Key Takeaways
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Medicare enrollment isn’t automatic for everyone. You need to know the right enrollment periods to avoid late penalties and gaps in coverage.
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There are multiple enrollment periods, each serving different needs—whether you’re enrolling for the first time, switching plans, or making changes due to life events.
Understanding Medicare Enrollment Periods
Enrolling in Medicare can feel like navigating a maze, but knowing when you can sign up is the first step to making the right choices. Whether you’re nearing 65, still working, or experiencing a qualifying life event, there’s a specific enrollment period that applies to you. Missing the right window can result in costly penalties and delays in coverage, so let’s break down the key enrollment periods you need to keep in mind.
Initial Enrollment Period (IEP): Your First Chance at Medicare
The Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare when you become eligible. It’s a 7-month window that includes:
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Three months before your 65th birthday
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The month of your 65th birthday
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Three months after your 65th birthday
If you enroll before your birthday month, coverage starts the first day of that month. If you wait until your birthday month or later, your coverage start date may be delayed. Missing this period could mean facing lifelong late penalties and waiting for the next opportunity to enroll.
General Enrollment Period (GEP): A Second Chance with a Catch
If you miss your Initial Enrollment Period, you can sign up during the General Enrollment Period (GEP), which runs from January 1 to March 31 each year. However, there’s a catch—your coverage won’t start until the following month, and you may have to pay a late enrollment penalty for Medicare Part B and Part D, which lasts for as long as you have Medicare.
Special Enrollment Periods (SEPs): When Life Changes Give You Another Chance
Special Enrollment Periods (SEPs) allow you to enroll in or change Medicare plans outside of the usual enrollment periods if you meet certain criteria. SEPs are triggered by specific life events, such as:
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Losing employer or union coverage: If you’re working past 65 and covered by an employer plan, you get an 8-month SEP to sign up for Medicare after your coverage ends.
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Moving to a new location: If you move outside your plan’s service area, you can switch to a new Medicare Advantage or Part D plan.
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Medicaid eligibility changes: If you gain or lose Medicaid eligibility, you get a chance to enroll in, drop, or switch plans.
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Other qualifying events: This includes losing a Medicare Advantage plan, plan termination, or being released from incarceration.
Each SEP has specific time limits, usually lasting 2 to 3 months after the triggering event, so acting quickly is crucial.
Medicare Open Enrollment Period (AEP): The Annual Chance to Make Changes
Every year, Medicare offers an Annual Enrollment Period (AEP) from October 15 to December 7. This is your opportunity to make changes to your existing coverage, including:
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Switching from Original Medicare to a Medicare Advantage plan (or vice versa)
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Changing from one Medicare Advantage plan to another
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Enrolling in, changing, or dropping a Medicare Part D prescription drug plan
Changes made during AEP take effect on January 1 of the following year.
Medicare Advantage Open Enrollment Period (MA OEP): Adjustments for Current Enrollees
For those already enrolled in a Medicare Advantage plan, there’s a Medicare Advantage Open Enrollment Period (MA OEP) from January 1 to March 31. This period allows you to:
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Switch from one Medicare Advantage plan to another
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Drop Medicare Advantage and return to Original Medicare (with or without a Part D plan)
Unlike AEP, you can only make one change during this period, and it takes effect the first of the following month after you make the switch.
Five-Star Special Enrollment Period: Upgrade to a Higher-Rated Plan
Medicare rates plans using a five-star quality system, with five stars being the highest rating. If a five-star Medicare Advantage, Part D, or Cost Plan is available in your area, you can switch to it once per year between December 8 and November 30 of the following year. This is a great opportunity if you want better-rated coverage.
Special Enrollment for Those with Low Income or Extra Help
If you qualify for Extra Help (a program that assists with Medicare prescription drug costs), Medicaid, or a Medicare Savings Program, you may be eligible for an ongoing Special Enrollment Period that allows you to make changes once per calendar quarter during the first nine months of the year (January – September).
When Does Medicare Coverage Begin?
Your coverage start date depends on when you enroll:
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Enrolling before your 65th birthday month: Coverage begins the first day of your birthday month.
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Enrolling during or after your birthday month: Coverage may be delayed by 1-3 months.
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General Enrollment Period (Jan 1 – Mar 31): Coverage starts the first of the following month.
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Special Enrollment Periods (SEPs): Coverage start dates vary based on the specific SEP rules.
Avoiding Late Enrollment Penalties
Enrolling on time is important because late penalties for Medicare Part B and Part D never go away:
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Medicare Part B penalty: If you don’t sign up when first eligible, your premium increases by 10% for every full 12-month period you were eligible but didn’t enroll.
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Medicare Part D penalty: If you go 63 days or more without creditable drug coverage, you’ll pay a penalty added to your premium for as long as you have Part D.
These penalties can add up over time, making it even more important to enroll at the right time.
Ready to Enroll? Get Help from a Licensed Agent
Choosing the right Medicare plan and knowing when to enroll can be confusing, but you don’t have to figure it out alone. Speaking with a licensed agent listed on this website can help you find the right coverage for your needs and ensure you don’t miss key deadlines.
