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Medicare Enrollment Periods

medicare supplement

When you turn 65 years old, you will automatically be enrolled in Medicare Part A and Medicare Part B if you are receiving benefits from Social Security or from the Railroad Retirement Board (RRB).

If you are age 65 and you are not yet getting Social Security or RRB benefits yet (because you’re still working), you won’t get Part A and Part B automatically: you need to sign up for them.

If you need to sign up for Part A, you can sign up during the following times:

  • Initial Enrollment Period – When you are first eligible for Medicare. (This is a 7 month period that begins 3 months before the month you turn age 65, includes the month you turn age 65, and ends 3 months after you turn age 65.)
  • General Enrollment Period – Between January 1 through March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.
  • Special Enrollment Period – If you or your spouse (or family member if you are disabled) is currently working, and you are covered by a group health plan through an employer or union.
  • Special Enrollment Period for International Volunteers – If you are serving as a volunteer in a foreign country.

If you’re automatically enrolled in Original Medicare, your Medicare benefits will start on the first day of the month that you’re eligible for coverage. For example: If your 65th birthday is October 20, 2019 and you automatically qualify for Medicare, your Medicare effective date would be October 1, 2019. If your birthday is on the first day of the month, Medicare Part A and Part B will be effective on the first day of the prior month. So then, if your 65th birthday is October 1, your Medicare effective date would be September 1.

If you aren’t already receiving retirement benefits when you turn 65, you won’t be eligible for automatic Medicare enrollment and will need to sign up for Medicare coverage during your Initial Enrollment Period (see below for more details).

If you have health coverage because you’re still currently working (or you’re covered under a working spouse), you may choose to delay enrollment in Medicare Part B, since this part of Medicare comes with a monthly premium. You will get a Special Enrollment Period to sign up for Medicare that starts when you stop working or your employer-sponsored health insurance ends. If you don’t sign up during this Special Enrollment Period, you can do so during the General Enrollment Period (which runs from January 1 to March 31), but may owe a late-enrollment penalty (see below for more details).

Medicare Part A enrollment when you turn 65 will depend on if you have enough work history to get Part A without a premium. If you’ve worked at least 10 years (40 quarters) and qualify for premium-free Medicare Part A, you’ll be automatically enrolled in Part A when you turn 65 even if you’re still working at the time. However, if you don’t have enough work quarters to get Part A without a premium, you’ll need to manually enroll in Part A. You can do so during your Initial Enrollment Period or, if you’re still working, during a Special Enrollment Period when you stop working or your health coverage ends.

If you are under age 65 and disabled, you automatically get Part A after you get disability benefits from Social Security or certain benefits from the RRB for 24 months. You will get your Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.

If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you automatically get Part A the month your disability benefits begin.

If you have End Stage Renal Disease (ESRD), different rules apply.

Annual Election Period

Once you’re enrolled in Original Medicare or a Medicare Advantage plan, you can generally only make changes to your coverage during certain times of the year. The Annual Election Period (AEP), which runs from October 15 through December 7, is a good time to make changes to your Medicare health or prescription drug coverage. Take a look at the chart below to learn about the different changes you can make during this period.

Your new coverage will begin January 1 of the following year, as long as the plan gets your enrollment request by December 7. In most cases, you must stay enrolled for the calendar year.

During this time you may do the following:

October 15 through December 7, 2022

If you currently have this Medicare plan:You can:
Original MedicareSwitch to a Medicare Advantage Plan withPrescription Drug coverage
 Switch to a Medicare Advantage Plan withoutPrescription Drug coverage
 Join a Medicare Prescription Drug Plan, if you do not have one.
 Drop your Medicare Prescription Drug coverage completely, if you have one. Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
 Stay with your current plan.
Medicare Advantage PlanSwitch back to Original Medicare
 Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
 Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to another Medicare Advantage Plan that offers drug coverage.
 Switch from a Medicare Advantage Plan that offers drug coverage to another Medicare Advantage Plan that doesn’t offer drug coverage.
 Stay with your current plan

Individuals in a Medicare Advantage plan can also make changes during the Medicare Advantage Disenrollment Period that runs from January 1 through February 14. During this time, you can leave your Medicare Advantage plan and return to Original Medicare.  If you use this election period to disenroll from a Medicare Advantage plan, you can also enroll into a stand-alone Medicare Prescription Drug Plan during this time.

Once the Annual Election Period has passed, you’re much more limited in the types of changes you can make to your Medicare coverage. However, in certain situations, you may be eligible for a Special Election Period to enroll in a Medicare plan, switch plans, or make other changes to your coverage.

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