Understanding Medicare’s enrollment periods for eligible recipients can help you plan for the future. Enrollment periods will allow you to sign up for Medicare coverage when you first qualify, and change plans at certain times during the year if you choose to do so.
Are Open and Initial Enrollment Periods the Same?
Medicare’s multiple enrollment options can be confusing for those who are newly eligible and it can be easy to mistake the Initial Enrollment Period as synonymous with the Open, or Annual Enrollment Period. During either period, recipients have a lot of freedom to make a variety of choices for their coverage through Original Medicare and other Medicare-related plans like Medicare Advantage and stand-alone Part D Prescription Drug plans.
The Medicare Initial Enrollment Period starts 3 months before a recipient turns 65, then lasts through the month of their 65th birthday and for 3 months after that month. During this period, recipients can enroll in Original Medicare Parts A and B, a Part C Medicare Advantage Plan, or they can enroll in Parts A and B and choose a Medicare Supplement Plan instead of a Part C Medicare Advantage Plan. Recipients can choose to enroll in a stand-alone Part D Prescription Drug Plan alongside Original Medicare and Medigap plans, or if they choose a Part C plan that does not offer prescription drug coverage.
After the Initial Enrollment Period is over, recipients may face late-enrollment penalties for certain Medicare plans. Medigap has a separate Initial Enrollment Period that begins when you turn 65 and are enrolled in Part B. During this 6-month period, you can purchase any Medigap plan sold in your state without being subject to medical underwriting. After the Medigap Initial Enrollment Period has ended, you may be turned down for coverage or charged more due to pre-existing conditions.
What Choices are Available During Open Enrollment?
Medicare’s Annual Enrollment Period starts October 15th and ends December 7th of every year. This period allows current Medicare recipients to change how they receive their Medicare benefits in a few different ways.
Recipients who have only Original Medicare Part A and Part B can elect to enroll in a Part C Medicare Advantage Plan. Medicare Advantage Plans bundle Original Medicare coverage with additional benefits that Part A and Part B don’t cover, like routine vision or dental care. While any Part C plan must provide everything already included with Original Medicare, carriers can choose which additional benefits they offer and the costs associated with those additional benefits. Each insurer may offer several plan packages at different prices to help recipients control their out-of-pocket costs better.
If a recipient is already enrolled in a Part C plan when Annual Enrollment begins, they can drop the plan and return to Original Medicare or change to a different Part C plan. Any recipients who are enrolled in a Part D plan or drops a Part C plan with Part D benefits can choose a new Part D plan or drop their existing one.
Coverage acquired during annual enrollment begins the following year on January 1st.
Options After the Annual Enrollment Period Ends
If you miss your Initial Enrollment Period, Medicare has other enrollment periods that you can use to acquire certain types of coverage. The General Enrollment Period, which runs from January 1st through March 31st of each year, allows recipients to join Original Medicare. If have not already enrolled in Part A, you will need to do so in order to enroll in Part B. Coverage begins July 1st following enrollment during this period.
Special Enrollment Periods allow recipients to choose Medicare coverage without accruing penalty delays and charges once their Initial Enrollment Period is over. If you had qualifying, creditable coverage through other insurance providers, such as plans provided by an employer, you can enroll in Medicare and Medicare-contracted plans if that coverage is ending. Special Enrollment Periods are also activated when Medicare-contracted plans, such as those offered through Medigap or Part C carriers, are no longer available in your area or you move outside of the coverage area.
Medicare Advantage plans have a separate enrollment period in which recipients can switch Part C plans or return to Original Medicare and choose a standalone Part D Prescription Drug Plan. The Medicare Advantage Open Enrollment Period begins January 1st and ends March 31st, but the first 3 months that a recipient is enrolled in Original Medicare can also activate an enrollment period for Medicare Advantage plans.