Medicare Enrollment Periods can be confusing.

Lets break down the different enrollment periods, so you can navigate your options with ease!

Possibly one of the most confusing things about Medicare is all the enrollment periods. As confusing as they may be, they’re also critically important. Missing one could cause you to be without coverage, or you could even be subject to late enrollment penalties.

Today, we’re going to list all the Medicare enrollment periods you should be aware of. You may not need to utilize all of them, but you should know a little about each one so you can take advantage of them if need be.

Medicare Enrollment Periods

Your Initial Enrollment Period (IEP) is tied to your 65th birthday month. It starts three full months before your birthday month and ends three full months after it.

For instance, if your birthday is on July 2, your IEP runs from April 1 to October 31. If you enroll before your birthday month, coverage can begin on the first day of the month you turn 65, meaning your Medicare would start on July 1 in this example.

There is one exception: if your birthday falls on the first day of the month, your IEP starts a month earlier. For example, if your birthday is on July 1, your IEP would begin on March 1, and your Medicare coverage would start on June 1.

During your IEP, you should enroll in Parts A and B and consider any additional coverage you might need, such as a Medicare Supplement plan, a Medicare Advantage plan, or Medicare Part D.

Planning ahead for your IEP is crucial. Missing this enrollment period could lead to a lapse in coverage and incur late enrollment penalties. The only way to avoid this is to have other creditable coverage in place.

Creditable coverage typically comes from an employer-sponsored group health plan. If your employer has at least 20 employees, their health insurance is considered creditable. This allows you to postpone Medicare enrollment without penalties. However, always confirm with your advisor or HR director before making this decision.

Initial Enrollment Period

General Enrollment Period

If you miss your Initial Enrollment Period, you'll need to wait for the General Enrollment Period (GEP) to sign up for Medicare.

The GEP takes place annually from January 1 to March 31. During this time, you can enroll in Original Medicare and supplemental coverage. However, enrolling in a Medicare Supplement plan during the GEP may require medical underwriting.

Under the recent changes brought by the BENES Act, your coverage will begin the month after you enroll. For example, if you enroll in February, your coverage will start in March. Previously, coverage wouldn't start until July 1.

Be aware that enrolling during the GEP will likely result in late enrollment penalties.

Medigap, also known as Medicare Supplement plans, provides additional coverage for expenses not covered by Original Medicare. The Medigap Open Enrollment Period begins on the effective date of your Part B coverage and lasts for six months. This is a one-time enrollment period.

While Medigap plans are optional, they are a popular choice for supplementing Original Medicare coverage. Most people opt for either a Medigap plan or a Medicare Advantage plan. It's important to note that if you don't enroll in a Medigap plan during your Open Enrollment Period, you will need to pass medical underwriting to get a Medicare Supplement plan later, unless you qualify for an exception.

If you missed your Medigap Open Enrollment Period but are still interested in a Medigap plan, call Guardian Insurance Group for guidance on your options.

Medigap Open Enrollment Period

Special Enrollment Periods (SEPs) are designated for significant life changes, qualifying you for a period to make changes to your Medicare coverage. The actions you can take during an SEP depend on your specific situation.

Common events that trigger an SEP include getting married or divorced, losing a spouse, losing income, or moving to a new service area. One of the most frequent reasons for qualifying for an SEP is continuing to work past the age of 65 while being enrolled in creditable insurance.

Another common reason for an SEP is moving out of your current plan’s service area. Since Medicare Advantage and Part D plans operate within specific service areas and provider networks, moving outside your current area gives you a two-month window to find a new plan in your new location.

There are many situations that might qualify you for an SEP, so it's always worth asking. We can help you determine if you qualify and guide you through the process.

Special Enrollment Periods

Medicare’s Annual Election Period (AEP) is one of the most crucial enrollment periods for all beneficiaries. Regardless of the type of Medicare plan you currently have, it's essential to mark your calendar for AEP.

AEP occurs annually from October 15 to December 7. During this period, you can make several changes to your Medicare coverage, including:

  • Switching from one Medicare Advantage plan to another

  • Switching from one Part D plan to another

  • Changing from Medicare Advantage to Original Medicare

  • Changing from Original Medicare to Medicare Advantage

Any changes made during AEP will take effect on January 1 of the following year.

AEP is vital because Medicare Advantage and Part D plans operate on annual contracts, and while your plan will automatically renew if you do nothing, the plan's specifics often change each year. These changes can include adjustments to premiums, deductibles, cost-sharing amounts, and benefits. For instance, a medication you have been taking for years may no longer be covered by your plan, or you might find a new plan with lower copays.

Even if you do not plan to make any changes, it's important to review your plans during the Annual Election Period. Guardian Insurance Group can help you stay updated on any changes to ensure you continue to have the coverage you need. Use our expertise to review your options and confirm that your current plan still meets your healthcare needs.

Annual Enrollment Period

Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period is an annual window that runs from January 1 through March 31.

This period is specifically for beneficiaries who are already enrolled in a Medicare Advantage plan. During this time, you can make a one-time change to your Medicare Advantage plan or switch back to Original Medicare.

If you choose to change your plan, the new coverage will take effect on the first day of the following month. If you switch back to Original Medicare, you can also use this time to enroll in a Part D plan for prescription drug coverage.

Understanding these enrollment periods is essential to ensure you have the coverage you need. Call to speak with a trusted advisor to discuss your options.