Medicare: Enrollment Periods

Enrollment in Medicare can be an inundating and confusing process, whether it is during initial enrollment or open enrollment.

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  • There three enrollment period for Medicare: Initial (IEP), Special (SEP), and Open (OEP).
  • People are guaranteed Supplement (Medigap) eligibility only during Initial and Special Enrollment periods.
  • Open Enrollment occurs in the last quarter of every year and plan changes can be made at that time.

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Six months before your loved one's 65th birthday, their mailbox will be filled with letters, pamphlets, invitations, and more information than either of you can ever be read. Your loved one may even receive electronic communications. And every year thereafter, during Open Enrollment, they will be bombarded with this information again.

Beware of Medicare enrollment phone calls. Medicare advisors or plan representatives will never call your loved one unless they are already enrolled (renewal calls).

Initial Enrollment Period (IEP)

Your loved one has a 7-month window to join Medicare – from 3 months before the month they turn 65, through their birthday month, and 3 months after the month they turn 65.

  • So, if they're birthday is in November, they will have August-October (age 64), November (birthday month), and December-February (now age 65) to enroll.

Special Enrollment Period (SEP)

An 8-month Special Enrollment Period occurs when your loved one retires and no longer has healthcare through their employer. This is a strictly time-limited offer without penalty. They should...

  • Start thinking about Medicare enrollment a few months before retiring.
  • Talk to their employer's benefits administrator about how their retiree coverage works with Medicare.
  • Sign up for Medicare about a month before the employer insurance coverage ends.
  • Ask their employer to complete the employment form.
  • Stop contributing to an HSA program (if applicable) 6 months before retiring to avoid a tax penalty.

It is only during Initial Enrollment and Special Enrollment that your loved one has guaranteed eligibility for a Medicare Supplement (Medigap) policy. It is only during these enrollment periods that there are NO eligibility requirements. Beyond these periods, such as during Open Enrollment (below), your loved one will have to qualify for Medicare Supplement and may not meet eligibility requirements at that point.

Open Enrollment Period (OEP)

The annual Open Enrollment Period for Original Medicare (Parts A & B) or Medicare Advantage (Part C) is from October 15 – December 7 each year.

Each year, your loved one can change their Medicare Advantage plan (Part C) or Medicare prescription drug plan (PDP, Part D) for the following year. There are no changes your loved one can make to Original Medicare (Parts A & B).

To reiterate, during Open Enrollment, your loved one can:

  • Sign up for a plan
  • Switch plans
  • Leave a plan
  • Apply for Medicare Supplement (eligibility requirements apply)

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