Navigating the complex world of Medicare can be overwhelming and confusing to your clients, particularly when it comes to understanding the various enrollment periods. These enrollment periods play a crucial role in determining when and how they can enroll in Medicare, choose a plan, or make changes to coverage. In this blog, we will cover the different Medicare enrollment periods and how each affects plan enrollments and changes.
Initial Enrollment Period (IEP)
The Initial Enrollment Period is the first opportunity most individuals have to enroll in Medicare Part A and Part B. It begins three months before your 65th birthday month and ends three months after. Missing this seven-month window may result in late enrollment penalties, so it’s important to take action during this period.
Can you enroll in a plan during your IEP? You have the same 7-month period to enroll in an MA/MAPD or PDP plan. The period for Medicare Supplement guaranteed issue enrollment is different, and gives you 6 months from the month you turn 65 or 6 months after you enroll in Part B, whichever is later.
Initial Enrollment Period for Disability (IEP2)
If you first become eligible due to a disability, then you will also get a 7-month initial enrollment period around your 25th month of disability. You will generally be automatically enrolled by the 25th month, but you can enroll early so you have time to pick a plan to start the same month as your Medicare. When you do turn 65 after already having Medicare due to disability, you will become entitled again and will have another Initial Enrollment Period.
Can you enroll in a plan during your IEP2? You have the same 7-month period to enroll in an MA/MAPD or PDP plan. People under 65 cannot enroll in a Medicare Supplement in some states. You must first check with your state’s guidelines.
General Enrollment Period (GEP)
If you missed your Initial Enrollment Period, you will have to wait until the General Enrollment Period to enroll in Medicare Part A and Part B. Since you did not enroll in Medicare when you were first eligible, you will likely incur a monthly penalty. The GEP runs from January 1st to March 31st each year. Coverage during this election period will start the month after you sign up.
Can you enroll in a plan during the GEP? Yes. You can enroll in an MA/MAPD plan during this time, but coverage must start the same time as your Medicare effective date. If you are enrolling in Part A and Part B during the GEP, then you may enroll in a PDP plan. However, if you already had Part A and are using the GEP to enroll in Part B, then you cannot enroll in a PDP plan at this time unless you have a Special Election Period. You have 6 months to enroll in a Medigap plan with guaranteed issue.
Annual Enrollment Period (AEP)
AEP is the time when you can make changes to your Medicare Advantage (Part C) and Medicare Prescription Drug Coverage (Part D) plans. It runs from October 15th to December 7th each year. During this period you can switch or add an MAPD or PDP plan. You can also drop an MAPD plan and return to Original Medicare with a PDP. The new coverage will start January 1. If you want to add a Medicare Supplement during this time, you would need to go through medical underwriting unless you qualify for a different election period that gives you guaranteed issue.
Medicare Advantage Open Enrollment Period (MA OEP)
The Medicare Advantage Open Enrollment Period gives beneficiaries who are already enrolled in an MA or MAPD a chance to make changes to their coverage. It runs from January 1st to March 31st each year. During this period, you can switch to a different MA or MAPD plan or switch back to Original Medicare with a Part D prescription drug plan. However, you cannot add a Medicare Advantage plan if you do not already have one. This enrollment period is helpful if you enrolled in an MAPD plan and after the new year you learn that your doctors are not in network or coverage is not what you expected.
Special Enrollment Periods (SEP)
Special Enrollment Periods are available to individuals who experience certain qualifying life events. These events include moving to a new area, losing creditable employer coverage, qualifying for or losing Medicaid or Extra Help, and more. SEPs allow you to make changes to your Medicare Advantage plan or PDP plan, and in some circumstances, add a Medicare Supplement.
Understanding the various Medicare enrollment periods can help you assist and advise your clients so they can avoid penalties and make informed decisions about Medicare coverage.
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