Understanding enrollment periods for Medicare Advantage, Prescription Drug and Medicare Supplement plan insurance can be confusing. It’s important to know and understand when the enrollment periods take place to avoid insure you are enrolled for coverage on time.
There are typically four enrollment periods every year:
Annual Enrollment Period (AEP/OEP) – Occurs every year on or around October 15th and runs through early December. This is the time when anyone who is eligible for Medicare can opt into or switch out of a Medicare plan. When enrolled during AEP, the new plan will go into effect January 1st of the following year (approximately a 6 week duration period).
Initial Enrollment Period (IEP) – This is the enrollment time frame for individuals who are new to Medicare. It typically occurs three months prior to an individual becoming eligible for Medicare and lasts until three months after an individual is eligible for Medicare (approximately a 6 month duration period).
Special Enrollment Period (SEP) – Is for individuals who have a qualifying exception to enroll in a Medicare Plan outside of IEP and AEP. SEP is determined by factors such as: coming off of an employer or union plan and moving out of your plan’s service area.
General Enrollment Period (GEP) – Is an annual time frame (January 1st-March 31st) wherein individuals who did not sign up for Part A and/or Part B, and who are not eligible for a Special Enrollment Period, can enroll. Those who chose to enroll during General Enrollment Period will begin receiving coverage on July 1st of that year and may be responsible for paying a higher premium cost.
Medicare Advantage Disenrollment Period (MADP) – During this time frame (January 1st- February 14th) individuals are able to drop Medicare Advantage plans (except MSA plans) and switch to Original Medicare and also join stand-alone Medicare Prescription drug plans. Coverage will begin the first day of the month (after receiving your Medicare forms).
Don’t forget the Details
The above is just a synopsis; there are many details and complexities that can factor in to your eligibility, so it’s important that you are aware and prepared.
For example, if you are newly eligible for Medicare because you’re disabled and under the age of 65, Starting 21 months after you get Social Security or RRB benefits you are eligible to sign up for a Medicare Advantage Plan (with or without prescription drug coverage) or a Medicare Prescription Drug Plan. Your Medicare coverage begins 24 months after you first receive the Social Security or RRB Benefits. This enrollment period ends 27 months after you receive these benefits.
Additionally, if you are already eligible because of a disability and you turn 65, the enrollment is slightly different. During the 7‑month period that starts 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65 you can sign up for a new plan, switch plans, or drop a plan completely. If you sign up for a Medicare Advantage Plan during this time, you can drop that plan at any time during the next 12 months and go back to Original Medicare.
There have been instances wherein clients are disabled and not fully aware of the enrollment constraints, and forced to pay a 10% higher penalty for the remainder of their lives because they were not prepared.
Enrollment periods are definitely not something to take lightly, professional guidance is recommended.