Even if you’re already on Medicare, you need to be aware of several enrollment periods that could impact you.
The Annual Enrollment Period (AEP) provides the most options to make additions and changes on a yearly basis, while a Special Enrollment Period (SEP) allows similar options but only in rare circumstances specific to you.
The “open enrollment” period that begins January 1 each year provides a variety of options depending on your current coverage.
If you’re a Medicare beneficiary, then by definition you’ve already taken advantage of a Medicare enrollment period.
That doesn’t mean that Medicare enrollment periods no longer apply to your life.
Even though you already signed up for Medicare by utilizing your Initial Enrollment Period (or a different period if you didn’t enroll when first eligible), you need to know about other enrollment periods that could impact you.
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This period is worthy of some level of attention every year. From October 15 through December 7, the Annual Enrollment Period empowers you to:
- Switch from Original Medicare (Parts A and B) to a Medicare Advantage plan (or vice versa). You also can switch from one Medicare Advantage plan (also known as Part C) to another one.
- Enroll in a Part D drug plan, drop a drug plan or switch between plans.
Note: Changes take effect on January 1.
There’s no date you can circle annually on your calendar related to a special enrollment period; rather, things happen in your life to trigger them.
What is considered a Special Enrollment Period? Typically, a SEP opens a window to take action related to your Medicare coverage that you normally can only take during a regularly scheduled enrollment period. SEPs are triggered by things like:
- A loss of access to an employer-sponsored group health insurance plan.
- A change of address that impacts your coverage options.
- Administrative issues out of your control.
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Generally referred to as “open enrollment,” the annual period from January 1 through March 31 allows you to make different additions or changes depending on your coverage entering the period. Added/new coverages take effect the first day of the month following the enrollment.
- If you’re only enrolled in Part A and don’t have access to a SEP to enroll in Part B, then January-March is your General Enrollment Period (GEP) and enables you to add Part B.
Original Medicare coverage.
- If you’re already in a Medicare Advantage plan, then January-March qualifies as Medicare Advantage Open Enrollment Period (OEP) for you. A Medicare Advantage beneficiary can switch to a different Medicare Advantage plan or can switch back to Original Medicare (paired with a new Part D drug plan if needed).
The detailed dates related to this period aren’t nearly as important as what it represents: An Initial Coverage Election Period (ICEP) represents your right to switch to Medicare Advantage from Original Medicare at the time that you initially enroll in Part B.
You must be enrolled in both Parts A and B of Original Medicare in order to switch to Medicare Advantage.
- Your first ICEP aligns with the Initial Enrollment Period that surrounds your 65th birthday. In short, if you enroll in Original Medicare Parts A and B in conjunction with turning 65, you have the option of switching to a Medicare Advantage plan for your coverage. It becomes active the same day Original Medicare would have (usually the first day of the month you turn 65).
- If you don’t sign up for both Parts A and B at age 65, then you will have a second ICEP (a second chance to sign up for Medicare Advantage) when you have both Parts A and B for the first time. Whatever date your Part B coverage is set to start, the three months leading up to that date becomes your ICEP. You have that time to switch from Parts A and B to Medicare Advantage, and if you take advantage, your coverage will begin on the same day that Part B would have.
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While most people enroll in Part A when they turn 65 because it provides hospital insurance without a monthly premium, some do pass on Part B because they have similar medical coverage from another source. Once that Initial Enrollment Period passes, you can only add Part B during another enrollment period.
If you’re granted a Special Enrollment Period because you leave an employer insurance plan, you usually can enroll in Part B without penalty. Otherwise, you’ll have to wait until the General Enrollment Period that runs from January 1-March 31 and may incur penalties for enrolling after you turn 65.
If you already have Part A, you can’t sign up for Part B online during a Special Enrollment Period. [i] You’ll need to call the Social Security Administration at 1-800-772-1213 (TYY 1-800-325-0778) or visit your local Social Security Office.
Medicare Advantage plans, administered by private health insurance companies, provide Part A and Part B to replace Original Medicare, and most include Part D and hearing, vision, and dental coverage. And while Medicare Advantage typically limits plan participants to a network of providers in their area, it often can do so at a lower cost. A GoHealth licensed agent can help you decide which plan is right for you.