (IEP)
If you are about to turn 65 and are newly eligible for Medicare, the IEP is your gateway to start receiving your Medicare benefits.
The IEP last for 7 month around your birth month and allows you to enroll in Medicare if you are about to turn 65, still working, and not yet receiving Social Security benefits (or Railroad Retirement benefits). If you are already receiving Social Security or Railroad Retirement benefits you will automatically be enrolled in both Medicare Part-A and Part-B.
Your IEP last for the three months before your birth month, your birth month, and for three months after your birth month. For example, if you were born July 12, your IEP would be the entire months of April through October. There are exceptions to this. If your birthday is on the first of the month, you are counted as having a birth month as month prior. For example, if you were born July 1, your IEP would be March through September.
During your IEP you can
- Enroll in Original Medicare
- Enroll in Medicare Part-D
- Enroll in Medicare Part-C
Failing to enroll in Original Medicare and/or Part-D coverage, may result in penalties. You can learn more about those penalties and how to avoid them here.
2) General Enrollment Period (GEP)
The GEP is used when you miss your IEP and you do not qualify for a SEP. It runs from January 1 through March 31. Coverage will begin the following month after you sign up.
3) Annual Enrollment Period (AEP)
AEP extends from October 15 until December 7 each year. Any changes you make to your coverage will begin on January 1. If no changes are made to your coverage, your current plan or plans will automatically renew on January 1.
During AEP you can
- Enroll or disenroll from a Medicare Advantage Plan
- Switch from one Medicare Advantage Plan to a different Medicare Advantage Plan
- Switch from one Part-D plan to another Part-D plan
- Enroll in a Medicare Part-D plan
- Unenroll from a Part-D plan.
4) Open Enrollment Period (OEP)
OEP runs from January 1 until March 31. This enrollment period allows you to change your current Medicare Advantage Plan if you are unhappy with it. Unlike AEP, you only have a one-time opportunity to change plans. Coverage benefits will change on the 1st of the following month.
During OEP you can
- Switch from one Medicare Advantage Plan to another.
- Unenroll from your Medicare Advantage Plan and return to Original Medicare
- Enroll in a Part-D plan only if you are returning to Original Medicare.
During OEP, you may not
- Switch from Original Medicare to a Part-C Plan
- Join a Part-D plan if you were already on Original Medicare
- Switch from one Part-D plan to another Part-D plan
5) Medigap Open Enrollment Period
The Medigap Open Enrollment Period is a 6-month window that starts from the month you turn 65 and have Medicare Part-B and ends 5 months after your birth month.
During this enrollment period you may purchase a Medigap plan without any medical underwriting. This typically leads to better pricing and a wider choice of Medigap plans. You also have guaranteed issue rights and can not be denied coverage because of you health status or pre-existing health issues.
If you do chose to purchase a Medigap plan outside of your Medigap Open Enrollment Period, insurance companies may use underwritting to decide on if they want to insure you or how much they will charge you for the plan.
6) Special Enrollment Period (SEP)
There are a lot of special enrollment periods, and each one is triggered by a different life event. In general, they allow Medicare beneficiaries to make changes to their existing Medicare health & drug coverage outside the regular enrollment periods.
You may qualify for a SEP if
- You moved to a new address that is not in your current plan’s service area.
- You recently moved into or out of a nursing home or rehabilitation hospital.
- You lose your current employee benefit coverage
- You no longer qualify for Medicaid
- You have a change to join coverage offered by an employer or union.
- You are enrolled in other creditable coverage just as TRICARE or VA coverage.
- Your current plan changes its contract with Medicare
- You become eligible for Medicaid
- You want to join a plan that had 5-star quality rating
- If you qualify for an SEP under certain Special Need Plan stipulations
While there are a lot more reasons you may qualify for an SEP, these are the most common. If you would like help determining if you qualify for an SEP, contact us and we will help guide you through the process.
During an SEP, you may join, switch, or drop a Medicare Advantage Plan or a Part-D plan.
Ready to Start the Conversation?
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