If you’re eligible (or soon to be eligible) for Medicare, you may have noticed that there are specific times when you can enroll, add, change or drop coverage. These enrollment periods can be confusing! There are so many different enrollment periods and each has different rules. In this article we’ll attempt to make the enrollment periods a bit less confusing.
Initial Enrollment Period
When you first reach age 65 and become eligible for Medicare benefits, there is a set period of time when you can enroll. The initial enrollment period actually begins before your 65th birthday, and is a total of seven months. This includes the three months before your month of birth, the month that you reach age 65, and the three months after your birth month. So if your 65th birthday is in July, your initial enrollment period starts on April 1 and lasts until October 31.
During this period you can enroll in Medicare Part A and Part B. You can then choose other additions to your Medicare coverage, including prescription drug coverage, a Medicare supplement policy (Medigap), or maybe a Medicare Advantage plan.
The month in which you enroll determines when your Medicare Part B coverage will begin. If you enroll in Medicare during the any of the 3 months prior to your 65th birthday, your coverage will begin during the month of your birthday. If you enroll during your birthday month, coverage begins on the first of the following month. If you wait to enroll during any of the remaining 3 months in your initial enrollment period, there will be a two-month lag before your benefits will begin. For example, if your birth month is July and you wait until August to enroll for Medicare, your Part B coverage will not commence until October 1.
Medicare Part A is different. Your coverage begins on the first of the month when you reach age 65, even if you enroll up to 6 months after your birthday. Beyond 6 months after your birthday, Medicare coverage always begins retroactively 6 months before the date that you enroll.
Delaying enrollment in Medicare Part A until some time after your initial enrollment period carries no penalty (unless you’re not eligible for “free” Part A). However, delaying Medicare Part B enrollment until after the initial enrollment period can result in premium penalties.
Medigap Initial Enrollment Period
Once you have enrolled in Medicare Part B, you have a 6-month period when you can enroll in Medigap. Generally, if you do not purchase a Medigap plan during this period, you may be required to provide evidence of insurability to the insurance provider if you attempt to purchase a policy later. This may result in higher premiums or denial of coverage altogether, if there is a pre-existing condition.
During the 6 months after Medicare Part B enrollment, insurers are required to accept you as an enrollee in whatever Medigap Plan you choose, as long as you can pay the premiums.
You can also make changes to your Medigap plan on an annual basis, however, as noted elsewhere, making changes to your Medigap plan may require additional information about your medical history, especially if changing to a more comprehensive plan. Choosing a less comprehensive plan typically does not cause any issues.
Annual Enrollment Periods
There are several annual enrollment periods that you need to be aware of. There is the General Enrollment Period, the Open Enrollment Period, and These are explained briefly below:
General Enrollment Periods – This is from January 1 to March 31 each year. During this period you are allowed to enroll in Medicare Part B if: 1) you didn’t sign up when you were first eligible during your initial enrollment period; and 2) you aren’t eligible for a Special Enrollment Period. You can always sign up for Medicare Part A at any time, with no penalty.
When you sign up for Medicare Part B during the General Enrollment Period, most often you will pay a penalty on your premiums for Medicare Part B. There is no penalty for signing up for Medicare Part A late if you’re eligible for the “free” coverage. If less than a year has passed since your initial enrollment period, you may not have a penalty for your late enrollment.
Your Medicare Part B coverage will not begin until July 1 of the year that you sign up during the General Enrollment Period. Medicare Part A coverage is back-dated to six months prior to your enrollment date, or the month of your 65th birthday if you enroll less than six months after that date.