Medicare Election & Enrollment Periods
Medicare election and enrollment periods can be confusing. The purpose of this page is to provide you a summary of the different election and enrollment periods.
Initial Enrollment Period: Is for you when you first receive Medicare Part A and/or Part B through age (turning 65) or disability. According to 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.”
The Initial Enrollment Period is the time that you also can choose to enroll into a Part C Medicare Advantage Plan and/or a Part D Prescription Drug Plan. If you sign up prior to your Part A and/or Part B starting (which is the way to do it in most cases), then your plan will be effective the same month your Part A and Part B is effective.
Medigap Open Enrollment Period: This is important! Many Medicare Supplement companies will allow you to enroll up to six months prior to your Part A and Part B starting, but your policy will not become effective till the first of the month that your Part A and Part B start.
The Medigap Open Enrollment Period is for your Medicare Supplement. It is a 6-month period that begins on the first day of the month in which you’re 65 or older and enrolled in Part B. When you enroll during this time you are guaranteed to be accepted regardless of past or present health conditions. After the 6 month period, there’s no guarantee you will be able to purchase a Medicare Supplement policy except for very special circumstances.
Don’t Forfeit Your Guaranteed Right!
One thing people mess up on is they get both Part A and Part B at 65 but continue their group coverage through an employer and that employer has 20 or more employees and when it comes time to apply for a Medicare Supplement in this case, they are NOT guaranteed to be accepted. This is because when you have Part A and Part B and group coverage with 20 or more employees, then the group coverage is primary and Medicare is secondary. And when Medicare is secondary and you later come off of your group coverage and want a Medicare Supplement, you have forfeited the guaranteed right.
General Enrollment Period: The General Enrollment Period is for those who received Part A when they turned 65, but delayed Part B coverage for some reason. The General Enrollment Period is from January 1st through March 31st each year. During this time you can enroll in Part B and it will become effective July 1st. You may also incur the Part B late enrollment penalty.
Original Medicare Special Enrollment Period: This is for Part B and is typically used when you have Part A but delayed Part B because you had comparable coverage through a group, employer or union with 20 or more employees.
Annual Election Period: The Annual Election Period is specifically for Medicare Advantage Part C and Prescription Drug Part D plans. The Annual Election Period starts October 1st and runs through December 7th.
During the Annual Election Period you can make changes to your existing Part C and/or Part D coverage as many times as you want. You can switch from one plan to another for the following year. You can make numerous changes during this time. The last change you make up to December 7th will be the one that starts January 1st.
Pre-Annual Election Period: The Annual Election Period is also preceded by the Pre-Annual Election Period. This runs from October 1st through October 14th.
The Pitfalls Of The Pre-Annual Election Period
This period is absolutely pointless. It confuses and compromises many a Medicare beneficiary’s coverage.
During the Pre-Annual Election Period a Medicare beneficiary can review the plans for the upcoming year. They just can’t officially enroll until October 15th. But, they or an agent can fill out an enrollment form and they can hold it till October 15th and then mail it in.
But what happens is: PEOPLE FORGET TO MAIL IT IN! And when that happens, they end up stuck with the same plan they had or even worse…no plan at all.
Due to the fact that from October 15th through December 7th you can change your mind and make as many changes as you want…what is the point of the Pre-Annual Election Period? Congress should get rid of it!
Medicare Advantage Open Enrollment Period: And if you have a Medicare Advantage Part C plan and you still don’t think you chose or kept the right plan during the Annual Election Period, then from January 1st to March 31st you can make one more and final change.
Special Enrollment Periods: These are periods where either certain people or certain circumstances may allow you to change your Part C and/or Part D coverage in the middle of the year. These include, but are not limited to the following:
• You are on or have added or lost Extra Help/LIS
• You are on or have added or lost Medicaid
• You have moved out of the plan’s service area • You moved back to the U.S.A.
• There’s a 5 Star plan available…very rare
• You are in, moved in or moved out of a skilled nursing facility or long-term care hospital
• The Federal Government has declared some “emergency” or “disaster” situation due to things like snow storms, hurricanes, forest fires, COVID, etc. And during that declared time you had normal election period but couldn’t exercise it due to the “emergency” or “disaster” situation.
