What Is the Medicare General Enrollment Period?

For most of us, the first chance to get Medicare coverage is the Initial Enrollment Period (IEP), which includes the three months before and after the month of your 65th birthday. But that’s just the beginning; you still have multiple opportunities to change your coverage and benefits each year.  

All the different enrollment windows can get confusing, but you’ll be ready to make better decisions about your healthcare if you know the key dates that are coming up. Let’s dig into the different enrollment periods and how they apply. 

What Can I Do During the General Enrollment Period? 

The General Enrollment Period (GEP) runs from January 1 to March 31.  

If you missed your Initial Enrollment Period (IEP), the GEP is another chance to sign up for Medicare Parts A and B, the health insurance programs administered by the federal government for U.S. citizens and permanent residents over 65.  

Part B (which provides medical insurance) charges monthly premiums, but delaying enrollment might cost you more in the long run. If you don’t have insurance coverage from another source, such as a policy through your or your spouse’s employer, you could pay penalties when you do eventually sign up for Part B. For each year that you were eligible for Part B but didn’t enroll, your monthly premium may increase by 10%. 

The GEP could be your opportunity to avoid or minimize late enrollment penalties. 

Add Medicare Part D or Switch to Medicare Advantage

Submitting your application for Medicare Part A or B during GEP kicks off a related Special Enrollment Period for prescription drug coverage. For two months after your new coverage begins you can sign up for either a standalone Medicare Part D prescription drug plan or a Medicare Advantage plan from a private insurer that includes prescription drug coverage. 

Medicare Advantage, also referred to as Part C, substitutes for Original Medicare, matching the federal program’s Part A and B benefits. Most also offer Part D prescription coverage, plus other supplemental benefits such as dental, vision, and hearing. 

Whether you choose Medicare Advantage or get prescription drug benefits separately, check your options carefully. Each plan has its own list of covered drugs, called a formulary, with copays or coinsurance rates that you’ll have to pay at the pharmacy. 

If you’re Medicare-eligible and don’t currently have drug coverage, such as health insurance through an employer or TRICARE, enroll as soon as possible to avoid penalties. 

What Can I Do During the Medicare Advantage Open Enrollment Period? 

For those who are currently enrolled in a Part C Medicare Advantage plan, the period from January 1 to March 31 is the Medicare Advantage Open Enrollment Period (OEP). Here’s how you can adjust your coverage during this time: 

Switch From One Medicare Advantage Plan to Another

Enrolling in Medicare Advantage is an important decision, but both the plans and your own situation can change. For example, you may become interested in different supplemental benefits or find out that your preferred doctor or pharmacy is no longer in your plan’s provider network. 

Fortunately, you’re able switch from one plan to another during the Open Enrollment Period. The plans that are available to you may shift on a yearly basis, depending on where you live and your financial resources. By taking time to review the possibilities with a licensed insurance agent, you can find the coverage that most closely aligns with your needs. 

Go Back to Original Medicare 

If you decide that Medicare Advantage is not right for you, OEP is a good time to switch back to your Part A and B coverage. You’ll also likely want to sign up for a Part D prescription drug plan and explore Medigap plans that cover some of the expenses not included in Original Medicare. 

Other Enrollment Periods 

The General Enrollment Period is just one of the times when you can make changes to your Medicare coverage. 

The Annual Enrollment Period runs from October 15 to December 7, and during this time you can:  

• Switch from Original Medicare to Medicare Advantage or vice versa. 
• Move from one Medicare Advantage plan to another. 
• Add or change a Medicare Part D prescription drug plan. 

You may also qualify for a Special Enrollment Period under certain circumstances, such as moving out of your current plan’s service area or losing coverage through an employer. 

To get the most out of your Medicare coverage, mark these dates on your calendar and be prepared to reach out to a licensed insurance agent. 

About GoHealth 

GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.