Navigating Medicare Advantage can feel like threading a needle. One missed window now means you might be stuck waiting months to switch plans.
Here’s everything you need to know about the multiple Medicare Advantage enrollment periods and how to know which enrollment period applies to your situation.
When Is the Medicare Advantage Initial Enrollment Period?
The initial enrollment period is the first time you’re eligible to sign up for Medicare Advantage, or Medicare Part C. This initial period lasts for a total of seven months, starting three months before you turn 65 and ending three months after the month you turn 65.
[Read: When Can You Sign Up for Medicare?]
When Is the Medicare Advantage Annual Enrollment Period?
The annual enrollment period is from October 15 to December 7 each year. This is open to anyone over age 65 (and those younger than 65 with qualifying disabilities) to enroll in a Medicare Advantage plan if they have not already, or to change to another Medicare Advantage plan, for the following year.
[Read: Medicare Fall Open Enrollment: What You Need to Know.]
When Is the Medicare Advantage Open Enrollment Period?
The Medicare Advantage open enrollment period lasts from January 1 to March 31. This eligibility is narrower and is only for those already enrolled in a Medicare Advantage plan. During this time, you can switch your plan or return to an original Medicare plan, and changes take effect the first day of the following month after you switch.
During open enrollment, you may want to consider:
— If you have new health needs that have arisen in the past year
— If you feel your current plan has comprehensive health coverage
— If you are satisfied with your coverage network of providers and specialists
— If your monthly premiums and out-of-pocket costs have felt manageable
“A common, costly mistake people make is focusing exclusively on the monthly premium when selecting their Medicare Advantage plan,” says Seth Teich, the Nashville, Tennessee-based CEO at Healthpilot, a digital broker for Medicare. “Plans with the cheapest premiums can sometimes be the most expensive in the long run, depending on individual health care needs.”
Lower-premium plans could cost more in the long run because of higher out-of-pocket expenses for services, including specialist visits, hospital stays or prescription drugs, which may not be covered by plans with lower premiums.
[Read: Medicare Advantage vs. Medicare Cost Plans: What’s the Difference?]
What Is a Special Enrollment Period?
The Medicare Advantage special enrollment period allows those who are eligible to make changes to their coverage outside of the usual enrollment periods and is helpful for when circumstances are out of your control.
“They exist to help you keep your coverage without penalties when life throws you a curveball,” explains Alfred Polizzotto III, the managing partner of the law firm of Polizzotto & Polizzotto LLC in Brooklyn, New York. Polizzotto handles financial planning cases.
The special enrollment period may open when:
— You lose your coverage through no fault of your own
— You permanently change your home address
— Your Medicare Advantage plan violated its contract, such as through misleading marketing practices or failing to provide you with proper care in a timely manner
For a full breakdown of special enrollment circumstances and effective coverage dates, visit Medicare.gov.
Understanding the Different Medicare Advantage Enrollment Periods
With several Medicare Advantage enrollment periods, understanding the difference between them can help you avoid gaps in coverage.
| Enrollment period | Timeline | Eligibility | Coverage effective date |
| Initial enrollment period | Seven months total, starting three months before you turn 65 | The first opportunity to enroll in Medicare Advantage (or original Medicare) | Coverage begins the first day of the month you turn 65 or the first day of the month after you sign up. |
| Annual enrollment period | October 15 to December 7 every year | Time to review coverage and switch or make changes to your plan for the following year | Changes take effect on January 1 of the following year. |
| Open enrollment period | January 1 to March 31 every year | Those already enrolled in Medicare Advantage can make one-time changes to plans or return to original Medicare. | Changes take effect the first day of the following month after you switch. |
| Special enrollment period | Varies | For specific life events | Coverage begins the first day of the following month. |
FAQs
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To find Medicare Advantage plans near you, check out U.S. News & World Report’s top-rated plans. To determine the top-rated insurance companies, U.S. News consulted with Medicare experts to identify and weigh the most important quality measures for Medicare Advantage consumers. U.S. News applied these weights to data from the Centers for Medicare & Medicaid Services and then adjusted for enrollment.
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Medicare Advantage Initial Enrollment Period and Special Enrollment Periods originally appeared on usnews.com
