Medicare Enrollment Periods

IEP (Initial Enrollment Period)

Your IEP is 7 months long. For individuals who become eligible for Medicare due to age, your IEP includes your 65th birthday month plus the 3 months before and the 3 months after. It begins and ends 1 month earlier if your birthday is on the first of the month you turn 65. You may enroll in Part A, Part B, or both. You may also choose to join a Medicare Advantage plan (Part C), Medicare supplement insurance plan, or a Part D prescription drug plan. You have 6 months to be guaranteed coverage in a Medicare supplement insurance plan (Medigap), starting the first month you are age 65 or older and enrolled in both Medicare Part A and Part B. You may apply at other times, but you could be denied coverage or charged a higher premium based on your health history.

GEP (General Enrollment Period)

GEP is for those individuals who did not sign up for Medicare around their 65th birthday. You can enroll in Medicare Part A, Part B, or both. GEP happens every year from January 1 to March 31, with coverage beginning July 1. You may enroll in a Medicare Advantage plan (Part C) or a Part D prescription drug plan from April 1 to June 30 the same year.

SEP (Special Enrollment Period) – Working past 65

You may qualify for a SEP to enroll in Part A, Part B, or both without penalty for up to 8 months after the month your (or your spouse’s) employment or employer coverage ends, whichever comes first. You may join a Medicare Advantage plan or prescription drug plan up to 2 full months after the same event if you are eligible.

Situations to consider when working past 65:

· If your employer has 20+ employees, you may be able to delay without penalty. But if your employer has less than 20 employees, you will likely need to enroll in Medicare.

· If you have a health savings account (HAS), be aware that once you enroll in any part of Medicare you can no longer make contributions to your HAS.

· If you delay, you will be required to provide written proof of your creditable drug coverage to avoid Part D penalties.

· Some employers require covered spouses to enroll in Medicare at age 65 in order to remain on the employer’s plan.

AEP (Annual Enrollment Period)

Medicare Annual Enrollment is each year from October 15 to December 7. During this time, you may join, switch or drop a Medicare Advantage plan (Part C) or a Part D prescription drug plan. If you drop a Medicare Advantage plan, your coverage reverts to Original Medicare.

SEP (Special Enrollment Period) – Qualifying Life Event

You have 2 full months after the month of a qualifying event to make plan changes. During this time, you may join, change, or drop a Medicare Advantage or Part D prescription drug plan outside of the Medicare AEP without penalty. Common qualifying life events include, moving and leaving retiree, union, or COBRA coverage.

MA OEP (Medicare Advantage Open Enrollment)

If you are enrolled in a Medicare Advantage plan on January 1, you can make one coverage change between January 1 and March 31. You may switch to a different Medicare Advantage plan or return to Original Medicare. If you go back to Original Medicare, you may also enroll in a Part D prescription drug plan during this time.

Assistance paying for Medicare

You may qualify for help if you have a low income and few assets. Income includes money you get from retirement benefits or other money that you report on your income tax returns. Income eligibility levels vary by state and program. Different programs cover costs for different Medicare items. Some may help with Parts A & B, prescription drugs, and some may even help with all your Medicare costs.

Medicaid

Medicaid is a joint federal and state health insurance program for low-income individuals and families. I may also offer some services not covered by Medicare. Each state creates and manages its own program.

Extra Help

A program specifically designed to help qualified beneficiaries pay some or all Medicare Part D premiums, deductibles, copayments, and coinsurance.

Medicare Savings Programs

Medicare Savings Programs help pay some or all Part A and Part B premiums, deductibles, and coinsurance. There are four types of Medicare Savings Programs. You automatically qualify for the Extra Help program if you qualify for a Medicare Savings Program.

PACE (Program of All-Inclusive Care for the Elderly)

PACE provides the care and services covered by Medicare and Medicaid for individuals 55 or older who need a nursing home-level of care, live in the service area of a PACE organization, and can live safely in their community with PACE’s help. This program is not available in all states.