Think 65

Medicare Enrollment Periods

If you’re about to become Medicare eligible, you need to make some decisions about your future health care coverage. This is because if you wait to enroll until after the initial enrollment period, you may have to pay a penalty and there may be a gap in your coverage. 

Once you’ve decided what parts of Medicare you would like to enroll in, it’s time to figure out when your plan’s enrollment period is.

When is my Medicare Initial Enrollment Period?

Your initial enrollment period begins three months before the month of your 65th birthday and ends three months after your 65th birthday month. 

This happens with one exception: if your birthday is on the first of the month. This will cause your enrollment period to begin one month early.

For example: if your birthday is November 1, your enrollment period will begin July 1 and your Medicare will begin one month early as well — October 1. 

During your initial enrollment period, you can enroll in Original Medicare (Part A and B), Medicare Advantage plan, or Medicare Part D.

When is Medigap’s open enrollment period?

Once you are enrolled in Medicare Part A and B, there is a six-month open enrollment period for Medigap (Medicare Supplement) plans. This window begins with your Part B effective date and is a one-time election period.

What if I missed my Medicare enrollment period?

If you miss your initial enrollment period, there are a few penalties you will face. However, these only apply if you do not have any other coverage, such as creditable employer coverage. 

The penalties are as follows: 

  • If you do not enroll in Part B during initial enrollment, you’ll pay a late enrollment penalty. The penalty is an extra 10% of your premium for every 12-month period you should have had Part B. That 10% is tacked on each month for as long as you have coverage, as a lifetime penalty.

  • If you don’t have Part D coverage and miss your enrollment period, you’ll pay a late enrollment penalty. The penalty is an extra 1% of your premium for as long as you have coverage, as a lifetime penalty.

  • Should you not qualify for free Part A coverage because you didn’t work long enough and you miss your enrollment period, you’ll pay an extra 10% of your premium for twice the number of years you didn’t have coverage.

What if I have employer coverage?

Many people work beyond age 65 and would like to continue their employer coverage instead of signing up for Medicare. You may choose to keep your employer coverage, depending on the size of your employer you can delay enrolling into Medicare. However if there aren’t 20 or more employees on the plan it does not qualify as creditable coverage and you will receive a late enrollment penalty.

This enrollment period is eight months long that begins either the month you or your spouse quits working or the month your group coverage ends, whichever comes first.

What is a Medicare Special Enrollment Period?

There are a couple situations that allow you to enroll into Medicare during a Special Enrollment Period. 

As mentioned above, if you work beyond age 65 and have employer-provided health coverage that you would like to continue instead of Medicare, you are allowed to delay enrollment without penalty. 

Another example would be if you move outside of a plan’s service area. This would trigger a two-month enrollment period in which you could switch to a new Medicare Advantage or Part D prescription drug plan. You could also return to Original Medicare without penalty. Sometimes, you can also enroll into Medigap.

There are other unique situations in which you may also be eligible for a special enrollment period. You are welcome to contact us to learn what options are available for you.

When can I enroll in Medicare Advantage or Medicare Part D?

You can enroll into Medicare Advantage or Part D, 3 months before you turn 65 and up to 3 months after the month you turn 65.
The annual open enrollment period is from Oct 15th – Dec 7th each year, during that time you can join or change your Medicare Advantage plan or Part D.
If you miss this enrollment period and still need to make a change you can do so during the next enrollment period which is from Jan 1st through March 31st.