Understanding Medicare Enrollment

There are certain times of the year when you can sign up or change your Medicare coverage. These windows are called enrollment periods, and they can be confusing. 

However, you should know when they are so you can get the most from your Medicare, avoid late enrollment penalties, and feel confident in your decisions. When you need guidance, Lacayo Group Insurance is here to help.

Initial Enrollment Period

When you’re signing up for the first time, you have a seven-month period called your Initial Enrollment Period (IEP) — which is the best time to enroll in Part A and Part B. Your IEP begins three months before your 65th birthday, includes your birth month, and ends the three months after. But there are some exceptions.

If you’re already getting Social Security benefits, you’ll be automatically enrolled in Parts A and B. If you decide not to enroll in Part B when you’re first eligible, you may have to pay a late-enrollment penalty.

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Annual Election Period (AEP)

If you have Medicare, you can make changes to your coverage during the Annual Election Period. It’s October 15 to December 7 each year.

Here are some examples of what can happen during AEP:

  • If you have (or are signing up for) Parts A or B, you may join or drop a Part D plan.
  • If you have Original Medicare (A & B), you can switch to a Medicare Advantage (Part C) plan.
  • If you have a Medicare Advantage plan, you can drop it and return to Original Medicare.
  • If you have a Medicare Advantage plan, you can switch to a new Advantage plan.
  • If you have a Medicare Part D plan, you can switch to a new Part D plan, OR opt-out of Part D coverage altogether.

If you make a change, your new coverage will start on January 1 of the following year.

General Enrollment Period (GEP)

Some people forget to enroll in Medicare when they’re first eligible. If this happens, you have a chance to sign up for the coverage that you’re entitled to. If you’re eligible for Medicare and you’ve delayed enrollment for some reason, you’ll need to sign up during the General Enrollment Period — which is January 1 to March 31 every year. When you enroll during the GEP, your coverage will begin on July 1.

Medicare Advantage Open Enrollment (MAOEP)

If you have a Medicare Advantage plan but you’re not happy with it, you have some options. During the Medicare Advantage Open Enrollment Period (also runs from January 1 to March 31), you can:

Switch to a different Advantage plan with or without prescription drug coverage.
Return to Original Medicare and, if needed, also enroll in a Part D drug plan.

If you do either of these things, your new coverage will begin the first day of the month AFTER your new plan receives your coverage request.

Special Enrollment Period (SEP)

Some circumstances might make you eligible for a Special Enrollment Period to apply for Medicare. For example, if you move or lose other insurance coverage, these events may trigger an SEP. The rules about when you can make plan changes and what changes you can make are DIFFERENT for every SEP.

There are also SEPs for Medicare Advantage and prescription drug plans. You have 2 months to enroll in either type of plan or make changes to your coverage.

Medigap Open Enrollment Period

If you’re interested in Medicare Supplement insurance, it’s best to buy a plan during your Medigap Open Enrollment Period. It begins the first month you have Medicare Part B and you’re 65 or older. During this 6-month window, you can purchase any Medigap plan sold in your state, even if you have health issues. Medigap open enrollment is important because you typically get better prices during this time.

Need a visual aid? Review the chart below.

How to Apply for Medicare

Remember, some people don’t have to apply for Medicare since they’re automatically enrolled. If you have to manually sign up for Parts A and B, you’ll do this with your Social Security office in one of three ways:

  1. Online
  2. Over the phone
  3. In-person at your local office

When it comes to choosing a Medicare Advantage (Part C), Medigap, and/or prescription drug (Part D) plan, it’s best to work with an agent like Lacayo Group Insurance. We have access to the best insurance companies and can help you pick the right plan at the right price.