Medicare Enrollment Periods

This is perhaps the most intimidating part of joining the Medicare system. It can be difficult for new beneficiaries to make sense of all the different enrollment periods and how they are applicable to their situation.

Previous reports completed by the Medicare Rights Center estimates that some 700,000 people per year pay a late enrollment penalty for their Medicare Part B coverage and that it is happening more and more. Another costly penalty you could incur is if you lack credible prescription drug coverage or wait to enroll in a Part D drug plan. Medicare will charge a penalty monthly on top of what you will pay in premium for those plans.

With all this being said it is important to be familiar with the enrollment periods for 2019 and also those in coming years you don’t want to be left out in the cold when it comes to your health care coverage or pay more than you should for the coverage you need.

What is the Medicare Initial Enrollment Period (IEP)?

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This is perhaps the most important period of time that you need to be aware of as a Medicare beneficiary. It is a seven-month period of time beginning three months before your 65th birthday, includes the month of your birthday and then proceeds another three months after. During this time, you are eligible to join a Medigap plan with no health questions asked. You cannot be turned down and you will not be charged higher premiums because of your current health status. There is no need to worry about pre-existing conditions because coverage cannot be denied or delayed by any carrier you choose.


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What To Do If You Miss Your Initial Medicare Enrollment Period.

Unfortunately, there are a lot of costly consequences that you could face by missing one of these important enrollment periods.

If you do not carry a prescription drug plan (Part D) or have some form of credible coverage and miss your IEP you will pay a penalty monthly for the amount of time that you did not have coverage throughout the lifetime of your enrollment into the Medicare program. The penalty is a 1% per month based on the national average premium of a Part D plan, which currently stands at about $36 per month. For example, if you go 12 months with no credible prescription drug coverage after joining or becoming eligible for Medicare Part A and B you will pay about $4 a month extra as long as you have coverage per month and that is on top of the monthly premium you will pay for the plan. This penalty increases if the national average premium of these plans goes up so over time, this can end up costing thousands of extra dollars.

Failure to enroll in Medicare Part B during the IEP means that you could possibly also pay another late enrollment penalty. The Part B late enrollment penalty is 10% per year that you are not enrolled and were eligible. It is again based off a national average premium which currently stands at $36.50 meaning you’ll pay about $14 extra dollars per month for the lifetime of your enrollment into the Medicare program. Again, added up this could possibly costing you thousands of extra dollars over the years. Keep in mind that if you choose not to enroll in Part B coverage you may have to wait to the next enrollment. Which is the General Enrollment Period (GEP). The longer you go without coverage the more you will pay in penalties.

This is not common but if you do not qualify for Medicare Part A To be free either because you do not have enough work history or you did not enroll during your IEP you will also pay a premium penalty here of 10% the penalty is twice the number of years that you chose not to enroll in this part of Medicare.

The Medicare General Enrollment Period (GEP).

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If for some reason you missed your IEP and also do not qualify for a Special Enrollment Period (SEP), you will have to wait until the next General Enrollment Period (GEP) to sign up for Original Medicare. Remember Original Medicare refers to Parts A and B. The GEP is from January 1 to March 31 of each year. If you choose to enroll during this time, your coverage does not begin until July 1 of that year. This enrollment only applies to Original Medicare Parts A and B. The Annual Enrollment Period (AEP) is when you can enroll in a Medicare advantage plan otherwise known as part C of Medicare or a part D plan for your prescription drug coverage.

Enrolling in Medicare Advantage (Part C) or Prescription Drug Plan (Part D) if I miss my IEP

The Annual Enrollment Period AEP which runs Oct 15 to Dec 7 annually. Again, this enrollment period applies only to Medicare Parts C and D. So, if you miss your IEP you can you use this time period to enroll in your chosen plan. During this time beneficiaries can switch from Part C (Medicare Advantage) back to Original Medicare.

This is also a period of time when you can and roll or switch to a different Part D plan if you are currently in enrolled, you can also choose to disenroll at this time.

Medicare Advantage Open Enrollment Period

This is an enrollment period in which you can change your mind about enrolling into a Medicare Advantage Plan (Part C). The nature of this type of coverage often leaves many beneficiaries overwhelmed or under satisfied. While a beneficiary can change their mind and go back to Original Medicare and then enroll into a Medigap policy coverage is not guaranteed like it is during your IEP. You will have to answer health questions and the carrier does not have to choose to issue coverage.

Special Enrollment Period SEP

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This is a two-month period of time and rich Medicare grants you the ability under certain circumstances like moving or entry into a nursing home. to switch to a new Medicare advantage plan or part D plan you can also return to original Medicare and sometimes enroll into a Medigap plan with no medical questions asked.

Medigap Open Enrollment Period

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Enrollment into Medicare Parts A and B qualifies you for a six-month open enrollment window for Medigap plans. The period of time starts on your Part B effective date and it is a one-time occurrence if you choose to take it advantage. You can enroll in any Medigap plan you choose and there are no health questions asked.

Do You Need Help with Your Medicare Enrollment Options?

While working hard has entitled you to Medicare benefits it’s important to follow the rules and know the regulations as well as your rights under the program.

We highly recommend keeping this information about the different enrollment periods handy throughout your time as a Medicare beneficiary. Again, if you miss these important dates you could pay hundreds of dollars per year for the rest of your life in late enrollment penalty’s between Medicare Parts B and D.

The best way to avoid missing any of these important deadlines is to reach out to one of our advisers here who can help you enroll and avoid those penalties going forward.


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