There are many types of Medicare enrollment periods — so much so that it can all get pretty confusing!
A good rule of thumb is to remember the 7 months initial enrollment period that encompasses the three months before your 65th birthday, three months after, and the month of your birthday.
Similarly, if you are under 65 and have been receiving disability benefits from Social Security for nearly two years (24 months), your 7 month period encompasses three months before the 25th month of receiving benefits as well as the three months after.
There are also two periods a year that can be used to add, drop, or modify a Medicare Advantage (Part C) plan. If you are dropping your Medicare Advantage plan, you may also be eligible to add Part D coverage with no penalty during this time, provided you have had continual prescription drug coverage since your eligibility began.
Finally, there is a Medicare special enrollment period (SEP) that can apply if you are still working at age 65 and have creditable coverage from a qualifying insurance plan but later decide to retire or drop this coverage.
Your Medicare Initial Enrollment Period
The initial enrollment period (IEP) for Medicare is different for every beneficiary because it depends on the date of their 65th birthday. Or, in the case of individuals under 65 receiving Social Security disability benefits, it corresponds to the 25th month of them receiving benefits.
In a nutshell, your Medicare initial enrollment period is 7 months, total. It encompasses the month of the date when you are officially eligible to be enrolled in Medicare as well as the 3 months before and the 3 months after.
| Your 7 Month Medicare Initial Enrollment Period | ||
| 3 months before | The month of your 65th birthday Under 65: the 25th month you receive Social Security Disability benefits | 3 months after |
This initial enrollment period is crucial for a number of reasons. First, signing up during this time prevents you from having a gap in available coverage.
Secondly, signing up for Medicare Part B and/or Part D during this time ensures you don’t get a penalty. If you choose to not obtain either Part B or Part D and wish to enroll in either later, you will likely be charged a penalty on top of your monthly premiums, with very few exceptions.
Finally, if you have all of your paperwork in order to receive Social Security benefits by the time you are 67, then you will be automatically enrolled in Part A and likely Part B during this time.
Most Medicare recipients approaching 65 receive notice during this initial enrollment period, and they should receive their red, white, and blue Medicare card in the mail around four weeks before their 65th birthday.
You can choose not to enroll in any Medicare program, including Part A if you wish. You will be able to sign up later during the general enrollment period.
However, if you do not have a creditable group health insurance plan provided through an employer, then choosing to not have any Medicare coverage can lead to penalties if you wish to sign up later on. You are also ineligible to receive Social Security retirement benefits until you enroll in at least Medicare Part A.
Medicare Special Enrollment Period
You can elect to delay your enrollment in Medicare Part A and/or optional Part B and Part C without fear of a penalty if you have qualifying coverage provided through an employer (or a spouse’s employer) when you turn 65.
Individuals who elect not to sign up for Medicare have the opportunity to enroll later once they retire or drop their group insurance during what is known as the Medicare special enrollment period (SEP).
The 8 month special enrollment period begins the month after the relevant employment ends or the individual decides to end their current group health plan.
Another type of special enrollment period can apply if you elected to sign up for a Medicare Advantage (Part C) plan during your initial enrollment period. You have three months from the time your benefits start to change your mind, disenroll from Part C, and return to Original Medicare Part A and Part B coverage.
Medicare General Enrollment Period
There are two main Medicare general enrollment periods.
The first general enrollment period lasts from January 1 – March 31 each year. It allows you to:
- Enroll in Medicare Part A and/or Part B if you have not already
- Switch from one Medicare Advantage plan to another
- Disenroll from a Medicare Advantage plan to return to Original Medicare coverage, including the option to add Part D coverage
The January 1 – March 31 period does not allow you to:
- Switch from Original Medicare to a Medicare Advantage plan
- Add Part D coverage to Original Medicare
- Change Part D plans if you’re enrolled in Original Medicare
The second general enrollment period happens towards the end of the year, from October 15 – December 7. This period is considered the main open enrollment period for Medicare Advantage. During this time you can:
- Change from Original Medicare coverage to a Medicare Advantage plan
- Switch from Medicare Advantage back to Original Medicare
- Change Medicare Advantage plans
- Add or drop drug coverage from your Medicare Advantage plan
- Add Part D coverage if you do not have a Part C plan with prescription drug coverage
- Change Part D coverage plans if you already have it
- Drop Part D from your coverage plan
How Do I Know What Enrollment Period Applies to Me?
Like we said, all of these dates and the different things you can do on them can get quite complex for the average person. Luckily, you can reach the Social Security office or talk to an insurance professional experienced with the Medicare program here at MMIG to get your questions answered.
To contact Social Security you can reach them:
- Online at https://www.medicare.gov/eligibilitypremiumcalc/
- By phone at 1-800-772-1213 (TTY: 1-800-325-0778)
- At your local Social Security office
You can also contact us to answer your questions and also receive guidance on what Medicare plans, Medicare Advantage plan and/or Medigap plans can best meet your health needs as well as your personal preferences. We have helped Georgians like you for many years, and our biggest concern is helping you protect what’s ahead.