Medicare 101

New to Medicare Series: Part 4

by Rebecca Hambleton | Published July 13, 2020 | Reviewed by John Krahnert

Your Guide to Medicare Enrollment Periods

Most people become eligible to sign up for Medicare three months before their 65th birthday, but some people qualify earlier if they have a disability or certain medical conditions.

There are certain times when Medicare eligible individuals can enroll in Medicare or make changes to their coverage, known as Medicare enrollment periods. Different enrollment periods apply to different situations, so it’s important to understand how they compare.

This guide explores the different Medicare enrollment periods and explains how to enroll in Medicare once you’re eligible.

Medicare Initial Enrollment Period

Your Initial Enrollment Period (IEP) is the first time you can sign up for Medicare Part A and Part B.

  • If you are 65 or approaching 65, your Medicare Initial Enrollment Period begins three months before your 65th birthday, includes your birthday month, and ends three months after your 65th birthday.

  • If you’re younger than 65 and eligible for Medicare because of a disability, you should be automatically enrolled on the 25th month of receiving Social Security Disability Benefits.

  • If you’re younger than 65 and eligible for Medicare because you have ALS, your Medicare benefits will begin the first month you have Social Security Disability Benefits.

  • If you have end-stage renal disease (ESRD), you typically must manually enroll.

Failing to enroll in Medicare during your Medicare Initial Enrollment Period can cause you to pay late enrollment penalties, so we recommend enrolling as soon as you’re eligible.

Medicare Special Enrollment Period

If you or your spouse are still working at age 65 and are covered by a group health insurance plan, you do not have to enroll in Medicare during your Initial Enrollment Period. If this applies to you, you will likely qualify for a Medicare Special Enrollment Period once you or your spouse retires or you lose your group coverage.

If you are eligible for a Special Enrollment Period, you typically will not have to pay a late enrollment penalty.

Special Enrollment Periods also apply to people who already have Medicare and face certain life events, such as moving or losing their coverage though no fault of their own.

Medicare General Enrollment Period

If you don’t enroll in Medicare during your Medicare Initial Enrollment Period and do not qualify for a Special Enrollment Period, you can enroll during the General Enrollment Period, which runs from January 1 to March 31 each year.

Keep in mind, however, that enrolling during this time may not be in your best interest, as your coverage won’t begin until July 1, and you may have to pay late enrollment penalties.

Medicare Annual Election Period

The Medicare Annual Election Period runs from October 15 to December 7 each year.

This period is also referred to as the Medicare Open Enrollment Period and the Fall Open Enrollment Period, and is a time when Medicare beneficiaries can make changes to their Medicare Advantage or Medicare Prescription Drug Plans.

During the Medicare Annual Election Period, you can typically:

  • Switch from Medicare Part A and Part B to a Medicare Advantage plan

  • Switch from a Medicare Advantage plan back to Medicare Part A and Part B

  • Switch from one Medicare Advantage plan to another Medicare Advantage plan

  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan. You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

  • Opt out of a Medicare Prescription Drug Plan

How to Enroll in Medicare

Some people are automatically enrolled in Medicare and others must manually enroll. Typically, you are automatically enrolled in Medicare Part A and Part B if one of the following applies to you:

  • You get benefits from Social Security or the Railroad Retirement Board at least four months before you turn 65

  • You’ve been getting Social Security disability benefits for more than 24 months

If you must manually enroll in Medicare, you can do so by:

  • Calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday 7AM-7PM

  • Visiting the Social Security website at www.SocialSecurity.gov

  • Visiting your local Social Security office

  • If you worked for a railroad, you can enroll in Medicare by contacting the Railroad Retirement Board at 1-877-772-5772 (TTY users 1-312-751-4701), Monday through Friday 9AM-3:30PM

Learn More

For more information about Medicare, read through some of the other guides in this series or speak with a licensed insurance agent.

 

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