Priscilla Wright

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Medicare Enrollment Period


Trying to make sense of all those Medicare enrollment periods and what they mean for you and your coverage? You’re not alone. According to a 2012 report by the Medicare Rights Center, about 700,000 people paid a late enrollment penalty for Part B that year. Turns out it’s pretty common to miss your Medicare enrollment period. It doesn’t help much that there is Medicare open enrollment period, Medicare initial enrollment period and Medicare special enrollment periods.

Sheesh! Who can keep all that straight?

Roughly 12% of Medicare beneficiaries also lacked creditable prescription drug coverage, making them potentially liable for a premium penalty when they later do enroll in a Part D Drug Plan.

That’s about 6 million people who could pay monthly penalties for as long as they have Medicare coverage. That could add up to a lot of money over the years.

Here’s a look at the different Medicare enrollment periods for 2019 and beyond that you should be aware. You don’t want to wind up without essential health care coverage—or paying more than you should for the coverage you want.

What is the Medicare Initial Enrollment Period?

Your Medicare Initial Enrollment Period is probably the most important date for you to know as you’re approaching the age of Medicare eligibility.

Your Initial Enrollment Period (or IEP) is a seven-month period of time. It begins three months before the month of your 65th birthday. It then includes the month of your birthday, and extends for three months after your birthday month.

For example, if you turn 65 on May 20th, your Medicare IEP would run from Feb 1st to August 31st.

One exception: if your birthday falls on the 1st of the month – your IEP will start one month early. For example, if your birthday is April 1st, your IEP will begin December 1st and your Medicare will begin one month early on March 1st.

During the IEP, you can enroll in Original Medicare (Part A and Part B) or a Medicare Advantage plan (Medicare Part C). Enrolling during your IEP avoids any late enrollment penalty.

You can also avoid late penalties for Part D by enrolling drug coverage during this same window. That drug coverage can be a standalone plan or part of a Medicare Advantage plan that includes Part D.

If you enroll in Original Medicare, you may want additional coverage with a Medicare Supplement Plan (Medigap). For this, you will use your Medicare Supplement Open Enrollment Period. This is a 6-month window starting on your Part B effective date. Using the Medigap OEP to enroll in a Medigap means:
•You can’t be turned down for any Medigap plan available in your area regardless of your health status.
•Your insurance company cannot charge you higher premiums because of your health status or pre-existing conditions.
•Your coverage for any pre-existing conditions cannot be delayed


When is the Medicare General Enrollment Period?

If you missed your IEP and you don’t qualify for a special enrollment period, you can sign up for Original Medicare during the General Enrollment Period (GEP). This runs from January 1 through March 31 each year.

Don’t be fooled into thinking the GEP is a safety net so you don’t have to worry about your IEP, however. Even though you can enroll in Original Medicare during this time, you are still subject to the late enrollment penalties.

Even more problematic, your coverage won’t begin until July 1, which means you may go without coverage for months.

Keep in mind that the General Enrollment Period only applies to Original Medicare. If you want a Medicare Advantage plan or Medicare Part D coverage for prescription drugs, you’ll have to wait for the Annual Enrollment Period.


When is the Medicare General Enrollment Period?

If you missed your IEP and you don’t qualify for a special enrollment period, you can sign up for Original Medicare during the General Enrollment Period (GEP).

This runs from January 1 through March 31 each year.

Don’t be fooled into thinking the GEP is a safety net so you don’t have to worry about your IEP, however. Even though you can enroll in Original Medicare during this time, you are still subject to the late enrollment penalties.

Even more problematic, your coverage won’t begin until July 1, which means you may go without coverage for months.

Keep in mind that the General Enrollment Period only applies to Original Medicare. If you want a Medicare Advantage plan or Medicare Part D coverage for prescription drugs, you’ll have to wait for the Annual Enrollment Period.

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The Medicare Advantage Open Enrollment Period

The Medicare program also gives you a window of opportunity to change your mind about a Medicare Advantage plan. If you enroll in a Medicare Advantage plan and for any reason you don’t like it, you can disenroll during the new 2019 Medicare Open Enrollment Period from January 1 – March 31.

You can:
•Return to Original Medicare and elect a Part D drug plan to go alongside it
•Switch Medicare Advantage plans once

Keep in mind that if you return to Original Medicare and plan on picking up a Medigap plan, that is not guaranteed. In many circumstances you may have to answer health questions for the Medigap plan and the carrier does not have to accept you.

What is a Medicare Special Enrollment Period?

There are certain situations that will trigger a Special Enrollment Period that is specific to you. For example, moving outside the plan’s service area will qualify you for a Special Enrollment period. During this two-month, you can switch to a new Medicare Advantage or Part D prescription drug plan. You can also return to Original Medicare without penalty. You can sometimes also enroll in Medigap under guaranteed issue rights—with no medical underwriting.

There are also other situations in which you may be eligible for a Special Enrollment Period. If you don’t see your situation above, get in touch with us to learn what your options are.

The Medigap Open Enrollment Period

Once you are enrolled in Medicare Parts A and B, you will also qualify for a 6-month open enrollment window for Medigap plans. This starts with your Part B effective date and is a one-time election period. You can enroll in any Medigap plan that you like, with no health questions asked.


Help with your Medicare Enrollment Period Choices

You’re entitled to your Medicare benefits—after all, you worked hard to make sure you have health care once you retire. Nonetheless it’s important to understand the rules and regulations, as well as your rights and benefits under the program.

Take a moment to learn the key Medicare enrollment periods so you get all your benefits under the Medicare program. Miss an important date, and you could pay the consequences for the rest of your life.

Want to make sure you don’t miss any deadlines? Reach out to Priscilla Wright today! She’ll help you with when to enroll so that you can avoid any Medicare late penalties.

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