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Navigating Medicare can be overwhelming, especially with all the enrollment deadlines and the consequences of missing them. In this article, we’ll break down the key dates that pertain to the different aspects of Medicare, including enrollment, coverage options, and potential penalties.
Medicare Initial Enrollment Period (IEP)
The initial enrollment period starts three months before your 65th birthday, including your birthday month, and lasts for an additional three months after, for a total of seven months. For example: Sam’s 65th birthday is on August 15. If he signs up for Medicare in May, June, or July, his coverage will start on August 1.
For those whose birthday falls on the first day of the month, Medicare coverage will begin on the first day of the previous month. For example, John’s 65th birthday is on May 1. If he signs up for Medicare in January, February, or March, his coverage will start on April 1.
If you miss the IEP, you can still enroll during the general enrollment period. However, missing both enrollment periods could result in late enrollment penalties. Also, you can sign up for a Medicare Advantage plan or drug plan during your IEP.
Medicare Enrollment if You Have Employer Healthcare Coverage?
If you are planning to work past age 65 and are enrolled in an employer group health plan, you may be able to delay enrollment in Medicare without penalties. A word of caution, as this availability will depend on your employer’s overall coverage and the number of employees working for your company. As such, we strongly recommend contacting your group health coverage provider regarding any potential gaps in coverage. For additional information, click here.
If you do qualify for the premium-free Part A, it is common for people to sign up for this part directly with their employer’s group health plan coverage. Furthermore, you can delay Part A enrollment if you plan to continue to make contributions into a health savings account (HSA) or if you do end up paying a premium for Part A. Also, it is recommended that you stop making contributions to your HSA at least six months before applying for Medicare since you cannot contribute to your HSA if you have Medicare. Finally, if you are not enrolled in an employer group health plan, you should sign up as soon as you are eligible for Parts A and B to avoid any penalties.
Part B: If you are enrolled in a group plan, you can delay enrollment in Part B until you leave or lose employer coverage (or your spouse’s coverage). You will have an eight-month special enrollment period from when your employment or employer coverage ends to enroll.
Open Enrollment Period
Medicare OpenEnrollment is between October 15 and December 7 each year. During open enrollment, you have the option to join, drop (ex: drug coverage), or switch to another plan. If changes are made, the updated coverage will begin on January1 of the following year.
General Enrollment Period
The general enrollment period is between January 1 and March 31 of each year. Coverage will start on July 1.
Medigap Open Enrollment Period
The Medigap Open Enrollment Period depends on your 65th birthday and your Part B enrollment status. The six-month period starts on the first day of the month you turn 65 and are enrolled in Part B. If you are already 65 or older, the six-month period starts once you’re enrolled in Part B. Applying for Medigap beyond your open enrollment period might require a medical underwriting process, during which the insurance company decides whether to accept your application based on your health and medical history.
Medicare Advantage Open Enrollment Period
If you are enrolled in Parts A and B, you may enroll in a Medicare Advantage Plan. These plans may offer additional benefits and services outside of basic Medicare coverage. Medicare Advantage Open Enrollment is between January 1 and March 31. During this period, you can switch to another plan or drop the coverage and go back to original Medicare. Coverage will start on the first of the month after the plan gets your request.
Special Enrollment Period
In certain situations, you can sign up for Parts A and B during a special enrollment period without any late enrollment penalties. This special enrollment period is only available for a limited time, so if you qualify for a special enrollment period but wait for the general enrollment period, you may have to pay a monthly late enrollment penalty.
Annual Notice of Change
Each September, your plan provider will send you an Annual Notice of Change (ANOC). This notice includes any changes to your coverage and cost that will be effective January 1 of the following year.