Medicare Part B General Enrollment Period

What Is The Annual Enrollment Period For Medicare

The Annual Enrollment Period for Medicare occurs each year from October 15 to December 7. This Annual Enrollment Period allows those on Medicare to make several changes to their coverage.

These changes include:

• Switching from Original Medicare to Medicare Advantage
• Go from Medicare Advantage to Original Medicare
• Switch from one Medicare Advantage plan to another
• Enroll, change or drop your Medicare Part D prescription plan

Suppose you use the Annual Enrollment Period to return to Original Medicare from Medicare Advantage. You can enroll in a Medicare Supplement plan to alleviate your Original Medicare out-of-pocket costs. This plan will begin on January 1 of the following year.

However, you must pass medical underwriting to enroll in the Medicare Supplement plan.

Medicare Part B Enrollment Sometimes Automatic Sometimes Not

U.S. citizens and legal permanent residents of at least five continuous years may be eligible for Medicare coverage. Youâre usually enrolled in Medicare Part A and Part B automatically when you turn 65 or qualify by disability at any age and you receive Social Security Administration or Railroad Retirement Board benefits. For details about how you qualify for automatic enrollment, see Medicare Enrollment.

Youâre not automatically enrolled in Medicare Part B in all situations. Here are a few examples of when you may qualify for Part B, but you need to sign up manually:

• If you live in Puerto Rico, youâre typically signed up for Medicare Part A automatically when you turn 65 if youâre collecting SSA or RRB benefits. However, you need to manually.
• If you have end-stage renal disease , regardless of your age, you may qualify for Medicare but you generally have to apply manually.
• If youâre not receiving SSA or RRB benefits when you turn 65, if you want to enroll in Medicare Part B, you need to sign up for it.

You can sign up for Medicare Part B during the following enrollment periods:

To add Medicare Part B, contact the Social Security Administration at 1-800-772-1213 , 7AM-7PM, Monday to Friday. For additional information, contact Medicare at 1-800-MEDICARE , 24 hours a day, 7 days a week.

How To Apply For Medicare Through The Rrb

If you worked for the railroad, call the Railroad Retirement Board at 877-772-5772 or submit an online service request through the RRB website.

The best time to apply is during the Medicare Initial Enrollment Period. Or, you can sign up during the Medicare General Enrollment Period.

Note: If you are still working, you can still sign up for RRB Medicare coverage when you turn 65. No need to retire.

If you, or a family member, are already receiving a railroad retirement annuity, you will automatically be enrolled in Medicare Part A and B. Coverage begins when you turn 65.

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Medicare Supplement Open Enrollment Period

If youre looking to supplement your Original Medicare coverage to help with additional costs, the best time to buy a Medicare Supplement plan is during the six-month enrollment period that starts the first day of the month you turn 65 as long as you have signed up for Medicare Part B.

If you dont sign up for a Medicare Supplement plan during this Open Enrollment Period, you may not be able to buy a Medicare Supplement plan. Unless you have a guaranteed issue right, you may be required to answer medical questions.

How Can I Get Assistance Paying My Health Care Costs

If you have a limited income, you may be able to get assistance with your health care costs through certain programs:

• Medicaid: If you have a low monthly income and minimal assets, you may be eligible for coverage through Medicaid to pay Medicare costs, like copays and deductibles, and for health care not covered by Medicare, such as dental care and transportation to medical appointments.
• Medicare Savings Programs : If you do not qualify for Medicaid but still have problems paying for health care, you may qualify for an MSP, a government-run program that helps cover Medicare costs. There are three types of MSP, and all of them pay the monthly Medicare Part B premium. The Qualified Medicare Beneficiary program covers deductibles and coinsurances as well.
• Extra Help: Also known as the Part D Low-Income Subsidy , this is a federal program that helps pay for some to most of the costs of Medicare Part D prescription drug coverage. You may be eligible for Extra Help if you meet the income and asset limits. Also, in many cases, enrollment in an MSP automatically leads to enrollment in Extra Help.
• State Pharmaceutical Assistance Programs: SPAPs are offered in some states to help eligible individuals pay for prescriptions. Most SPAPs have income guidelines. Many also require you to enroll in a Medicare Part D plan and to apply for Extra Help.

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Savvy Senior: Understanding Medicare’s Enrollment Periods

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Dear Savvy Senior,

What can you tell me about the different enrollment periods for Medicare? Im planning to work past age 65 and understand Medicare offers Initial, Special and General periods in which I can enroll. How does this work? Medicare Illiterate

Dear Medicare,

The rules for signing up for Medicare can be quite confusing, especially if you plan to work past age 65. But its critical to understand the ins and outs of enrolling because the consequences of missing a deadline can be costly and last a lifetime. Heres what you should know about Medicares three different enrollment periods.

What Is The Iep For Medicare Before Turning 65

If you receive Medicare benefits before age 65 due to a disability, you will receive a second Initial Enrollment Period. This will happen when you turn 65 and is known as the Initial Enrollment Period 2.

For example, if you become eligible for Medicare at age 57 due to 24 months on disability, you will have another opportunity to enroll again at age 65 with no late enrollment penalties.

During the Initial Enrollment Period 2, you can sign up for a Medicare Advantage or Medicare Supplement plan and a Medicare Part D plan. The Initial Enrollment Period 2 runs for the same seven-month period as the Initial Enrollment Period.

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Medicare Open Enrollment 2023 Guide

Everything you need to know about the annual election period, including opportunities to change coverage, eligibility details and enrollment deadlines

Reviewed by our health policy panel.

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Some Medicare beneficiaries stick with the same MA-PD or Part D plan and do well with it for years. But before you settle for your current prescription drug plan, shop around and assess your choices.

Medicare Coverage And End Stage Renal Disease

You may get Medicare benefits at any age if you have ESRD and one of the following applies:

• You are eligible for Medicare based on your work record.
• You are already getting Social Security or Railroad Retirement Board benefits, or you are eligible for benefits.
• Your spouse or parent meets one of the above requirements.

Medicare coverage starts the fourth month you receive dialysis treatments. For example, your Medicare coverage would start on October 1 if you start getting your dialysis treatments in July.

Medicare coverage could start the first month you receive treatments if all of these apply:

• You attend a home dialysis training program provided by a Medicare-certified training facility.
• Your doctor expects you to complete the training and be able to do your own dialysis treatments.
• You maintain regular dialysis treatments throughout the usual required waiting period.

You must enroll in Original Medicare yourself. Once you have both Part A and Part B, you may make other Medicare coverage choices, such as adding Medicare Part D prescription drug coverage or choosing a Medicare Advantage plan.

If you are 65 or older, or disabled, and are already enrolled in Part A, you may enroll in Part B without penalty if you are approved for Medicare based on ESRD. You may also have an existing Part B late enrollment penalty removed.

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If I Keep My Work Insurance Do I Need To Enroll In Medicare

If you have coverage through a current employer, you are not required to enroll in Medicare Part A and B. Below are some things to keep in mind about each part of Medicare.

Part A: For most people, Part A does not charge a premium. Typically, Part A pays after your work insurance. Part A probably wont pay much of the bill, but doesnt cost anything to have. For that reason, most individuals enroll in Part A at age 65.

Part B: Everyone pays a monthly premium for Part B. Part B typically pays after your work coverage and may not pick up much of the bill. Enrolling in Part B will also start your one-time guarantee to purchase a Medicare Supplement. Once this 6-month time frame starts, it cannot be stopped. For these two reasons, most people wait until their work coverage ends to enroll in Part B.

Part D: Everyone pays a monthly premium for Part D. As long as you have other “creditable coverage,” you do not have to enroll in a Part D plan. Creditable coverage means the insurance is as good as, or better than, a standard Part D plan. Check with your HR department to verify if your policy is creditable coverage. Typically, prescription insurance through work offers better coverage than what you can get through Medicare. For this reason, most people wait until their work coverage ends to enroll in Part D.

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.

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The Parts Of Medicare

Social Security enrolls you in Original Medicare .

• Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
• Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.

Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.

• Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
• Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
• Medicare Part D helps cover the cost of prescription drugs.

Most people age 65 or older are eligible for free Medicare hospital insurance if they have worked and paid Medicare taxes long enough. You can sign up for Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .

Who Is Eligible For Medicare

You are eligible for Medicare Part A and Part B at age 65 if:

• You are a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years
• You or your spouse have worked long enough to be eligible for Social Security or Railroad Retirement benefits
• You or your spouse are government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes

You can meet Medicare eligibility under 65 if you:

• Have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months
• You have End-Stage Renal Disease and you or your spouse have paid Social Security taxes for a certain length of time

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Who Qualifies For A Special Enrollment Period

There are several special cases that make you eligible for a Special Enrollment Period.

Here are some common situations:

• You move: If you move to an address outside your plans service area, into a nursing home, or you have different plan options at your new address, youll be able to apply for a new plan.
• You want to switch to a 5-star Medicare plan: Every year, Medicare evaluates plans based on a 5-star rating system. Medicare considers these plans excellent. You can make the switch once to a 5-star plan anytime from Dec. 8 through Nov. 30 if one is available in your area.
• You lose your current coverage: This applies if you or your spouse will retire or change to a job that doesnt offer coverage. It doesnt apply if your insurance company cancels your coverage because you didnt pay your monthly premiums.
• Your plan changes its contract with Medicare: Enrollment in a plan depends on the plans contract with Medicare, and for various reasons these contracts could change.

Your new coverage begins on the first day of the month after you sign up.

Is Medicare Open Enrollment Open Yet

Yes, the fall Medicare Open Enrollment Period for Medicare Advantage plans and Medicare prescription drug coverage began October 15 and lasts until December 7.

During fall Medicare open enrollment, you may be able to drop, switch or enroll in a Medicare Advantage or Medicare Part D prescription drug plan for the 2023 plan year.

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Special Enrollment Period For Parts A And B

Some people with health care coverage through their job or union, or through their spouse’s job or union, wait to sign up for Medicare Part A and/or Part B . If you or your spouse are actively working for an employer with more than 20 employees when you turn 65, you can get a Special Enrollment Period to sign up for Parts A and/or B:

• Any time you’re still covered by the employer or union group health plan through you or your spouses current employment or
• During the eight months following the month the employer or union group health plan coverage ends, or when the employment ends .

If you delay enrolling even longer, you may have to wait for coverage and you may pay a lifetime late enrollment penalty surcharge on your Medicare premiums.

If you’re under age 65, and eligible for Medicare because you’re disabled and working , the SEP rules also apply to you as long as the employer has more than 100 employees.

Fall Medicare Open 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 Open Enrollment Period.

The 2023 Medicare Open Enrollment period is also called the Medicare Annual Election Period .

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 2022 Medicare Fall Annual Enrollment Period go into effect January 2023.

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When Do I Use My Medicare Cards

Everyone who enrolls in Medicare receives a red, white, and blue Medicare card. This card lists your name and the dates that your Original Medicare hospital insurance and medical insurance began. It will also show your Medicare number, which serves as an identification number in the Medicare system.

If you have Original Medicare, make sure you always bring this card with you when you visit doctors and hospitals so that they can submit bills to Medicare for payment. If you have a supplemental insurance plan, like a Medicare Supplement Plan, retiree, or union plan, make sure to show that plans card to your doctor or hospital, too, so that they can bill the plan for your out-of-pocket costs.

Note: Medicare has finished mailing new Medicare cards to all beneficiaries. You can still use your old card to get your care covered until January 1, 2020. However, if you have not received your new card, you should call 1-800-MEDICARE and speak to a representative.

If you are enrolled in a Part D plan , you will use the Part D plans card at the pharmacy.

Remember: Do not give your Medicare or Social Security numbers or personal data to strangers. Medicare will never ask for this information over the phone. If you believe you have been the target of Medicare marketing or billing fraud, contact your local Senior Medicare Patrol.