Medicare Enrollment Periods Simplified

What are Medicare Enrollment Periods?

Simply, Medicare enrollment periods are times you can enroll in Medicare and Medicare plans. When put simply, it seems very straight forward. However, in practice, they can get very confused with so many different situations that need to be addressed with these enrollment periods. 

There are many things to consider in your own situation to ensure you make the right decision going into Medicare. Hundreds of thousands of Americans pay Part B late enrollment penalties with even more paying Part D penalties. 

Being aware of your enrollment periods will keep you from paying more for coverage or going without essential healthcare coverage. Here is a look at the Medicare Enrollment Periods for 2020. 

Initial Enrollment Period (IEP)

The Medicare Initial Enrollment Period (IEP) is the first and may be the most important enrollment period. The IEP is a 7 month period of time in which you can enroll in Medicare Part A and Part B. It begins 3 months before the month you turn 65, the month you turn 65, and 3 months after. 

For example, if you turn 65 on June 20th, your Medicare IEP would start from March 1st and end on to September 31st.

**Exception: If your birthday falls on the 1st of the month, your IEP will start 4 months before the month of your 65th birthday. 

For example, if your birthday is April 1st, your IEP will begin December 1st and your Medicare will begin one month early on March 1st.

It is of utmost importance to enroll in Medicare Part A and Part B during this time to ensure you have coverage and do not begin accruing late enrollment penalties. If you do have employer coverage you may be able to delay your Part B without penalty. Before making that decision please read our page on Employer Coverage and Medicare and speak to an AHIC agent to find the right option for your situation.

An agent can be reach directly at 888-603-9445

There is another enrollment period that will usually coincide with your IEP, your initial coverage election period (ICEP). Let’s take a look below. 

Initial Coverage Election Period (ICEP)

The Medicare Advantage ICEP is the period during which an individual newly eligible for Medicare Advantage (MA) may make an initial enrollment request to enroll in an MA plan. Or, simply that you are entitled to Medicare Part A and Part B and you have your Part A and Part B effective dates. 

The ICEP begins three months immediately before the individual’s first entitlement to both Medicare Part A and Part B. ICEP will end 3 months after the month you turn 65 if you enrolled in Part B during your IEP. You make 1 election with your ICEP.

If you delayed your Part B because you had coverage through your employer, your ICEP will start 3 months before the month her Part B starts and ends the last day before the month of the Part B start date. 

This is quite confusing as the ICEP has 2 definitions depending on your situation. Let’s look at some examples to break this down and make each more clear. 

Example: Beth and Mary are both turning 65 in May and are interested in Medicare Advantage. Beth is retired and Mary is still working and her employer offers her health coverage at no cost to her. 

  • Retired Beth: Beth is retired and is paying for her own health coverage so she would like to start Medicare when she turns 65 in May. She is taking Social Security Income so she is automatically enrolled in Part A and Part B and she would like to choose a Medicare Advantage plan in her area. Beth may use her ICEP 1 time starting February 1 and ending August 31 to enroll into the MA plan her and her agent have found works best for her needs and budget. 
  • Working Mary: Mary still has great coverage at no cost from her employer and would like to continue this while she is working past 65. She decides to delay enrolling in Part B until 67 when she plans to retire. Mary later sets her retirement date for April and applies for Medicare Part B in December during her 8 month Special Enrollment Period (continue reading for more information) for an April 1 effective date. Mary’s ICEP begins January 1 and ends March 31 during which she works with an agent and enrolls in a MA plan for an April 1 effective date. 

What if Mary had missed her ICEP because she wasn’t aware of this difference? Well the answer takes us right into the next enrollment period, the Annual Election Period (AEP). Mary would be required to wait until AEP to enroll into a Medicare Advantage plan for the following year.

Annual Election Period (AEP)

The Annual Election Period (AEP) takes place October 15 to December 7 and is available to all MA and Part D eligible beneficiaries. This is the one time each year where all Medicare beneficiaries can make changes, drop, or enroll into MA and Part D plans. 

More than one choice can be made during AEP with the final application submitted being the choice that begins January 1. This is a very important choice as this is the choice for the whole of the next year so you will want to consider that before making a choice. 

The AEP exists because MA and Part D plans change every year. Copays, deductibles, coverages, ect can and will change each year for these plans. What works for you one year may not be the same in the next as your needs, budgets, and prescriptions can change year to year.  Sitting down with your agent and discussing these changes is crucial to making the right choice for you. 

Speak with an AHIC agent to get help during AEP at 888-603-9445.

** The Annual Election Period does NOT apply to Medicare Supplements (Medigap) plans. You can change your Medicare Supplement at any time but you may have to answer health questions that you can be denied for. **

Medicare Advantage Open Enrollment Period (MA OEP)

The MA OEP takes place from January 1 – March 31 each year. During this time you can make 1 more change to your MA plan. Only MA plan members can use this 1 time OEP to make a change. 

  • During the MA OEP MA and MA-PD enrollees may:
    • Change to a different MA or MA-PD plan
    • disenroll from their plan and return to Original Medicare and add Part D coverage.

All changes made are effective for the first of the following month. The MA OEP is very helpful if your needs change in the beginning of the year or if you missed AEP. 

After the MA OEP you are generally locked into your coverage for the remainder of the year so use it wisely. There are special circumstances that do allow you to change during the year that we will take a look at below. 

Special Enrollment Periods (SEP)

Special Enrollment Periods (SEP) are as they sound, special circumstance situations that allow you to enroll or change your MA, MAPD, or Part D plan outside of the standard enrollment periods. There are dozens of situations that SEP’s apply to, but generally they will be life changing events. Generally, most SEPs begin on the first day of the month in which the qualifying special event occurs and last for three months.

Some, but not all SEPs are listed below:

  • Moving outside your plans service area
  • Involuntary loss of creditable drug coverage
  • Gaining or losing Medicaid eligibility
  • Gaining or losing the Part D low-income subsidy
  • Individuals who dropped a Medigap policy when they enrolled for the first time in an MA plan, and who are still in a “trial period”
  • Certain disabling chronic conditions 

If any of these situations apply to your or you think there may be another SEP that would apply to you, give us a call and an AHIC agent can confirm this for you. Our services are completely free and no cost to you.

Medicare Supplement (Medigap) Open Enrollment Period:

The Medigap Open Enrollment is a 6 month window that begins the month you begin your Medicare Part B. This is generally the best time to enroll into a Medigap plan as Medigap companies must give you the best available rate regardless of your health, and they cannot deny you coverage. 

Outside of the Medigap Open Enrollment you will usually have to answer health questions that may affect rate and Medigap companies can deny you for health related issues. It is very important to use this enrollment period to ensure you receive the best rate and the plan you desire.

Get someone on your side:

Still have questions or need assistance with getting a Medigap quote? You are not alone, AHIC is here to help. If you would like someone to walk you through the process of applying for Medicare, shopping for a plan, then please click on the link below. Our services are at NO COST to you and we will be here to help you for the lifetime of your policy. 

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