If you have Medicare or you’re turning 65 this year, there are some key dates you need to know for when to sign up for Medicare.
Understanding the basics of Medicare can help keep you — and your coverage — on track. This comprehensive guide to Medicare deadlines details everything you need to know about the initial enrollment, general enrollment, open enrollment and special enrollment periods.
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Initial Enrollment Period
The initial enrollment period for original Medicare (Part A and Part B) refers to a seven-month time period that lasts three months before you turn 65, the month you actually turn 65 and three months after you turn 65. For example, if your birthday is in June, your enrollment period would last from March through September of the year you turn 65.
If your birthday falls on the first of the month, Medicare treats it as if it were the last day of the previous month, meaning that you can sign up four months before and two months after your birthday month. However, coverage can’t start earlier than the month you turn 65, regardless of when you sign up.
Part A is hospital insurance and helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care. Part B is medical insurance and helps cover outpatient care, including durable medical equipment (wheelchairs, walkers, hospital beds and other equipment, for example) and many preventive screenings and vaccines.
In addition to signing up for Medicare Part A and Part B, there are a few additional things to know about the Medicare initial enrollment period:
— You can also use this time period to sign up for Medicare Part C, also known as Medicare Advantage. These plans are offered by private insurance companies and approved by the Centers for Medicare and Medicaid Services, and they may provide additional benefits.
— You also can sign up for Medicare Part D, which is a prescription drug plan.
It’s important to explore your options for how to pursue Medicare after retirement. Don’t wait until the last minute to do this, and don’t count on health insurance coverage like the Consolidated Omnibus Budget Reconciliation Act. COBRA gives people who lose their health benefits the right to continue coverage through their group health plan for a limited time. While this is a popular stopgap measure, premiums can be high, and coverage can be minimal.
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Medigap initial enrollment
Medicare supplemental insurance plans, or Medigap, can help you cover some of Medicare’s out-of-pocket costs.
The Medigap open enrollment period is different from other parts of Medicare. It’s a six-month period that begins when you are 65 or older and have enrolled in Medicare Part B. During this open enrollment period, the government requires private Medicare-approved health insurance companies to sell you a Medicare supplemental insurance plan, regardless of your health status. This is often the arrangement of choice for those with chronic conditions or anticipating significant health care needs.
While Medicare beneficiaries can sign up for a Medicare supplemental insurance plan after this enrollment period, insurance companies are allowed to use medical underwriting to decide how much to charge for the policy. They can even reject individuals they don’t want to cover.
“This is one reason that it is important to assess your needs and seek the best and most appropriate coverage,” says Meredith Ramsey, a New Orleans-based insurance consultant. “Don’t wait until you get sick to make decisions or attempt to make changes because it might be too late.”
General Enrollment Period
Medicare’s general enrollment period runs from January 1 to March 31. It’s geared toward people who didn’t sign up for Medicare when they were first eligible.
During general enrollment, even if you have health coverage from another source or you are still working, you can sign up for Medicare Part B coverage. You will likely have to pay a penalty for not signing up during the initial enrollment period. The penalty may be 10% of your monthly premium, or it could be more. That’s why it’s a good idea to sign up for Medicare during the initial enrollment period versus waiting and having to pay a penalty.
If you sign up for Medicare during the general enrollment period, your coverage will begin the month after you sign up.
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Special Enrollment Period
Medicare’s special enrollment period refers to an eight-month time period when you have certain changes in life that may affect your Medicare Part C or D coverage, such as a move to a different state. You also may qualify to sign up for Medicare Part A and Part B during the special enrollment period if you don’t already have those plans.
Here are some examples of when you may qualify for Medicare’s special enrollment period:
— You’re moving to a new state or city that isn’t covered under your current plan.
— You had health insurance coverage elsewhere, like through your job or a spouse’s plan, but now you don’t.
— Medicare has ended coverage with your current plan.
Medicare Open Enrollment Periods
Medicare fall open enrollment runs from October 15 to December 7 every year. During this time, current Medicare enrollees can join a new Medicare Advantage plan, sign up for Medicare Part D or switch from original Medicare to Medicare Advantage. Changes made during this period will take effect on January 1 of the following year.
Medicare Advantage open enrollment runs from January 1 to March 31 each year. This is when beneficiaries can switch from one Medicare Advantage plan to another or change from Medicare Advantage to original Medicare, with or without a separate Medicare Part D prescription drug plan.
For members on either Medicare Advantage or a Medicare Part D prescription drug plan, look for your plan’s Annual Notice of Change toward the end of September.
“This is extremely important because it will tell you about what your coverage will be in the coming year. Even if you plan to work beyond age 65 and will have coverage, don’t make assumptions about coverage after retirement. You could get tripped up if you do,” says Diane Omdahl, Wisconsin-based president and co-founder of the Medicare consulting firm 65 Incorporated. “If you ignore this, you could be in for some unpleasant surprises. Know about any changes to your plan, and compare and contrast with others so you can make sure you have the best one for your needs.”
This notice will provide you with updates about changes to the coverage and costs of your current plan that will take effect on January 1.
If you want to modify your plans based on these changes, the open enrollment period is the time to do it.
When Medicare Coverage Starts
Medicare Part A and Part B coverage starts the month after you sign up. If you enroll, say, in mid-January, your coverage will begin February 1.
If you’re receiving Social Security benefits, you may be automatically signed up for Medicare Part A and Part B when you turn 65.
If you’re purchasing Medicare Advantage or a Medicare supplement plan, the coverage typically starts the month after you have signed up. So, signing up in June will put your Part C plan into effect July 1. If you sign up for Medicare Part C before you turn 65, then your coverage will begin when you reach your 65th birthday.
What Happens If You Miss a Deadline?
If you miss a deadline, you may have to wait up to a year to apply for coverage or make a change in your plan. However, it’s important not to panic.
“Talk to an independent insurance agent or someone else with expertise in Medicare,” Ramsey suggests.
They may be able to help you find or keep coverage or make changes. Even if you have to deal with penalty fees or higher premiums, it may be worth the investment. However, the best move is to put these key dates on your calendar now and plan ahead.
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When Can You Sign Up for Medicare? originally appeared on usnews.com
Update 10/04/24: This story was previously published at an earlier date and has been updated with new information.
