Enrollment Periods for Medicare Insurance Plans
Medicare has four parts (Part A, Part B, Part C / Medicare Advantage, and Part D).
Medicare Parts A & B
U.S. citizens and legal permanent residents (residing in the U.S. for five continuous years) who are within three months of their 65th birthday may enroll in Medicare Part A. If you already receive Social Security benefits or the Railroad Retirement benefits, you will be automatically enrolled in Medicare Part A the first day of the month in which you turn 65 years old. Your Medicare card will be mailed to you about three months before your 65th birthday. You are also eligible to enroll for Medicare Part B the month in which you turn 65.
If you are receiving neither Social Security nor Railroad Retirement pension or disability benefits, you are eligible to enroll in Medicare Part A and Part B up to three months before the month of your 65th birthday. This Initial Enrollment Period (IEP) continues through the three months after the month of your birthday. To enroll during this period, you must submit your Medicare application to the Social Security Administration.
Individuals under the age of 65 are eligible to enroll in Medicare Parts A and B if they meet one of the following conditions:
- You have a qualifying disability such as blindness or a qualifying medical condition
- You received disability payments from Social Security or the Railroad Retirement Board for the past 24 months
- You are a disabled widow or widower between age 50 and age 65 but have not applied for disability benefits because you're already getting another kind of Social Security benefit
- You have permanent kidney failure and you receive dialysis and/or have received a kidney transplant and you (or your spouse or parent if you are a dependent) meet certain work conditions
Medicare Advantage Health & Drug Plans
Individuals who have Medicare Part A and Part B may enroll in a Medicare Advantage plan during the 2013 Annual Election Period (AEP), which lasts from October 15 through December 7.
In addition, beneficiaries will have from January 1 through February 14 to disenroll from their plan and return to traditional Medicare. A Medicare Advantage enrollee, however, cannot switch from his or her existing Medicare Advantage plan to a different plan during this period.
As is the case for Medicare Part D, Medicare Advantage plans allow for Special Election Periods (SEP) for qualifying individuals. Some of the conditions that can qualify you for a Special Election Period are:
- Your 65th birthday
- Any time you move to a new coverage area
- If you suffer from certain chronic medical conditions
- You are enrolled in the Extra Help from the government or qualify for this program
- You are enrolled in Medicaid
During a Special Election Period, an individual may enroll or disenroll from a Medicare Advantage plan.
In 2013, the Annual Election Period runs from October 15 through December 7. Individuals who were eligible for Medicare Part A or enrolled in Part B as of the effective date of coverage could have enrolled in a Part D plan or switched Part D plans during this time. Individuals could have also enrolled in a Part D plan if they had qualified for a Special Election Period (SEP). Part D has identical qualifications for a Special Election Period as those listed above in the Medicare Advantage section of this page.
Anyone who has both Medicare Part A and Part B may enroll in a Medigap program at any time during the year. However, the optimal time in which to enroll in a Medigap plan is during the Open Enrollment Period (OEP). Your individual Medigap Open Enrollment Period is six months long and begins on the first day of the month in which you are at least 65 years old and enrolled in Medicare Part B. During this period you have a guaranteed issue right to buy a Medigap policy. This means the insurance company may not subject you to medical underwriting (a review of your medical history and the potential risk level it represents to the insurance company). However, outside of this Open Enrollment Period, your enrollment application to a Medigap plan would be subject to medical underwriting. In this scenario, you may be denied coverage or you may be charged more because of particular health problems.
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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.