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Everything to Know about Medicare Enrollment Periods

There are many different Medicare enrollment periods during which you can enroll in coverage, change plans, or drop coverage if you need to. However, all of these options can leave you confused about when is the best time to enroll. Enrolling late could mean you’re hit with a late enrollment penalty that sticks with you the entire time you have Medicare coverage, so it’s important to enroll on time. Here are six Medicare enrollment periods and their time frames.

1. Initial enrollment period

This is your first opportunity to enroll in Medicare coverage. This seven-month window begins the three months before your 65th birthday, your birthday month, and the following three months. Because it revolves around your birthday, the initial enrollment period will be different for everyone, so don’t wait to enroll in Medicare coverage because someone you know hasn’t enrolled yet.

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2. Open enrollment period

If you miss enrolling during your initial enrollment period, the open enrollment period is the best time for you to enroll. Medicare open enrollment is October 15 – December 7 of every year. Any changes made during this time will go into effect January 1 of the following year. You can do the following during open enrollment:

  • Make no changes and keep your plan as it is
  • Switch from Medicare to Medicare Advantage
  • Switch from Medicare Advantage back to Medicare
  • Change Medicare Advantage plans
  • Change Part D plans, sign up for Part D, or drop a Part D plan

3. General enrollment period

Medicare’s general enrollment period runs from January 1 to March 31 of each year. During this time, you can enroll in Original Medicare (Part A and Part B) if you didn’t enroll during your initial enrollment or open enrollment. Any coverage purchased during this time will go into effect July 1 of the same year.

4. Special enrollment period

You may qualify for a special enrollment period if you continue to work after you turned 65 and have health insurance through your employer, or if you are covered by a spouse’s plan. Your special enrollment period window lasts for the eight months starting the month your previous insurance ends or when your employment ends, whichever comes first. To see if you qualify for a special enrollment period without penalty, contact your local Social Security office.

Medicare Advantage (Part C) and Medicare Part D have their own special enrollment periods too. These special enrollment periods begins 63 days after you lose your previous health insurance coverage or when your employment ends, whichever is first. In order to get Medicare Advantage or Medicare Part D, you must be enrolled in Part A and Part B first.

5. Medigap open enrollment period

The six-month window when you can purchase a Medigap policy begins the month you turn 65 and are enrolled in Part B. If you purchase a Medigap policy outside of this window, you could be subject to medical underwriting in which an insurance company can charge you higher premiums based on your health history or even deny you coverage.

6. Medicare Advantage open enrollment period

Beginning January 2019, Medicare Advantage open enrollment period will run from January 1 – March 31 every year. During this time, you can do the following:

  • Switch Medicare Advantage plans
  • Drop your Medicare Advantage plan and return to Original Medicare
  • Sign up for or drop your stand-alone Part D plan

Late enrollment penalties

Remember, it’s crucial that you enroll in Medicare on time. If you don’t, you could be hit with a late enrollment penalty that sticks with you the entire time you have Medicare coverage.

The late enrollment penalty for Part B is 10 percent of the Part B premium for every year you go without coverage. For example, if you go without Part B coverage for five years, your penalty will be 50 percent of $134, which is $67. This would be added onto your monthly premium the entire time you have Medicare coverage, bringing your monthly premium up to $201.

Even if you don’t currently take any prescription drugs, you should still enroll in a prescription drug plan. The Part D late enrollment penalty is 1 percent for every month you go without drug coverage, multiplied by the national base beneficiary premium ($35.02 for 2018), and rounded to the nearest $.10. For example, if you go 13 months without prescription drug coverage, the math would be as follows:

$35.02 (2018 national base beneficiary premium) x .13 (13% penalty) = $4.55 rounded to the nearest $.10 = $4.60 monthly penalty

With so many Medicare enrollment periods to choose from, it should be simple to find one that gives you the healthcare coverage you need.

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