When Can I Enroll in Medicare?
Original Medicare is a government program that provides healthcare coverage for individuals 65 years of age and older, or for certain people who qualify due to disability under the age of 65.
Turning 65 soon? The Initial Enrollment Period includes a 7-month window surrounding your birthday. This 7-month planning and enrollment window allows consumers to sign up for Medicare enrollment beginning 3 months BEFORE their 65th birthday and ending 3 months AFTER their 65th birthday.
Do you qualify soon for Medicare based on disability? If you’re under the age of 65 and have been getting disability benefits for 24 months from the Social Security Administration or the Railroad Retirement Board, you may be eligible for Medicare. If you are diagnosed with ALS or ESRD and meet the criteria, you may qualify for Medicare under the age of 65.
You may be automatically enrolled in Part A (hospital insurance), but Part B (medical insurance) is optional. Most Medicare recipients enroll in Part B when they are first eligible to avoid paying late enrollment penalties when they sign up later. Most people receive premium-free Part A due to taxes paid while working, but most people have to pay a Part B monthly premium.
You can choose to get your Part A and Part B benefits through Original Medicare, or you can enroll in a Medicare Advantage (MA) plan during your Initial Enrollment Period. MA plans are sold by private insurance companies who work with Medicare. They must include the same benefits as Original Medicare, but many plans include additional coverage for little to no additional costs.
Enrolling in Original Medicare? You may want to enroll in a Part D Prescription Drug Plan when you are first eligible, as well. You can also consider buying a Medicare Supplement, or Medigap, policy to help cover some of the out-of-pocket expenses not covered by Part A and Part B.
Medigap Enrollment Period
Once you are 65 years old and enrolled in Part B, you’ll enter a 6-month open enrollment period for Medigap. During this period, you’ll have a guaranteed issue right to buy any Medigap plan sold in your state. If you wait until the period ends to buy a policy, you will likely be subject to medical underwriting, and can be turned down or charged more for coverage based on pre-existing conditions.
General Enrollment Period
If you missed your Initial Enrollment Period and your situation does not meet the criteria for a Special Enrollment Period, another opportunity to sign up is during the General Enrollment Period. However, you may be subject to a late enrollment penalty.
- January 1 – March 31
- Coverage to be effective July 1
Additional Enrollment Periods
Depending on your situation, you may be able to enroll in Medicare or make a change to your coverage during a Special Enrollment Period.
Examples of situations that may trigger a Special Enrollment Period include:
- You are a returning U.S. citizen who lived in another country when you turned 65
- You moved out of your Medicare plan’s service area
- You lost your creditable coverage when employment ended
Medicare’s Open Enrollment Period
Once you’re enrolled in Medicare, you can make changes to your coverage during Medicare’s annual Open Enrollment Period. Between October 15 and December 7, you will have the opportunity to switch plans.
Medicare Advantage Open Enrollment Period (MA-OEP)
If you’re enrolled in a Medicare Advantage plan, you have a chance to make a change one time to another Medicare Advantage plan during the MA-OEP. The Medicare Advantage Open Enrollment Period is from January 1 through March 31.
5-star Special Enrollment Period
Medicare plans are given a rating based on information from customer surveys and providers. If you find a plan with a 5-star quality rating that you’d like to switch to, you can do so one time between December 8 and November 30.