Medicare Enrollment Periods

If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), as you approach your 65th birthday, you are automatically enrolled in Part A and Part B. Your red, white and blue Medicare card should arrive about 3 months before you turn 65. You can choose to delay enrollment if you're not ready to start Medicare, but you may be subject to a Part B late enrollment penalty in the future if you were not covered by an employer sponsored health plan during the time you delayed Part B.

If you’re close to 65, but NOT getting Social Security or Railroad Retirement Board (RRB) benefits, you’ll need to be proactive and sign up for Medicare. You can first sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. You apply through Social Security even if you don't plan to take those benefits at this time. To apply online visit SSA.GOV. You can also contact your local Social Security office to set up an appointment.

If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, in most cases, your coverage begins the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage starts the first day of the prior month. If you sign up the month you turn 65 or during the last 3 months of your Initial Enrollment Period, your coverage starts the first day of the month after you sign up.

If you’re under 65 and have a disability, you’ll automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. If you have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease), you’ll get Part A and Part B automatically the month your Social Security disability benefits begin.

After your Initial Enrollment Period is over, you may have a chance to sign up for Medicare during a Special Enrollment Period. For example, if you didn’t sign up for Part B (or Part A if you have to buy it) when you were first eligible because you have group health plan coverage based on current employment (your own, a spouse’s, or a family member’s if you have a disability), you can sign up for Part A and/or Part B anytime you’re still covered by the group health plan or during the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first.

If you have delayed Part B and you wish to enroll using the Special Enrollment Period you must submit two different Medicare Enrollment Forms: One completed by you (CMS-40B) and one to be completed by the employer (CMS-L564) providing the group health plan coverage. If you don't submit BOTH forms you may be subject to the Part B late enrollment penalty.

If you have to pay for Part A but don’t sign up for it and/or don’t sign up for Part B during your Initial Enrollment Period, and you don’t qualify for a Special Enrollment Period, you can sign up during the General Enrollment Period from January 1–March 31 each year. Your coverage starts the first day of the month after you sign up. You may have to pay a higher Part A and/or Part B premium if you are subject to the late enrollment penalty.

The best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which is the six-month period that begins on the first day of the month in which you turn 65 or older and have enrolled in Part B. After this enrollment period, you may be subject to medical underwriting and not be able to buy a Medigap policy. If you delay Part B because you have group health coverage based on your (or your spouse's) current employment, your Medigap Open Enrollment Period won't start until you sign up for Part B.

When first enrolling in Medicare

You can enroll in a Medicare Advantage Plan or Prescription Drug Plan during your Medicare Initial Enrollment Period once you've confirmed your effective dates for Medicare.

Between: October 15- December 7

Change from Original Medicare to a Medicare Advantage Plan.
Change from a Medicare Advantage Plan back to Original Medicare.
Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
Join a Medicare Prescription Drug Plan.
Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
Drop your Medicare prescription drug coverage completely.

January 1—Coverage Begins

Your new coverage begins if you switched to a new plan. If you stay with the same plan, any changes to coverage, benefits, or costs for the new year will begin on January 1.

Between January 1–March 31

If you’re in a Medicare Advantage Plan (like an HMO or PPO), you can make one change to a different plan or switch back to Original Medicare (and join a stand-alone Medicare Prescription Drug Plan) once during this time. Any changes you make will be effective the first of the month after the plan gets your request.

Special Enrollment

In most cases, if you join a Medicare Advantage Plan, you must keep it for the calendar year starting the date your coverage begins. However, in certain situations, like if you move or you lose other insurance coverage, you may be able to join, switch, or drop a Medicare Advantage Plan
during a Special Enrollment Period.

If you have questions about enrollment please give us a call. We're here to help.

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