Medicare Open Enrollment & Important Dates
Key Takeaways
- There are several times each year when you can make changes to your Medicare plan. This is true whether you have Original Medicare (Parts A and B)Original Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). or a Medicare Advantage (Part C)Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). plan.
- The Medicare Open Enrollment Period, also referred to as the Annual Enrollment Period, runs from October 15 to December 7 each year.
- If you plan to enroll when you turn 65, you’ll need to do so during your Initial Enrollment Period (IEP)The Initial Enrollment Period (IEP) is the seven-month period around your 65th birthday when most people are eligible for the first time to enroll in Medicare. . This is a seven-month Medicare enrollment period that includes the month you turn 65, plus three months before and after.
- If you miss your IEP and don’t qualify for delayed enrollment, you’ll probably have to pay monthly enrollment penalties for parts of your Medicare.
- Medicare’s other signup times include the General Enrollment Period and the Medicare Advantage Open Enrollment Period.
If you’re nearing Medicare eligibility, there are a host of healthcare benefits in store for you. Actually tapping into these benefits, however, requires you to be enrolled in Medicare. Some people are automatically enrolled when they turn 65, while others will need to take active steps to sign up during a Medicare enrollment period. On this page, we’ll explain the different ways and times to enroll in Medicare, with info on:
- Which Medicare enrollment period do you need?
- When is Medicare open enrollment?
- Is Medicare Part B enrollment separate from Part A?
What Medicare coverage is right for my specific situation?
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What Are the Medicare Open Enrollment Dates?
Once you’ve enrolled in Medicare, the Medicare Annual Enrollment Period (AEP) is your chance to make changes to your coverage each year. Here are two dates to circle on your calendar.
When does Medicare Open Enrollment begin?
- October 15 each year
- December 7 each year
- Switch from Original Medicare to a Medicare Advantage (Part C) plan
- Change back to Original Medicare from Medicare Advantage
- Enroll in a separate Part D prescription drug plan
- Change your Medicare Advantage plan to another Part C plan; this includes changing to a plan with or without drug coverage
- Switch or drop Medicare Part D plans
Do I Automatically Get Medicare When I Turn 65?
The answer is … maybe. According to Medicare, whether or not you’re automatically enrolled in Medicare when you turn 65 comes down to this: If you’re already receiving Social Security benefits when you’re first eligible for Medicare, there’s a good chance you’ll be automatically enrolled. If you’re not yet receiving your Social Security benefits, you may need to enroll in both Parts A and B yourself.
While Medicare is administered and run by the Centers for Medicare & Medicaid Services (CMS), enrollment is handled by the Social Security Administration. This also allows your Medicare premiums to be automatically withdrawn from your monthly Social Security benefits.
If you’re not yet receiving Social Security benefits when you turn 65, you’ll have a designated time frame during which to sign up. This is known as your …
Medicare Initial Enrollment Period (IEP)
For most, Medicare enrollment takes place the year they turn 65 during their Initial Enrollment Period (IEP). This seven-month window begins three calendar months before your birthday. It also includes your birth month, and three months after.
For example, if your birthday is May 15, your IEP opens February 1 and closes August 31.
(If you were born on the first of the month, then your IEP starts four calendar months before the month you turn 65 and closes two calendar months after.)
If you sign up before your birth month, your coverage typically begins the month you turn 65. If you enroll during the final three months of your IEP, your coverage can begin as late as three months later.
The first Medicare enrollment application you’ll need to fill out will be for Original Medicare (Parts A and B). Parts A and B comprise the two main parts of Medicare and provide hospital (Part A) and medical (Part B) coverage.
After you’re enrolled in Original Medicare, you can decide how you’d like to receive your Medicare. Your options include:
- Keeping just Original Medicare (Parts A and B).
- Adding separate Medicare Part D and/or Medicare Supplement Insurance (Medigap) plans.
- Switching to a Medicare Advantage (Part C) plan with or without drug coverage.
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Who Can Apply During Medicare Open Enrollment ?
Unless you’re already enrolled in Original Medicare or Medicare Advantage, you can’t apply for any form of Medicare during the Annual Enrollment Period. This open enrollment period is reserved for people who want to re-enroll or make changes to their existing coverage for the next year.
What Changes Can You Make During Medicare Open Enrollment ?
In many ways, Medicare’s Annual Enrollment Period is a bit of a catch-all, allowing you to make changes to your coverage and shop for plan options that fit your needs. As a result, there is a lot you can accomplish between October 15 and December 7. You can make sweeping changes to your coverage, or you can tweak smaller details to improve your current coverage. Either way, AEP is probably your time to do it.
What you’re able to do depends on which type of Medicare you have when AEP begins. For example:
Original Medicare beneficiaries
- Switch to a Medicare Advantage plan
- Add, switch, or drop your stand-alone Medicare Part D plan
- Switch back to Original Medicare
- Switch to another Medicare Advantage plan. This also means selecting a Part C plan that does or doesn’t feature drug coverage
- Add, switch, or drop your Medicare Prescription Drug Plan
What if I miss Medicare Open Enrollment?
As we mentioned, the Medicare Open Enrollment deadline is December 7. If you fail to act during the Medicare Annual Enrollment Period, your coverage will typically stay the same when the next benefit year begins on Jan. 1. So, if you were enrolled in Original Medicare and didn’t take action during AEP, you’ll have the same type of Medicare the next year.
There are exceptions, however — under certain circumstances. If December 7 comes and goes and you still need to make changes to your plan, check to see if you qualify for a Special Enrollment Period (SEP). These are enrollment periods that open when you experience a certain life-changing event, such as moving or losing other coverage. For example, if your doctor suddenly opts out of accepting your coverage, you may qualify for an SEP. We’ll get into more of these circumstances below.
Are There Different Enrollment Periods for Medicare Advantage?
Yes; whether you want to enroll when you’re first eligible, or you’re looking to change your existing Medicare coverage, there are designated enrollment periods during which you can take action, including the Annual Enrollment Period each fall.
Here are a few common Medicare Advantage enrollment scenarios and which enrollment period would apply.
Enroll when you’re first eligible
First things first — to sign up for a Medicare Advantage plan, you must first be enrolled in Medicare Parts A and B. This allows you to take part in the Medicare program, whether you stick with Original Medicare or switch to a Medicare Advantage plan. But that doesn’t mean you should delay your Part C planning; along with your IEP, you’ll also have a separate Initial Coverage Election Period (ICEP) that opens at the same time. This refers to your first chance to sign up for Medicare Advantage.
Like your IEP, the ICEP opens three months before you turn 65. It ends in two ways: You either reach the end of your IEP, or your enrollment in Parts A and B begins — whichever comes last. This allows you to sign up for Medicare Advantage when you first begin receiving benefits, whether you enroll at 65 or delay because you’re still working and have other coverage.
You have Original Medicare and want to switch to Part C
As discussed, you can switch from Original Medicare to Medicare Advantage each year during the open enrollment period from October 15 to December 7 .
You’re enrolled in Medicare Advantage and want to switch Part C plans
If you’re already enrolled in a Part C plan, you can switch to another during the Medicare Advantage Open Enrollment Period from January 1 to March 31 . This can be helpful if you need to switch to a plan with or without drug coverage, or if you’re unhappy with the plan you chose during the Medicare AEP. You’re allowed to switch to another plan once during this period.
You missed your IEP and want to sign up for Medicare Advantage
The General Enrollment Period (GEP) is your first chance to enroll in Medicare Parts A and B if you miss your Initial Enrollment Period. The GEP runs from January 1 to March 31. These plans take effect July 1. You can sign up for Medicare Advantage in the gap between when your GEP ends and your coverage starts — April 1 to June 30. Keep in mind that if you wait to sign up during the GEP, your Part B late enrollment penalty will likely follow you to your Part C plan.
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What Is the Deadline to Sign Up for Medicare?
Unless you’re able to delay your Part B enrollment (assuming that you also qualify for premium-free Part A), you’ll want to enroll in Medicare Parts A and B by the end of your Initial Enrollment Period. For most, this is at the end of the third month following the month you turn 65. So, if you turn 65 in April, your IEP closes July 31.
You’re not required to enroll in Medicare. So what happens if you don’t sign up on time?
You’ll pay more when you do sign up. Medicare Parts A, B and D all have their own enrollment penalties, each of which adds a years-long (sometimes permanent) surcharge onto your monthly premium payment.
The other Medicare enrollment periods have their own deadlines, but without the penalties. As a refresher, here are the start and end dates for the other Medicare enrollment periods.
- Medicare Advantage Open Enrollment Period: January 1 to March 31
- General Enrollment Period: January 1 to March 31
- Medicare Annual Enrollment Period: October 15 to December 7
However, the same can’t be said about every popular Medicare option.
Enrolling in Medicare Supplement Insurance (Medigap)
If you’re enrolled in Original Medicare, you have the option of adding a separate Medigap policy to help pay your out-of-pocket costs. These are plans offered by private insurance companies that have their own premiums and enrollment processes. Like the other policies associated with Medicare, there’s a set time to enroll. But unlike the others, not enrolling may actually keep you from getting the policy you want.
When you first enroll in Medicare Part B, your Medigap Open Enrollment Period begins; during this six-month window, you can purchase any Medigap plan available in your state. While you may have to go through some medical exams during enrollment, you have guaranteed issue rights — this means you can’t be denied coverage. You may have a waiting period for certain pre-existing conditions.
You may be able to purchase a Medigap plan after Medigap Open Enrollment. Private insurers use medical underwriting to determine eligibility and are allowed to deny coverage and charge more.
Medicare Part D Enrollment
No matter what kind of Medicare you have — Original Medicare or Medicare Advantage — prescription coverage is probably a big part of the equation. If you have Original Medicare, that means adding a stand-alone Medicare drug plan.
Your first opportunity to choose a Medicare drug plan is during your Initial Enrollment Period. Once your IEP ends, you’ll pay a Part D enrollment penalty if you go more than 63 consecutive days without Medicare drug coverage or some other form of creditable coverage, like group health insurance or COBRA.
If you had to sign up for Original Medicare during the General Enrollment Period, you can enroll in a Medicare drug plan from April 1 to June 30. Your coverage will start alongside your Original Medicare on July 1 — with an enrollment penalty.
Once you’re enrolled in Medicare, you’ll have more opportunities to add, drop and change your Medicare drug plans. Here is how Medicare Part D fits with the other Medicare enrollment periods:
Medicare Annual Enrollment Period (AEP)
Each year from October 15 to December 7, you can do the following:
- Enroll in a Part D plan if you have Original Medicare
- Change Part D plans
- Enroll in a Medicare Advantage plan with drug coverage
- Switch to another Medicare Advantage plan with or without drug coverage
While not as well known as AEP, the Medicare Advantage Open Enrollment Period may give you a chance to find the Part D coverage you need. If you decide to drop your Medicare Advantage plan in favor of your Original Medicare coverage, you’ll be able to choose a Medicare drug plan to supplement your Parts A and B coverage.
Want to stick with Medicare Advantage but don’t love your drug benefits? This is also your window — you can enroll in another Medicare Advantage plan with or without drug coverage.
Special Circumstances and Special Enrollment Periods
With all its different enrollment periods and penalties, Medicare can seem stringent and unforgiving. Fortunately, it also allows for flexibility when you need it.
When you go through certain life events, Medicare will open a special window for you to make the necessary changes to your plan. During this time you can enroll in Original Medicare, change to a Part C plan and sign up for a Medicare drug plan. How long your Special Enrollment Period remains open depends on why it was granted in the first place.
Here are some circumstances that may qualify you for a Special Enrollment Period from Medicare:
You lose group coverage after delaying your enrollment past 65: Once you stop working and lose your group coverage, you have eight months to enroll in Original Medicare (Parts A and B) without penalty. This eight-month window does not include any time you were covered by COBRA.
You have Medicare Advantage but move outside your plan’s service area: You can switch to Original Medicare or a new Medicare Advantage plan. You can have up to four full months to switch if you notify your plan beforehand. If not, you have two full months, plus the month you notify your plan.
If a Medicare Advantage or Medicare drug plan with five stars becomes available: Medicare offers a 5-star Special Enrollment Period which allows you to switch to a higher-rated plan once between December 8 and November 30 of the following year.
How to Apply for Medicare
Fortunately, you don’t really need to apply for Medicare. Since it’s public health insurance, all you need to do is qualify. Medicare is for U.S. citizens and legal residents age 65 and older. You may also qualify if you’re younger than 65 and:
- Have received disability-based benefits from the Social Security Administration for longer than 24 months.
- Are living with End-Stage Renal Disease (ESRD).
- Are living with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
How to enroll in Medicare
No matter what type of Medicare you want — Original Medicare or Medicare Advantage — the first step is to enroll in Medicare Parts A and B. Whether you’re approaching 65 and need to enroll during your Initial Enrollment Period or you’re signing up during a Special Enrollment Period, there are several ways to register for your Medicare benefits.
Online
To apply online for Medicare, you’ll need to visit the Social Security Administration (SSA) website and create a my Social Security account. From there you’ll be able to find available savings and apply for benefits.
In person
For those that prefer in-person assistance, the Social Security Administration will help you enroll in Medicare at a local office.
Over the phone
Do you need personal assistance with signing up for Medicare but can’t make it into an office? You can call Social Security for help with enrollment at 1-800-772-1213. Are you a TTY user? Call 1-800-325-0778.
Sources
- Medicare Open Enrollment. CMS.gov
- Medicare Advantage Enrollment and Disenrollment Rules. National Council on Aging.
- When can I buy Medigap? Medicare.gov
- Part D late enrollment Penalty. Medicare.gov
- Joining a health or drug plan. Medicare.gov.
- Special Enrollment Periods. Medicare.gov
- Medicare Benefits. SSA.gov.
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