Medicare Enrollment Periods

Submitted by Eric Gonzalez, Benefits in Action ~

It seems like Medicare is never ending. Open enrollment just ended, but we are only a couple weeks away from General Enrollment. Everyone also has an initial enrollment period. Are you confused about the difference between these three periods? If so, pay close attention to this article. This article is meant to differentiate between the three periods and discuss your rights and responsibilities during the upcoming General Enrollment Period.

First, let’s discuss the difference between Initial Enrollment, Open Enrollment and General Enrollment. An individual’s initial enrollment period is the first time they get the opportunity to apply for Medicare Parts A and B. This period is the three months before one’s 65th birthday, the month of the individual’s 65th birthday, and the three months after one’s 65th birthday. The exceptions to this initial enrollment period are if you have been on Social Security Disability Insurance for two consecutive years, in which case you are automatically enrolled in Medicare Parts A and B, and if you have employer sponsored health insurance, in which case you can wait for that coverage to end before applying for Medicare.

If you miss your initial enrollment period and don’t fall into an exception to the normal Medicare rules, then you must wait until General Enrollment to apply for Medicare. General Enrollment is from January 1 to March 31 of each year. General Enrollment is a period where anyone who failed to sign up for Medicare Parts A and B during Initial Enrollment can apply for those benefits. It is also a time where folks with Medicare Advantage Plans can switch or drop their plans and return to Medicare Parts A and B, also known as Original Medicare. However, you can’t join a Medicare Advantage Plan for the first time during General Enrollment. 

Open Enrollment is a period where anyone who already has Medicare can join, switch, or drop a Medicare Advantage Plan or a Medicare Part D plan. However, you can’t sign up for Original Medicare for the first time during Open Enrollment. Open Enrollment for this year just ended, but mark your calendars for October 15, 2023, as that is the start of next year’s open enrollment period.

Now that this introductory information is out of the way, you might be asking why General Enrollment is so important. For starters, it is the only time each year that you can sign up for Original Medicare if you miss Initial Enrollment. This is extremely important as penalties for missing Initial Enrollment may apply and may increase if you also miss General Enrollment. General Enrollment is also very important for those with Medicare Advantage Plans, especially if you are unhappy with yours.

So, what are your rights and responsibilities during General Enrollment. If you don’t have Medicare and are eligible, your first responsibility is to sign up for Medicare quickly. As previously mentioned, missing enrollment periods results in financial penalties, so you want to minimize those to the extent possible. If you have a Medicare Advantage Plan, then your responsibility is to review the plan, see if it still works for you, and switch it or go back to Original Medicare if needed. If you are on Original Medicare already, then you don’t need to worry about General Enrollment. However, you are going to want to pay close attention to Open Enrollment. As for your rights during General Enrollment, it is your right to sign up for Medicare or change or drop your Medicare Advantage Plan if you so choose.

Are you still looking for information about General Enrollment? If so, call Benefits in Action at 720-221-8354 or email us at info@benefitsinaction.org. Our experienced Medicare counselors can help you with your Medicare related needs.

Comments

  1. Thanks so much for talking all about the specifics of the Medicare enrollment times and what to do if you miss a period. I have a friend who can’t afford health insurance so we’ve been looking into Medicare for him. We’ll have to look into getting help enrolling for it so we can ensure he gets the best coverage he can.

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