Know When You Can Enroll in Medicare Part A and/or Part B
If you are already receiving retirement benefits from the Social Security Administration or Railroad Retirement Board at the time you become eligible for Medicare, you will be automatically enrolled in Medicare Parts A and B. For everyone else who is eligible, however, there are three specific times during which you can enroll in Medicare Parts A and B for the first time.
- The Initial Enrollment Period (IEP) gives you a six-month window which opens three months before your 65th birthday and closes three months after your 65th birthday. The effective date of your Medicare coverage will depend on when you enroll. If you want Medicare Parts A and B to begin the month of your 65th birthday, you should enroll in the first three months of your IEP.
- If you have a Part B Special Enrollment Period (SEP), it lets you delay enrollment in Part B without penalty if you were covered by insurance based on your or your spouse’s current work when you first became eligible for Medicare. You can enroll in Medicare without penalty while covered by insurance based on current work. You can also enroll without penalty for up to eight months after you lose your group health coverage or you (or your spouse) stops working, whichever comes first. Medicare coverage generally begins the first of the month after you enroll.
- You can enroll during a General Enrollment Period (GEP) if you did not enroll in Medicare when you originally became eligible. The GEP takes place January 1st through March 31st each year, with coverage starting July 1st. You may incur a Part B late enrollment penalty and face gaps in coverage if you sign up during the GEP.
Learn the Times of Year When You Can Make Changes to Your Medicare Coverage
Beginning in 2019, there is a Medicare Advantage Open Enrollment Period from January 1st through March 31st each year. During this time, beneficiaries enrolled in a Medicare Advantage plan will have one opportunity to change their Medicare Advantage plan or go back to Original Medicare with or without a stand-alone Part D prescription drug plan. Changes take effect the first of the following month. Otherwise, you will need to wait until the customary Medicare Open Enrollment Period to change your Medicare coverage.
Medicare’s Open Enrollment Period lasts from October 15th to December 7th each year. During this time, you can change the way you receive Medicare. If you have Original Medicare, you can switch to a Medicare Advantage Plan or change your stand-alone Part D prescription drug plan. If you have a Medicare Advantage Plan, you can change plans or you can switch to Original Medicare, with or without a stand-alone prescription drug plan. You can make as many changes as you want during Medicare’s Open Enrollment Period, and the last change you make will take effect on January 1st.
Use Special Enrollment Periods (SEPs) to change coverage due to special circumstances.
There are several circumstances in which you might qualify for an SEP to change your health or drug coverage outside of the enrollment periods. People with Extra Help, a program that helps pay out-of-pocket drug costs, have an SEP to change their Part D plan. It is available once per calendar quarter in the first three quarters of the year (January to March, April to June and July to September). Changes become effective the following month. You may also qualify for an SEP if you move out of your plan’s service area, if your Medicare Advantage Plan terminates a significant amount of its network providers or if you enroll in certain State Pharmaceutical Assistance Programs (SPAPs).
1. To enroll in Medicare Parts A and B, contact the Social Security Administration by calling 800-772-1213 or visiting your local Social Security office.
2. To enroll in a Medicare Advantage or Part D plan, or to switch health or drug coverage, call 1-800-MEDICARE (1-800-633-4227) or go online to the Medicare Plan Finder at www.medicare.gov.
3. If you have questions, want help comparing plan choices or think you might qualify for a SEP, contact United Way Area Agency on Aging’s State Health Insurance Assistance Program (SHIP) at 1-800-AGE-LINE (1-800-243-5463).
4. If you suspect you have been a victim of Medicare fraud, abuse or misleading marketing, contact United Way Area Agency on Aging’s Senior Medicare Patrol (SMP) at 1-800-AGE-LINE (1-800-243-5463).
Need More Information?
United Way’s Area Agency on Aging of Jefferson County and its SHIP and SMP programs are here to help. Visit www.uwaaa.org or call 1-800-AGE-LINE (1-800-243-5463) for assistance.
Information provided by SHIP National Technical Assistance Center (SHIP TA Center) and Senior Medicare Patrol National Resource Center.