January 22nd, 2018 BY HealthNetwork
When you’re researching your Medicare options, navigating the Medicare website can be confusing, especially if you’ve already passed your initial eligibility period. For most people, initial eligibility depends on age. You have three months before the month you turn 65, the month of your 65th birthday and three months after that month – for a total of seven months – to enroll in Medicare. After that, you’ll have to wait until certain enrollment periods to sign up for or make changes to a plan.
There are four different parts to Medicare: Part A (hospital coverage), Part B (coverage for medically necessary services, including doctor visits), Part C (Medicare Advantage, which is sold by private companies and combines Parts A and B with other benefits), and Part D (prescription drug coverage, also sold by private companies). There are also add-on options, like Medigap coverage, and savings accounts that may be applicable depending on the plan type you choose. If you’ve missed your initial enrollment window and want to know when to sign up for which kind of plan, here’s what you need to know.
General Enrollment: January 1 through March 31
Each year, there’s a general enrollment for Medicare, during which you can sign up for Part A and/or Part B, which together make up original Medicare. You can use this period if:
- You didn’t sign up for Medicare Part A and/or B when you were first eligible; or
- You aren’t eligible to sign up during a Special Enrollment Period.
Special enrollment periods exist for people who are still working when they qualify for Medicare. If you retain an employer group health plan (or your spouse does), then you can delay your initial enrollment into Medicare until you leave that job or the coverage ends. Check with Medicare for specifics in your case, but this special signup period lasts for eight months after you stop working or the group plan ends.
If you sign up for Parts A and/or B during the general enrollment period, coverage will begin on July 1. Higher premiums may also apply for either Part A or Part B if enrolled during this time since you may be subject to a late enrollment penalty for not signing up during your initial eligibility window.
Medicare Advantage Disenrollment: January 1 through February 14
If you have Medicare Advantage (MA), you can disenroll from this private portion of Medicare and enroll in original Medicare during a special period known as the Medicare Advantage Disenrollment Period. During this 6-week period, you can:
- Disenroll from your current MA plan
- Sign up for original Medicare
- Sign up for a Part D drug plan if you enroll in original Medicare
You cannot use this period to switch from one MA plan to another; change from original Medicare to Advantage; switch Part D drug plans; or join, switch or disenroll from a Medicare Medical Savings Account Plan. This period is strictly for disenrolling from your Medicare Advantage plan.
Special Circumstances: April 1 to June 30
For people who waited until general enrollment (January 1 to March 31) to sign up for Medicare Part A and/or B, there’s another special enrollment period during which they can choose a Medicare Advantage or Part D prescription drug plan. This signup period runs from April 1 to June 30, and it’s limited in scope. Keep in mind that you must have both Parts A and B to enroll in a Medicare Advantage plan. If you don’t have Part A, you can still sign up for a Part D drug plan during this enrollment period, but you won’t be able to sign up for Medicare Advantage.
Open Enrollment: October 15 to December 7
As with other kinds of health insurance, Medicare offers its members a chance each year to make changes to their plans. This is specifically designed for Medicare Advantage enrollees since these plans are private and vary more than original Medicare, but members of original Medicare can also take this time to review their plans and determine if Advantage might be better for them. From October 15 to December 7 each year, you can:
- Switch from original Medicare to Medicare Advantage;
- Switch from Medicare Advantage back to original Medicare;
- Change your Medicare Advantage plan (switch to a new one);
- Switch your current MA plan in favor of one with or without drug coverage, depending on your medical and prescription drug needs;
- Join a new Medicare Part D drug plan;
- Change your current Part D plan for another one; or
- Drop your current Part D drug plan entirely.
This is the biggest time of year for Medicare enrollees because it’s a good time to consider your health needs for the coming year in light of the current year. If you need to make changes, this is the time to do it. Otherwise, you may be stuck with your plan until the next open enrollment period. Certain enrollment periods also exist for other situations. If you’re in an MA plan but see that a new 5-star rated plan opens up in your area, you can switch to that plan even if it’s not during open enrollment. People who experience life changes, like moving to a new area, can also enroll in a new plan depending on circumstances. To learn more about specifics for your case, check with Medicare.