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Having trouble understanding when you can enroll in a Medicare plan or what changes you can make to your current Medicare coverage and when? Below we outline the most common Medicare enrollment periods, including what changes you can make and when.
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Enrollment Period
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What You Can Do
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When You Can Act
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Initial Enrollment Period Based on Age
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- Join Medicare Parts A and B
- Join a Medicare Advantage plan (if you’re eligible)
- Join a Medicare Part D plan
- Join a Medigap plan
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If joining Medicare, three months before, the month of and three months after your 65th birthday
(seven months total)
If enrolling in a Medigap plan, it’s the month you turn 65 and you have Medicare Part B, and five months after (six months total)
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Initial Enrollment Period Due to Disability
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- Join Medicare Parts A and B
- Join a Medicare Advantage plan (if you’re eligible)
- Join a Medicare Part D plan
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24 months from the qualifying date of your disability, which is established during the SSDI process
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Annual Enrollment Period
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- Switch Medicare plans (such as moving from one Medicare Advantage plan to another or one Part D plan to another)
- Go back to traditional Medicare from a Medicare Advantage plan
- Join a Medicare plan for the first time
- Leave the Medicare program
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Oct. 15 – Dec. 7
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General Open Enrollment Period
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- Join Medicare Part B if you didn’t join when you were first eligible
- Disenroll from Medicare Advantage and get Part D with traditional Medicare
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- Jan. 1 – Mar. 31 every year(enrollment effective on July 1 of same year)
- Disenrollment period: Jan. 1 - Feb. 14
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Special Enrollment Periods (SEP)
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- Switch from one plan to another (applicable when moving out of a plan’s service area, becoming eligible for low-income subsidy and moving to an institution)
- Join a Medicare plan for the first time
- Join Medicare Part B for the first time (applicable only when losing group health coverage)
- Join a Medigap plan for the first time (applicable only when losing group health coverage)
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Varies, depending upon the circumstances. For Medicare plans:
- Losing group coverage (the month of and seven months after you lose your coverage)
- Moving out of a plan’s service area
- Becoming eligible for the low-income subsidy
- Being institutionalized
- Being unhappy with your Medicare plan and having a 5-star plan available
- And more
For Medigap plans:
- 63 days after the date your coverage ends, the date you receive notice that your coverage is ending or the date on a claim denial (if that is the only way you know your coverage has ended)
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5-Star SEP
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- Switch from a plan with a quality rating of 4.5 stars or fewer to a 5-star plan if one is available in your area.
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From Dec. 8 (the day after AEP ends) throughout the year
- You can only take advantage of this SEP one time during the year.
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Low-Performing Plan Special Enrollment Period
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- Switch from a Medicare Advantage (MA) or Part D plan that has had an overall star rating of less than 3 stars for three or more years to another plan that is rated 3 stars or better
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After Jan. 1, you have one chance to change and enroll.
- New coverage will begin the first day of the month after you enroll.
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Getting Help
Whether enrolling for the first time or switching to a new plan, the Allsup Medicare Advisor® service makes it easy to navigate the complex process of selecting the right Medicare coverage to meet your needs. An Allsup Medicare Advisor expert is ready to help you make the Medicare choice that’s best for you.
In the event you’re not certain exactly how some of these enrollment periods work, here are a few examples (click on each for details):
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First-time enrollee based on age |
John is 64, but will turn 65 on June 14. He doesn’t have any healthcare coverage right now, but he’ll be eligible for Medicare on the first day of the month of his birthday. As long as he’s enrolled, he can actually begin using Medicare benefits June 1. But to make sure he can take advantage of his benefits and to avoid having to pay any penalties, he’ll need to enroll during the applicable enrollment period.
From the chart above, you’ll see that John will be in his initial enrollment period. This means that John can enroll in Medicare Parts A and B anytime between March 1 and Sept. 1, or three months before the month of his birthday, the month of his birthday and three months after. Once he has Medicare Parts A and B, he’ll also be eligible for other Medicare plans, like Medicare Advantage (Part C), which combines Parts A and B and often offers extra benefits like vision, dental and prescription drug coverage. If he wants to stay in traditional Medicare (Parts A and B) and increase his coverage, he can take advantage of Medicare Part D (prescription drug coverage) and a Medigap plan, which is supplemental insurance.
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First-time enrollee based on disability |
Linda is receiving Social Security Disability Insurance (SSDI) because she is unable to work due to a back injury. Her date of entitlement to cash benefits was Sept. 21, 2008. When she was awarded SSDI, she got a letter telling her that she would be eligible for Medicare on Sept. 21, 2010. Although she has COBRA coverage now, she’s eager to get on Medicare because it’s less expensive and could provide her with more choices. She wants to enroll as quickly as possible to make sure she can start using her Medicare benefits as soon as they’re available to her.
To make sure she enrolls in Medicare on time, Linda should take advantage of her initial seven-month enrollment period, including the three months before, the month of and three months after the 24th month she was awarded benefits (see above how entitlement relates to your date of disability, not the date of your award). So, she’ll be able to enroll in Medicare as early as June 1 and as late as Dec. 1. But, even if she enrolls as soon as possible, her Medicare benefits won’t begin until Sept. 1, 2010.
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Currently on Medicare, contemplating Medicare options |
Ellen is 67 and has a Medicare Advantage plan. For the past couple of years, she’s been happy with her plan, but it’s Oct. 31 and her plan has notified her that it’s going to raise its rates nearly 20 percent. She’s decided that she’d like to choose a different plan. She’s heard a lot about Medicare Part D plans in the media, and she’s a little confused about whether she needs to get another Medicare Advantage plan or if she should go back to traditional Medicare and get a stand-alone Medicare Part D drug plan. Either way, she needs to make a choice.
According to the chart above, Ellen is getting close to the annual enrollment period, when she’ll be able to make any changes to her Medicare coverage she wants, but the enrollment period only lasts between Oct. 15 and Dec. 7. She’s been getting lots of information on plans in her area, so she knows she has a lot of choices, but she needs to make a final decision as to which is right for her and enroll no later than Dec. 7.
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