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Medicare Enrollment Periods—Your Season to Sign Up

Medicare enrollment periods are a chance to cozy up to a health care plan that covers hospital and doctor’s visits, medications, and more.

About to turn 65?

It’s important everyone understands their Medicare options. There are two main ways to get Medicare coverage.

Option 1 is Original Medicare. Read all about it here.

Option 2 is Medicare Advantage (Part C). Read all about it here.

Initial Enrollment Period (IEP): when Medicare individuals first become eligible for Medicare. It’s a 7-month period to sign up for Medicare. It starts 3 months before the birthday month of turning 65. And ends 3 months after. (If the birthday falls on the first day of the month, coverage starts the first day of the prior month.)

Many people sign up for Medicare Part A and Part B (Option 1 Original Medicare) during their IEP. Enrollees pay a monthly Part B premium for Original Medicare. If they choose to join a Medicare drug plan to go along with their Original Medicare, they may pay a separate monthly premium for it. Enrollees may also add a Medicare Supplement Insurance (Medigap) policy to help pay the 20% coinsurance Original Medicare doesn’t cover. Members pay a separate monthly premium to a private carrier for their Medigap policy.

Or a person can go with Option 2 and choose a Medicare Advantage (MA) plan. An MA plan must include Medicare Parts A and B. And often includes prescription drug coverage (Part D) and added benefits Original Medicare doesn’t cover. Enrollees may pay a monthly premium in addition to the Part B monthly premium they pay to Medicare.

What if you don’t sign up at age 65?

Individuals may pay a penalty. If they decide to wait, here are their options.

Medicare Part A: A person can sign up any time after they turn 65 if they’re eligible for premium-free Medicare Part A. Most people don’t pay a premium for Part A. Individuals qualify for premium-free Part A if they or their spouse worked and paid Medicare taxes for the required amount of time (40+ quarters). Coverage starts six months back from when they sign up—although it can’t start earlier than their birthday month.

The premium a person must pay for Part A is based on the number of years they or their spouse worked and paid Medicare taxes. Those who didn’t buy Part A when first eligible may pay a penalty of an extra 10% on their monthly Part A base premium. They pay the higher premium for twice the number of years they could have had Part A but didn’t sign up.

Special Enrollment Period (SEP): Once a person’s IEP ends, they may have a chance to sign up for Part A (if they have to buy it) and/or Part B during an SEP. Enrollees must meet certain requirements to qualify for it.

If a person is covered under a group health plan based on current employment, they have an SEP to sign up for Part A and/or Part B at any time. But the enrollee or their spouse (or family member if they’re disabled) must be working. And the enrollee is covered by a group health plan through the employer or union based on that work.

If enrollment takes place during an SEP, Medicare coverage normally starts the first day of the month after signing up. People usually don’t pay a Part B late enrollment penalty when they sign up during an SEP.

General Enrollment Period (GEP): If a person didn’t sign up for Part A (if they have to buy it) and/or Part B when first eligible and do not qualify for an SEP, they may have to wait until the Medicare GEP. This enrollment runs annually from January 1 to March 31. Coverage normally starts the first day of the month after signing up. Individuals may have to pay a higher Part A and/or Part B premium for late enrollment.

Medicare Part B:
Enrollees pay a late enrollment penalty of an extra 10% for each year they didn’t have creditable coverage (like, from an employer) and could have signed up for Part B but didn’t. The amount is added to their monthly Part B premium for as long as they have Part B. The standard Part B monthly premium for 2024 is $174.70. The Part B monthly premium rate is higher for those with higher incomes.

Keep in mind, the amounts for Medicare Part A and B normally change each year.

Medicare Advantage (Part C): Enrollees must have both Medicare Parts A and B to join a Medicare Advantage plan. Medicare individuals can join, switch, or drop a Medicare Advantage Plan during the Annual Enrollment Period (AEP). This period runs every year from October 15 to December 7. Coverage starts the following January 1.

Drug Coverage (Part D): Individuals must have Part A and/or Part B to join a standalone Medicare Part D drug plan. Or if they have both Parts A and B already, they can go with a Medicare Advantage plan that includes drug coverage.

Medicare individual can join, add, or switch drug plans during AEP. Coverage starts the following January 1.

Medicare-eligible individuals may have a late enrollment penalty permanently added to their Medicare Part D premium. This happens when individuals do not receive Extra Help. And they go a period of 63 days or more in a row after their IEP ends without having one of the below coverages. They’ll pay this late enrollment penalty for as long as they have Medicare drug coverage (Part D), even if they switch plans.

  • Another form of creditable drug coverage, such as employer or union coverage
  • A stand-alone Medicare Prescription Drug Plan
  • Any Medicare health plan offering Medicare prescription coverage such as an MAPD

Anyone on Medicare

All Medicare individuals have an opportunity every year during AEP to join, switch, or drop their Medicare health or drug coverage.

If current Medicare coverage works, individuals don’t need to re-enroll. Medicare Advantage and drug plans may change so it’s important anyone on a Medicare plan annually reviews their current plan to be sure it still works for their needs.

Try the Plan Finder Tool

Compare Medicare Advantage or Part D plans by clicking on Plan Finder link If it’s time to change any part of your Medicare coverage, our licensed insurance agents can help—it’s Medicare made easier.

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MDDB628 1/2024