When can you enroll in Medicare? Well, there are 3 different enrollment periods to sign up for Medicare Part A (hospital) and Part B (medical/outpatient) -- the Initial Enrollment Period (IEP), Special Enrollment Period (SEP), and General Enrollment Period (GEP). You take care of this through the Social Security Administration. And then based on your Medicare start dates, you can select your supplemental medical and/or prescription drug coverage.
But we can’t forget about the Annual Election Period (AEP) for Medicare beneficiaries...the timeframe to select (or change) a Part D prescription drug plan or Medicare Advantage plan (Part C). And lastly, we will finish up with when you can enroll in a Medicare Supplement (Medigap) plan.
Enrollment in Part A & Part B -- through Social Security Administration
Initial Enrollment Period (IEP)
Initially, Medicare beneficiaries have the opportunity to enroll in Medicare Part A & Part B during their IEP when turning 65. It’s the 3 months before your birthday month, your birthday month, and the 3 months after your birthday month...for a total of 7 months.
Start dates are always the 1st of the month. Notice in the image on the right that the Part B start date is dependent on which month you submit the application. Part A will be the 1st of your birthday month no matter when you submit the application during your Initial Enrollment Period.
Note: If your birthday is on the 1st of the month, then you’re eligible for Medicare one month prior. So adjust the calendar accordingly in that scenario.
If you’re receiving Social Security benefits already, you’ll automatically be enrolled in Part A & Part B for the 1st of the month of your birthday month. If you’re NOT receiving Social Security benefits and you want Medicare coverage, you’ll need to proactively enroll in Medicare at www.ssa.gov or call Social Security at 800-772-1213. Watch our video How to Enroll in Medicare Online for a step-by-step tutorial of the process.
Special Enrollment Period (SEP)
The next enrollment period is the SEP. This takes place literally anytime after your IEP ends and you leave a group health plan. You would use the SEP if you’re covered in a group health plan, based on either your current employment or your spouse’s current employment. The SEP can be used anytime while you’re still working, or up to 8 months after losing group health coverage. Because of this, you have a lot of flexibility on when you want your Medicare Part A and/or Part B to begin. Watch our video How to Enroll in Medicare After Age 65 for guidance on how to properly complete the enrollment and not be penalized.
This can all be done without penalty, because of your continuous coverage through a group health plan, based on active employment. But after 8 months of separation from the employer, your SEP ends and you can’t enroll in Medicare again until the General Enrollment Period (GEP).
Note: COBRA continuation and retiree coverage are NOT considered coverage based on current employment, so Medicare Part B enrollment should be completed within 8 months of separation of service from the employer...to avoid a late enrollment penalty. Additionally, Medicare coverage due to End-Stage Renal Disease (ESRD) is not an SEP opportunity. Consider accepting ESRD Medicare Part A & Part B when initially eligible to avoid a late enrollment penalty.]
General Enrollment Period (GEP)
If you missed both your IEP and SEP, you must enroll in Medicare during the GEP. The GEP spans January 1st through March 31st each year. The application needs to be completed either in-person at a Social Security office or by phone (800-772-1213). You’ll need the Application for Enrollment in Medicare Part B form, which can be located by typing in “CMS 40B” in the search bar at www.ssa.gov.
Note: Your Part B start date will be delayed to July 1st of the year you enroll. And if your Part B start date is at least 12 months late, you’ll have a 10% late enrollment penalty. This higher premium will be assessed for life. The penalty can accumulate, based on how late you are. For example, if you’re 24 months late, a 20% lifetime premium penalty is charged. If you’re 36 months late, the penalty is 30%.
Enrollment in Part D Prescription Drug Plan, Medicare Advantage (Part C) Plan, or Medicare Supplement (Medigap) Plan -- through insurance carrier
You can enroll in a Part D prescription drug plan or Medicare Advantage (Part C) plan when initially eligible. For example, when you enrolled in Part A & Part B at the age of 65 (during your Initial Enrollment Period)...or after leaving group health coverage (during your Special Enrollment Period). But after that, you have one opportunity each year to make a plan change...during the Annual Election Period (or AEP).
Annual Election Period (AEP) -- October 15th through December 7th
Many confuse the AEP with the Medicare enrollment periods for Part A and Part B, as we detailed above. But the AEP only refers to enrollment in Part D prescription drug plans and Medicare Advantage (Part C) plans.
Medicare beneficiaries can enroll in one of these plans or switch their existing plan during this special period.
To enroll in a Part D prescription drug plan, you must be at least enrolled in Part A (having Part B is fine too).
To enroll in a Medicare Advantage (Part C) plan, you must be enrolled in BOTH Part A and Part B.
Medicare Supplement (Medigap) Open Enrollment
Don’t confuse this with the Annual Election Period (AEP) mentioned above, which some will casually call “open enrollment”. When in fact, they are two very different things. The Medigap Open Enrollment is specifically for Medicare eligible folks who are enrolling in a Medigap plan within 6 months of their Part B start date. During this period, there are no medical history questions (medical underwriting). Your plan approval is guaranteed.
But if you change that plan in the future (after Part B has been in existence for at last 6 months), there will be medical history questions that take pre-existing conditions into account.
There are some other situations where you can purchase a Medigap plan without medical underwriting, but in general...if your Part B has been in existence for at least 6 months, you’ll have to answer health history questions in order to change your Medigap plan.
Reference Links
www.medicare.gov
www.ssa.gov
Medicare Sign-Up Periods
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