fbpx
Menu

Medicare Enrollment Periods

Last Updated on June 15, 2023 by Chris Franchina

  1. Initial Enrollment Period (IEP):

    • When: The seven-month period that begins three months before your 65th birthday month and ends three months after.
    • Who Qualifies: Individuals who are turning 65 and are eligible for Medicare based on age.

  2. General Enrollment Period (GEP):

    • When: January 1 to March 31 of each year.
    • Who Qualifies: Individuals who didn’t enroll in Medicare during their Initial Enrollment Period and don’t qualify for a Special Enrollment Period (SEP). However, enrolling during this period may result in late enrollment penalties.

  3. Special Enrollment Period (SEP):

    • When: Throughout the year, depending on qualifying events.
    • Who Qualifies: Individuals who experience certain life events, such as moving to a new area, losing employer coverage, or qualifying for Extra Help (low-income subsidy). Each event has specific eligibility criteria and timeframes for enrollment.

  4. Annual Enrollment Period (AEP):

    • When: October 15 to December 7 of each year.
    • Who Qualifies: Individuals who are already enrolled in Medicare and want to make changes to their coverage. This includes switching from Original Medicare to a Medicare Advantage plan, switching between Medicare Advantage plans, or changing or adding a Part D prescription drug plan.

  5. Medicare Advantage Open Enrollment Period (MA OEP):

    • When: January 1 to March 31 of each year.
    • Who Qualifies: Individuals who are already enrolled in a Medicare Advantage plan and want to make a one-time change. During this period, you can switch to a different Medicare Advantage plan or return to Original Medicare and add a Part D plan.

  6. Medicare Part D Late Enrollment Penalty (LEP):

    • When: Applies to individuals who delay enrolling in Medicare Part D (prescription drug coverage) when they are first eligible and don’t have creditable prescription drug coverage (coverage that is at least as good as Medicare’s).
    • Who Qualifies: Individuals who have gone without creditable prescription drug coverage for 63 or more consecutive days after their Initial Enrollment Period.

    • Late Enrollment Penalties (LEPs) may apply if you don’t sign up for Medicare Part B or Part D when you are first eligible and don’t have other creditable coverage (coverage that is at least as good as Medicare’s). Here are the late enrollment penalties for Medicare Part B and Part D:

      1. Medicare Part B Late Enrollment Penalty:

        • Penalty Amount: The penalty is an additional 10% of the Part B premium for each full 12-month period that you could have enrolled in Part B but didn’t.
        • Duration: The penalty is permanent and continues for as long as you have Medicare Part B.

      2. Medicare Part D Late Enrollment Penalty:

        • Penalty Calculation: The penalty is calculated by multiplying 1% of the national base beneficiary premium by the number of full, uncovered months you were eligible for Part D but didn’t enroll.
        • Duration: The penalty is generally added to your Part D premium and remains in effect for as long as you have Medicare Part D. The specific penalty amount may vary depending on the length of time you were without creditable prescription drug coverage.

      It’s important to note that the penalties can vary depending on your specific circumstances, and the actual penalty amounts are determined by Medicare. To get precise and personalized information about late enrollment penalties for your situation, it’s recommended to contact Medicare directly or consult with a licensed insurance agent who specializes in Medicare.

Related Posts