Enrolling in Medicare or making changes to how you receive your Medicare benefits can be restricted to different times of the year or tied to specific circumstances. If you do not enroll during the annual enrollment period, you may be wondering what options you have.
Understanding the Open Enrollment Period
Medicare’s Annual Enrollment Period begins each year on October 15th and ends December 7th. Coverage from enrollment during this timeframe begins on the first day of the following year, January 1st.
During this time, recipients can enroll for the first time in any Medicare plan or switch to different plans if they are already enrolled in one without any penalties or increase in standard premiums.
Enrollment Considerations for Disabled Recipients Younger than 65
If you receive Social Security Disability Insurance (SSDI) payments, you can enroll in Medicare after you receive payments for 2 years. You become eligible for enrollment starting 3 months before you receive your 25th disability payment and this initial enrollment period lasts for 3 months after the month of your 25th disability check.
Coverage is typically tied to the first day of the month in which this 25th check is received. If a recipient is diagnosed with Lou Gehrig’s Disease (ALS), Medicare coverage can begin from the date of their first SSDI payment. Recipients diagnosed with End-Stage Renal Disease can enroll after their fourth month of dialysis unless they meet special conditions for starting the first month of treatment:
- Attending a Medicare-certified training facility’s home dialysis training program.
- A doctor recommends you for being able to complete dialysis at home upon completion of the training program.
- Regular dialysis treatments are properly maintained while waiting for approval.
Options When You Miss Medicare’s Annual Enrollment Period
Special Enrollment Period
Special enrollment periods are activated when a recipient experiences certain qualifying changes to their existing health care coverage.
For Parts A and B, a special, penalty-free enrollment period can begin before or following the loss of private health insurance provided by an employer with 20 or more employees, a union, or through a spouse’s job. Coverage with Medicare begins the first month after enrollment.
If a recipient is already enrolled in Original Medicare benefits but opted out of enrolling in a Part C or D plan due to having additional health coverage, the loss of that additional health coverage triggers a special enrollment period for Part C or D that lasts for 63 days after the additional health coverage ends.
Moving out of a coverage area or if a plan provider leaves a coverage area can also open up a special enrollment period for qualifying recipients. Entering, leaving or living in a nursing home, or becoming eligible for Medicaid’s Extra Help program for prescription drugs can activate special enrollment periods for Part C or D plans.
Medicare Advantage Open Enrollment Period
Throughout January 1st through March 31st each year, Medicare Part A and B offers a general enrollment period. During this period, any recipient who has an existing Medicare Advantage plan can switch to a different Medicare Advantage plan or revert back to Original Medicare and choose a standalone Part D plan.
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