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Medicare - A Detailed Guide
Enrollment Periods

There are different time periods during the year that you can enroll in different "Parts" of Medicare and it can get confusing real fast.  We have included this article to cut through the confusion and hopefully put you at ease.

Before we start discussing all of the different enrollment periods and what you can do during them, it is important to know that you can very likely change your Medicare at any time during the year.  To change your plan outside of the regular enrollment periods you are familiar with, your

agent will use a "Special Enrollment Period."  There are dozens of qualifying factors that would allow you to use a Special Enrollment Period at any time during the year.  A good agent will know how to advise you on which qualifying factor to use.  The point is...you are NOT stuck!  If you ever want to switch plans at any point in the year feel free to request a callback from one of our experienced agents.  With that said, let's discuss the different enrollment periods throughout the year.

Initial Enrollment Period

The Initial Enrollment Period can start at any time of year.  This enrollment period is for your first enrollment into Medicare when you turn 65.  You have 3 months before your birthday month and 3 months after your birthday month to enroll in Medicare.  For more specifics on this you can see our article: Step 1: Know Your Timing.

 

General Enrollment Period

The General Enrollment Period goes from January 1st to March 31st each year.  During this enrollment period you can enroll in your Part A and Part B if you didn't do so when you were first eligible.  Based on how long you have gone without Part B there may be a Part B penalty when you enroll.  Your Part B coverage will be effective on the 1st of the month following your enrollment.  For example, if you enroll in Part B on February 22nd, your coverage will begin on March 1st. 

 

Open Enrollment Period

Just like the General Enrollment Period, the Open Enrollment Period goes from January 1st to March 31st each year.  The Open Enrollment Period is often confused with the Annual Enrollment Period that runs from October 15th to December 7th each year.  The Open Enrollment Period provides time for people who got their Medicare Advantage plan during the Annual Enrollment Period to see if they are happy with it.   If you got a Medicare Advantage plan between October 15th and December 7th you can change your plan during the Open Enrollment Period for any reason.

Annual Enrollment Period

The Annual Enrollment Period goes from October 15th to December 7th each year.  This is the period that most people are familiar with.  When you see a thousand commercials asking you to call in and see what extra benefits you qualify for, you can be sure that it's the Annual Enrollment Period.  During the Annual Enrollment Period it is pretty much open season.  You can change from a Medicare Advantage policy to a supplement plan or a supplement plan to a Medicare Advantage policy.  You can drop all other coverages and revert to Part A and Part B.  You can get rid of your prescription drug coverage, or, if you don't have it, you can add it.  The Annual Enrollment Period allows you to make any changes you want to your Medicare without the need for any qualifying factors.

Special Enrollment Period

A Special Enrollment Period can be used at any time during the year.  There are dozens of qualifying factors that allow you to use a Special Enrollment Period.  If you meet any one of those qualifying factors you are allowed to make a change just like you would during the Annual Enrollment Period.  If you ever need help with this you can request a callback from one of our agent partners.  A good agent will know which qualifying factor to use in order to make the change you are looking for.

Here are just a few of the qualifying factors that can be used to grant you a Special Enrollment Period:

  • Change in residence

  • Contract termination with Medicare

  • Institutional needs

  • Involuntary loss of creditable coverage

  • SPAP enrollee

  • Special needs / Chronic conditions

  • Enrolling in a 5 star plan

  • Eligible for other creditable coverage

  • Delayed enrollment in Part B

  • Individual dropped Medigap - Trial period

  • Loss of SNP status

  • Retroactive Medicare decision

  • Dual/LIS (change of status)

  • Declared disaster/emergency (this happens surprisingly often)

  • CMS / State assignment

  • Exiting a low performing plan

  • Receivership

  • And many....many....more.....

The biggest take away here is that there are so many qualifying factors that a good agent will be able to choose the right factor that will entitle you to a Special Enrollment Period.  You can always request a callback from one of our agent partners for help with this.

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