When to Enroll in Medicare

Important dates and information about when you can enroll

Picking the right healthcare or prescription drug coverage can be tricky, especially now that there are so many more choices. Depending on what type of plan you want to enroll in, the time of the year it is, and when you became eligible for Part A or B of Medicare, your options may be limited. Keep reading to find out what the rules are. Medicare Advantage and Prescription Drug plans Medicare Supplement Plans

Medicare Advantage and Prescription Drug Plans If you recently became eligible for Medicare, through age or disability, you generally have the option to apply for coverage in a Medicare Advantage or prescription drug plan close to when your Medicare Part A or B coverage starts. If you are unsure what those dates are, look at the lower right corner of your red, white and blue Medicare card. Your coverage can’t start before your Part A or B coverage begins. However, you generally have a period of seven months to apply for coverage in a Medicare Advantage or prescription drug plan. For Medicare Advantage plans you can apply for coverage three months before, the month of, or three months after your Part B coverage starts. You must be enrolled in both Part A and Part B. For prescription drug plans you can apply for coverage three months before, the month of, or three months after the earliest of your Part A or Part B coverage starts.

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If you didn’t recently become eligible for Medicare, your options are different depending on the time of the year.

November 15 - December 31
Sometimes referred to as "Fall Open Enrollment," the Annual Coordinated Election Period (AEP) runs from November 15 through December 31 each year. During this time Medicare beneficiaries may change prescription drug plans, change Medicare Advantage plans, return to Original Medicare, or enroll in a Medicare Advantage plan for the first time. Coverage for enrollment changes take effect on January 1.

January 1 – March 31
If you are not satisfied with the choice you made in November or December, you may still be able to switch between January 1 and March 31, also known as the Open Enrollment period.

The table below outlines the rules that apply:

April 1 - November 14
Between April 1 and November 14 each year you will not be able to switch coverage. This time is often referred to as the “lock-in” period and you generally must stay with your current coverage until January 1, when any new coverage you choose, between November 15 and December 31 begins.

Even if you did not recently become eligible for Medicare, there are some exceptions that allow you to enroll in a prescription drug plan or Medicare Advantage plan any time during the year.

Examples of special circumstances include, but are not limited to individuals:

• who were enrolled in a plan and recently moved
  
  
• who entered a nursing home
  
  
• eligible for both Medicare and Medicaid
  
  
• with low income
  
  
• disenrolling from an employer group health plan
  
  
• who involuntarily lost creditable prescription drug coverage.

For questions about how to enroll if you qualify under other special circumstances, just give us a call at the number on the bottom of the page.

Medicare Supplement Plans

Medicare Supplement plans have different rules than Medicare Advantage and prescription drug plans.

If you are age 65 or older and want to enroll in a Medicare Supplement plan, add 6 months to your Part B coverage date. In some states these plans may be available to those under age 65. Here's how to determine if you can enroll in a Medicare Supplement plan.

• If that date is in the future, you are in your Medigap Open Enrollment Period, and you can apply for coverage in the plan.
  
  
• If the date is in the past, your Medigap Open Enrollment Period has ended, but it doesn’t mean you can't apply for coverage.

If you apply for coverage after your Medigap Open Enrollment Period has ended, the Medicare Supplement Company is allowed to use Medical Underwriting to decide whether to accept your application, and may charge a higher premium. Medical Underwriting involves looking at your medical history.

If you lose certain types of health coverage you may have the right to buy a Medicare Supplement policy outside of your Medigap Open Enrollment Period, and still not be subject to underwriting. These rights are called “Medigap protections” or guaranteed issue rights, because the law says that the insurance company must sell you a policy even if you have health problems. You must provide proof of the loss of your previous coverage.

Examples of these protections include:

• Your current Medicare Supplement plan (excluding Original Medicare) leaves your area or stops giving care in your area
  
  
• You have employer group health plan or union coverage that is ending
  
  
• You move out of the geographic area of your current plan
  
  
• You leave a Medicare Advantage plan, or drop a Medigap policy, because the company hasn't followed the rules or misled you

Refer to Choosing a Medigap Policy: A Guide to health Insurance for People with Medicare (developed jointly by the Centers for Medicare and Medicaid Services (CMS) and the National Association of Insurance Commissions) for more detail.

Keep in mind, if you have a Medicare Supplement plan, you are allowed to purchase a separate stand-alone prescription drug plan to help with your prescription costs. However, it is necessary to complete a separate enrollment application for both plans.

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