Medicare enrollment is limited to certain times of the year. There are different enrollment periods when someone can sign up for Medicare or make changes to their Medicare coverage.
People eligible for Medicare because of their age have an initial enrollment period (IEP) that starts three months before they turn 65. It continues through the third month after they turned 65.
For example, your birthday is June 5th. You can sign up for Medicare as early as March 1st (for coverage starting on June 1st). Your IEP ends on September 30th. This is because September 30th is the last day of the three months after June, the month in which you turned 65.
Except in rare cases, a person automatically gets Medicare Part A (hospital insurance). But the IEP is the time when most people sign up for Medicare Part B (medical insurance).
The IEP is also the time when most people with Original Medicare sign up for a Medicare supplement (Medigap) plan. During this period, a person can get a supplement even with a pre-existing condition.
Unlike Medigap plans, Medicare Advantage and Part D drug plans cannot deny enrollment because of a pre-existing condition, even after the IEP.
When someone delays their retirement, they have a special enrollment period that lasts for two full months after they leave their employer health plan.
Younger people getting Social Security disability benefits may sign up for Medicare starting in the 21st month after those benefits started and continuing until month 28.
Everyone with Medicare is allowed to change their Medicare plan (Medicare Advantage or Part D drug plan) during the yearly Medicare Annual Enrollment Period.
The Annual Enrollment Period starts on October 15 and ends on December 7 of each year. Changes made during in this period become effective on January 1st of the following year.
For example, it is November 15, 2021 and you wish to switch from Acme Medicare drug plan to Zeta drug plan. Or, you have Original Medicare and want to join a Medicare Advantage plan. You may enroll anytime through December 7 but your new coverage would not start until January 1, 2022.
Medicare enrollees can make changes at other times of the year if they qualify for one of 30 special enrollment periods.
Here are the ones most frequently used.
⦁ You get Extra Help paying for your Part D prescription drug coverage. Extra Help is officially known as the Part D Low Income Subsidy.
⦁ You moved into or out of a nursing home or rehabilitation facility.
⦁ You move to a new address where your current plan is not offered or where new plan options are available.
⦁ You are eligible for both Medicaid and Medicare, or you are losing your Medicaid coverage.
⦁ Your Medicare plan is going away or the Medicare program has sanctioned your plan because of a problem that may affect you.
⦁ You lose your union or employer health insurance, or you involuntarily lose drug coverage that was as good as Medicare Part D (called “credible coverage”).
Every special enrollment period has its own rules and restrictions but your coverage cannot start earlier than the first of the month after you use the enrollment period.
You can learn more about those rules by contacting Medicare directly or working through an insurance agent who specializes in these situations.