When Can You Enroll In Medicare Advantage
You can enroll in Medicare Advantage during your Initial Enrollment Period. But you must first sign up for Parts A and B during your Initial Enrollment Period.
You can also enroll if you qualify for a Special Enrollment Period. If you lose your health insurance at your job, you can sign up for a plan up to eight months after losing your coverage.
Medicare Annual Enrollment Period
If you choose not to sign up for a Medicare Advantage plan or stand-alone Medicare prescription drug coverage during your Initial Enrollment Period, you can also enroll in a Medicare Advantage plan during the annual Fall Medicare Annual Enrollment Period .
AEP is also called the Medicare Annual Election Period and the Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage.
This period runs from October 15 to December 7 every year.
During the Fall Medicare Open Enrollment Period for Medicare Advantage and Medicare prescription drug coverage, you can:
- Enroll in, make changes to or disenroll from a Medicare Advantage plan
- Enroll in, make changes to or disenroll from a Medicare Prescription Drug plan
Plan changes you make during the 2020 Medicare Fall Annual Enrollment Period go into effect January 2021.
Medicare Advantage Open Enrollment Period : When You Dont Like Your Medicare Advantage Plan
If you begin the year with a Medicare Advantage plan and then realize your needs have changed, the Medicare Advantage Open Enrollment Period could save you from buyers remorse. Just dont confuse this enrollment period with the fall Medicare Enrollment Period.
The annual Medicare Advantage Open Enrollment Period begins January 1 and continues through March 31. During this period, you can change to a different Medicare Advantage plan or switch to Original Medicare and add a Part D plan if desired.
Don’t Miss: Is Jakafi Covered By Medicare
What Are The Documents Required As Proof To Confirm That You Lived In An Emergency Declared County And Qualify For The Insurance
Generally, you dont need to show any proof to confirm that you lived in an affected county because there are chances that such documents may have been destroyed or you are unable to access them. However, if you have any proof available, you must provide it to FEMA or get an attestation as per the guidelines of FEMA.
It is imperative to know whether you qualify for a Medicare Special Joining Period. You can check on the FEMA website and also get in touch with the Marketplace Call Center at 1-800-318-2596. The representatives at Marketplace can give you live assistance after evaluating your circumstances and registering for the coverage.
People who have already registered for a Medicare plan and also get a Special Joining session generally can continue in their existing scheme or migrate to other programs. There are also chances that people may get an early coverage date. To get the coverage valid, the insurer must remit the premium before the coverage becomes effective.
Rejected or failed SEP applicants can file an appeal to the Health Insurance Marketplace and get the coverage reinstated to the date when it got rejected. Make sure to submit a copy of the eligibility document along with your application, which will help to process the appeal favorably.
Delaying Medicare Due To Work: Special Enrollment Period
If you didn’t enroll in Medicare because you were still working, and you were covered under a group health plan based on employment, you have a Special Enrollment Period during which you can sign up for Part A and/or Part B. While you or your spouse are still working and you’re still covered under a group health plan, you can sign up anytime.
After your or your spouse’s employment ends, your Special Enrollment Period lasts eight months, starting the month after the employment or group health plan ends . However, you have only two months after the employment or group health plan ends to sign up for a Medicare Advantage plan or Part D prescription drug plan . You can enroll in a Medicare Advantage plan starting three months before your Medicare Part B enrollment is due to take effect up to the day before your Part B coverage startsbut again, enrollment must take place within two months of your employment or group health plan ending.
Judy’s last day of work is July 1 and her group health plan ends July 31. She has eight months, until April 30, to sign up for Part B without a penalty. But if she wants to join a Medicare Advantage plan, she needs to do so by September 30 . Instead, on June 15, Judy signs up for Part B coverage to begin on August 1, so that she won’t have a gap in coverage. She has only until July 31 to add a Medicare Advantage plan . Her Medicare Advantage plan will start August 1.
Also Check: Is Viberzi Covered By Medicare
How To Get Ready For Medicare Advantage Open Enrollment
Whether you recently enrolled or have had your Medicare Advantage plan for years, you can take this opportunity to confirm – or change – your plan choice. Think about your experiences using your plan and review your plan benefits. How does your plan stack up in the following areas?
- Your doctor and other providers are in the plan network.
- Your prescription drugs are on the plan formulary.
- You are comfortable with your costs, including premiums, deductibles, copays, and coinsurance.
- You have the additional coverage that you want for things like dental, vision, and hearing care.
- You are happy with your plan’s additional benefits such as fitness programs, mail-order pharmacy, nurse line, and other wellness services.
If you decide to make a change, you have from January 1 – March 31 to do it. You can explore other plan options. Your new plan benefits will be in effect for the rest of the year.
What You Cant Do During Open Enrollment
You cant enroll in Parts A or B, and you cant enroll in a Medicare Advantage plan if you dont already have Original Medicare. You also cant enroll in a Medigap plan.
The best time to enroll in Parts A and B is often during your initial enrollment period or, for Medigap, during the Medigap open enrollment period. You can enroll in Parts A, B, and D or a Medicare Advantage plan during the general enrollment period if you miss your initial enrollment period. Your coverage would start July 1 in the year you signed up in this case.
Read Also: How Much Does Medicare Pay Doctors For Visit
Medicare Enrollment 2022 Important Dates You Shouldnt Miss
When you first become eligible for Medicare , you will automatically be enrolled in original Medicare Part A and Part B if you are receiving benefits from Social Security or the Railroad Retirement Board . You have an Initial Enrollment Period of seven months to add additional Medicare health care coverage with an Advantage plan, or Supplemental Insurance and/or a Prescription Drug plan.
Medicare enrollment or changes to plans you are already enrolled in are limited to specific times.
Important dates to enroll in, switch or cancel a Medicare plan for 2022 are:
Visit www.medicare.gov to get detailed and current information about your Medicare eligibility and enrollment options, or call 1-800-MEDICARE or TTY 1-877-486-2048.
What If An Employer Gives Me Money To Buy My Own Health Plan
A note about individual coverage: youll qualify for an SEP if you delayed Part B because you had employer-sponsored coverage through a group health plan . This is a specific type of insurance plan sponsored or run by your employer. It includes coverage your employer offers you through an insurer, and plans purchased from the Small Business Health Options Program marketplace.
Instead of offering GHP coverage, some employers provide you money to buy your own health insurance. They can reimburse you directly, in which case the money is taxed, or through a Qualified Small Employer Health Reimbursement Arrangement or an Individual Coverage Health Reimbursement Account . Coverage you buy on your own does not qualify you for the Part B SEP even if an employer paid for some or all of it. If you have individual coverage, you should sign up for Medicare when youre first eligible, and can enroll during your initial enrollment period or the general enrollment period.
Josh Schultz has a strong background in Medicare and the Affordable Care Act. He coordinated a Medicare ombudsman contract at the Medicare Rights Center in New York City, and represented clients in extensive Medicare claims and appeals. In addition to advocacy work, Josh worked on federal and state health insurance exchanges at the technology firm hCentive.
Contributions to healthinsurance.org and medicareresources.org represent only his own views.
Also Check: What Is Medicare Chronic Care Management
Your Plan Changes Its Contract With Medicare
- Medicare takes an official action because of a problem with the plan that affects me.
What can I do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
Your chance to switch is determined by Medicare on a case-by-case basis.
- Medicare ends my plan’s contract.
What can I do?
Switch from your Medicare Advantage Plan or Medicare Prescription Drug Plan to another plan.
Your chance to switch starts 2 months before and ends 1 full month after the contract ends.
- My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan’s contract with Medicare isn’t renewed.
What can I do?
Join another Medicare Advantage Plan or Medicare Prescription Drug Plan.
Should I Take Medicare Part B
You should take Medicare Part A when you are eligible. However, some people may not want to apply for Medicare Part B when they become eligible.
You can delay enrollment in Medicare Part B without penalty if you fit one of the following categories.
Employer group health plans may cover items normally not covered by Medicare Part B. If so, and you meet one of the categories above or below, then you may not need to enroll in Medicare Part B and pay the monthly premium.
If you are:
- a spouse of an active worker
- a disabled, active worker
- a disabled spouse of an active worker
and choose coverage under the employer group health plan, you can refuse Medicare Part B during the automatic or initial enrollment period. You wait to sign up for Medicare Part B during the special enrollment period, an eight month period that begins the month the group health coverage ends or the month employment ends, whichever comes first.
You will not be enrolling late, so you will not have any penalty.
If you choose coverage under the employer group health plan and are still working, Medicare will be the secondary payer, which means the employer plan pays first.
If the employer group health plan does not pay all the patients expenses, Medicare may pay the entire balance, a portion, or nothing. An employer group health plan must be primary or nothing.
Read Also: How Do I Find Medicare Number
What You Can Do During Open Enrollment
You can add or drop a Part D prescription drug plan If you’re already enrolled in Medicare Part A or Part B. You can also choose a different Part D drug plan if youre unhappy with your current one. You can switch from Original Medicare to a Medicare Advantage plan.
You can choose a plan that better suits your needs if you currently have a Medicare Advantage plan. You can switch to another Medicare Advantage plan without drug coverage, and vice versa. You can also switch to Original Medicare if you prefer. But you may not be able to get a Medigap policy if you go back to Original Medicare, and you may want to separately purchase Part D drug coverage.
You’ll be assessed a late enrollment penalty if you go 63 or more days without creditable prescription drug coverage once your initial enrollment period is over, and if you later you want Part D, The penalty is permanently added to your Part D premium and increases the longer you go without coverage.
Visit Medicare.gov to compare plans against your current plan for coverage, price, providers, and other benefits.
When Does Medicare Part A And B Coverage Start
To avoid a gap in coverage, sign up for Medicare Part A and Part B in the three months before your 65th birthday. If you do, your coverage will start in your birthday month.
If you sign up toward the middle or end of your Initial Enrollment Period, your coverage will start from one to six months after your birthday month, depending on when you enroll.
Recommended Reading: Is Healthfirst Medicaid Or Medicare
Should I Make A Change During Medicare Advantage Open Enrollment Period
ust because you can make a change doesnt mean you should. What you absolutely should do, during both AEP and MA OEP, is review your coverage. While doing so, ask yourself the following questions:
- Are my doctors still covered by this plan?
- Have my out-of-pocket costs increased?
- Have my needs changed from last year?
- Am I satisfied with the service Ive received from my plan?
As you review these questions, consider if any new plans are available in your area. A great way to do this is to work with an independent agent. They can review all of your plan options with you, then help you make the best choice.
When comparing your existing plan to a potential new plan, consider the following factors:
- Whether the new plan has better benefits
- Whether the new plan is accepted by your doctors
- Whether your medications are covered by the new plan
- Whether the new plan offers better extra benefits
If your review of your current plan indicates that a change is necessary, go ahead and switch during one of the open enrollment periods. Remember, if you end up not liking the new plan, you can always change it again during MA OEP or AEP.
If You Missed Enrolling Your Initial Or General Enrollment Period
If a group health plan covers you through your or your spouses employer or union, you can sign up for Medicare Part A or Part B anytime.
If your employment or group health plan ends, you have an eight-month Special Enrollment Period to sign up for Part A and Part B without facing a late enrollment penalty. Keep in mind that retiree health plans and COBRA dont qualify you for a Special Enrollment Period when that coverage ends.
Also Check: What Is Gap Coverage For Medicare
When Is The Medicare Supplement Open Enrollment Period
Medicare Supplement open enrollment begins when you have Medicare Part B and are at least age 65. It continues for six months.
This open enrollment period for Medicare Supplement is a little later than your initial enrollment period because it starts when you turn 65, not three months before your birthday.
This is the best time to buy a Medigap plan because youâll have preferred pricing, and you canât be denied coverage because of a preexisting condition. Plus, any plan you get is guaranteed renewable, helping you reduce the cost of medical bills for as long as you choose to keep the policy.
Two key points when choosing the best Medicare Supplement for you:
What happens if you miss your Medigap open enrollment when you turn 65?
However, if your circumstances qualifies you for a guaranteed issue period you’ll have the freedom to change your plan without going through the underwriting process.
Initial Enrollment Versus Automatic Enrollment
Do I have to enroll myself during my IEP, or am I automatically enrolled?
If you are already receiving Social Security/Railroad Retirement Board benefits prior to your 65th birthday, you will automatically be enrolled in Medicare Parts A and B when you first become eligible. For most, this is your 65th birthday and your coverage will start on the first of the month of your 65th birthday.
NOTE: If you do not want to enroll in Part A and/or Part B, you must contact Social Security and make a formal request to decline these benefits. See our Helpful Resources & Tools page to access this form.
If you arent among those who are already receiving social security or railroad benefits, you will need to sign up for Original Medicare yourself during your Initial Enrollment Period. Not sure how to enroll? See our How To Enroll page and well explain how.
Recommended Reading: Can I Change My Medicare Advantage Plan Now
When Can You Enroll In Prescription Drug Coverage
You have a few options as to when you can sign up.
- Your Initial Enrollment Period: This occurs when you first become eligible for Medicare.
- Open Enrollment Period : From October 15 to December 7 each year, you can enroll in a prescription drug plan.
- Medicare Advantage Open Enrollment Period: From January 1 to March 31 each year, if you are already enrolled in a Medicare Advantage plan without drug coverage, you can switch to a plan that includes the coverage.
- Special Enrollment Period: Certain events, like moving or losing your insurance coverage, make you eligible to enroll outside the usual times.
Decide On Medicare Advantage
Now that youve enrolled in Medicare Part A and Part B, you need to decide whether you want to stay with Original Medicare, Parts A and B, or sign up for Medicare Part C, also called Medicare Advantage.
With a Medicare Advantage plan, you continue to pay a premium for Part B while a private insurance carrier delivers your services. That company contracts with Medicare to deliver both Part A and Part B benefits. Policies vary, but most include prescription drug coverage and other benefits that arent covered by Original Medicare. You enroll with a private insurer to get your Part C/Advantage plan. You can compare plans at medicare.gov.
Also Check: What Is The Number For Medicare