Medicare Enrollment Periods
I am turning 65, when can I enroll in Medicare?
Most individuals can enroll into Original Medicare upon turning 65. Individuals are given part A of Medicare for free if they have worked long enough to receive 40 credits, while Part B of Medicare costs $148.50 (2021) each month. While enrollment into Part A is automatic, those that are not claiming social security benefits at or prior to 65 must proactively enroll in Medicare part B through the Social Security Administration. This can be done online at ssa.gov, or in person at any Social Security Office. The Medicare initial enrollment period for part B usually begins about 3 months prior to, the month of, and three months after turning 65. If you are already claiming Social Security benefits, you will be automatically in enrolled into Medicare Part B.
I am on permanent disability; when can I enroll in Medicare?
Most individuals may enroll into Original Medicare upon turning 65, having disability for 24 months, or having ESRD. For those on permanent disability, social security will automatically enroll beneficiaries into Medicare part A and B on the 25th month of the disability. This results in an initial enrollment period for Medicare Supplements 6 months prior to and past the Medicare part B date, and 3 months prior to and past the Medicare part B date for Medicare Advantage and Prescription Drug Plans. Those on disability are limited to certain supplements, but are given a new open enrollment with a full range of choices upon turning 65.
What if I do not need or want Medicare part B right now?
If you have credible coverage (Employer, VA, TRICARE) that is recognized by Medicare upon turning 65, you may waive part B and will not be penalized. If you are not claiming SS benefits, simply do not proactively enroll into part B until your credible coverage ends. You will be given a special election period (SEP) for 8 months after credible coverage ends to enroll into part B. If you are claiming social security already or are sent a card with Part B on it, simply sign the back of the card and return as instructed in the initial Medicare welcome letter. This will cancel your part B enrollment. If you do not have credible coverage, and do not enroll within 3 months of turning 65, you will be fined 10% of the monthly premium as a permanent penalty and be withheld from enrolling until between January 1st – March 31st of the following year.
When can I enroll into a Medicare Secondary or Prescription Drug Plan?
Beneficiaries can enroll into a Medicare supplement plan 6 months prior to, the month of, and 6 months past the month of the 65th birthday or the Part B effective date, whichever is later. During this period, called open enrollment, clients are not required to answer health underwriting questions. If beneficiaries enroll during this open enrollment period, Medicare Supplement policies are guaranteed issue for the life of the beneficiary and cannot be cancelled based on health claims. Please see our page on Medicare supplement or Medigap Plans for more information.
As for Medicare Advantage and Prescription Drug plans, the window is 3 months prior, the month of, and 3 months after turning 65 or enrolling into part B of Medicare. For a Medicare Advantage plan, having Medicare Part A and Part B is required. For more information on Medicare Advantage click here. For prescription drug plans, Medicare part A and/or Part B is required. To read more about part D and prescription drug plans, click here.
What is the Annual Enrollment Period (AEP)
Annual Enrollment is the period from October 15th through December 7th in which Medicare allows beneficiaries to change their Medicare Advantage or Medicare Prescription Drug plan. The new enrollment always starts as of the following January 1st. Beneficiaries can make as many plan changes as they would like to their PDP or MAPD during this period; the last enrollment prior to December 7th will be the one take place for the following year. This does not include Medicare Supplements, which requires beneficaires to undergo medical underwriting to make a change outside of their initial open enrollment or gauranteed issue.
Beneficiaries may only have an MAPD or a PDP, never both. By enrolling in one of them during AEP, beneficiaries are automatically knocked out of the other. Be sure to never enroll in a PDP if you do not plan on disenrolling from an MAPD and returning to Original Medicare.
Can I switch my Medicare Supplement plan every year?
One of the biggest misconceptions about Medicare plans is that every type of secondary can be changed each year. Once a year between October 15th and December 7th, during Annual enrollment period, Medicare allows beneficiaries to change their Prescription Drug Plan, or there Medicare advantage plan. They may enroll into a new Prescription Drug Plan, Medicare Advantage, or drop a Medicare Advantage it and return to original Medicare; but they cannot enroll into a Medicare supplement unless they are accepted through medical underwriting. In some cases, beneficiaries can pay an exorbitant amount of money to be accepted with some health issues, but still it may not be guaranteed.
The only way to guarantee enrollment into a Medicare supplement is to use your Open Enrollment period (upon turning 65 or joining Part B), or to have a qualifying event for guaranteed issue; like losing credible employer coverage, Medicaid, or to have your enrollment in an Advantage plan revoked due to the insurer leaving the region or state. Otherwise, switching Medicare Supplements will always require medical underwriting. Here at NJ Life and Health, we are experts in understanding carrier underwriting to help you assure you are enrolled in the best plan each year.