Medicare Enrollment

Medicare provides affordable health care coverage to American citizens who meet the eligibility requirements. If you are 65 or older, you are automatically eligible to enroll in a Medicare policy. People under the age of 65 who have been diagnosed with Amyotrophic Lateral Sclerosis or End-Stage Renal Disease may also be eligible for Medicare enrollment.

Some people receive Original Medicare (Medicare Part A and Part B) insurance automatically, but others have to sign up for these programs independently.

  • If you are already collecting Social Security for either disability or retirement, you will automatically be enrolled in Original Medicare when you are first eligible. 
  • If you aren’t collecting Social Security or aren’t yet eligible for Social Security Retirement, you will need to contact Social Security directly.

There are several standardized periods wherein U.S. citizens are allowed to enroll in different Medicare policies.

Initial Enrollment Period

The Initial Enrollment Period is a 7-month period that starts three months before the month someone turns 65 and ends three months after the month they turn 65.

  • Someone who became eligible due to a disability begins their Initial Enrollment Period three months before their 25th month of disability payments. It ends three months after.
  • Coverage start dates vary based on the month a person enrolls. Coverage can be delayed by up to three months.

Annual Enrollment Period

During the Annual Enrollment Period, you can switch from Original Medicare to a Medicare Advantage plan, change your prescription drug coverage, and update your coverage by switching plans or insurance providers.

  • The Annual Enrollment Period begins on October 15 and ends on
  • December 7. Changes to your coverage won’t take effect until January 1.

General Enrollment Period

The General Enrollment Period is a timeframe within which people who missed their Initial Enrollment Period will be able to enroll in Medicare policies.

  • The General Enrollment Period falls between January 1 and March 31 every year.
  • Coverage for people who enroll during the General Enrollment Period will start on July 1.

Medicare Supplement Open Enrollment Period

If you want to enroll in a Medicare Supplement Insurance (Medigap) policy, the best time to do so is during the Medicare Supplement Open Enrollment Period. During this period, you cannot be denied Medigap coverage by insurance providers.

  • This period begins on the first day of the month you turn 65 (as long as you have already signed up for Medicare Part B). 
  • You can still sign up for a Medigap plan outside of the open enrollment plan, but outside of this period, you may be asked to answer questions about your health status to qualify for coverage.
Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period is a timeframe wherein Original Medicare and Medicare Advantage beneficiaries can switch to a new plan.

  • If you have Medicare Advantage, you can switch back to Medicare Original during the Open Enrollment Period.
  • This period falls between January 1 and March 31.
Special Enrollment Period

Special Enrollment Periods allow prospective Medicare beneficiaries to enroll in Medicare or make changes to their Medicare coverage outside of the General and Initial Enrollment Periods. To qualify for a Special Enrollment Period, you must fit a specific set of special circumstances. Some of these circumstances include:

  • You lose your current coverage
  • Your plan changes its contract with Medicare
  • You change where you live

Determining whether you are eligible to enroll during a Special Enrollment Period can be difficult if you do not have significant knowledge of the Medicare system.

Grutz Financial can help you understand if you will be eligible for special enrollment and provide you with answers to any other Medicare or Financial Planning questions that you may have. Contact us now to find answers to your questions.

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