Medicare Eligibility and Enrollment

If your next birthday is your 65th, then it's an exciting time. You become eligible for Medicare - the federally-sponsored health insurance program for U.S. citizens.

Although it's a happy time, it can be stressful, too. Not only do you have to select the plans that make up your individual Medicare plan, but you also have to know when you're eligible and when to enroll. Read on to learn about eligibility and enrollment requirements.

Meeting eligibility requirements can be a significant point in your life. Most US citizens become eligible for Medicare the month of their 65th birthday. Eligibility may occur sooner if you have certain disabilities or end-stage renal disease. There are 4 key facts to remember when beginning your Medicare process.

1. Some people may be automatically enrolled, while others will have to physically sign up for Medicare.
2. You have the freedom to choose the type of coverage you will receive, how you will receive it, and the costs associated with your coverage.
3. There are certain times of the year when you can sign up; signing up during this period can help to avoid financial penalties.
4. There are programs available to help cover the financial burdens associated with Medicare for low-income individuals.

The timeframe when you are allowed to enroll in a Medicare plan is called an enrollment period. These dates are vital to receive timely coverage and to avoid costly penalties. There are several types of enrollment periods available including:

• Initial Enrollment Period
• Open Enrollment Period
• General Enrollment Period
• Annual Enrollment Period
• Special Enrollment Period

Initial Enrollment Period

The initial enrollment period gives you a 7-month time frame to enroll. This time frame consists of the 3 months prior to your birth month, your birth month, and the 3 months after your birth month. During this time you will have the opportunity to enroll in Original Medicare, a Medicare Part D prescription plan, or Medicare Part C (Medicare Advantage Plans).

If you fail to sign up during your initial enrollment period, you could face consequences in the form of higher annual premiums. In addition, you may not be permitted to enroll in Medicare Part B until the general enrollment period. This leaves you with several months of no Part B coverage at all.

General Enrollment Period

You can also enroll in Original Medicare (Part A and Part B) during the general enrollment period. This occurs between January 1st and March 31st as long as you meet certain criteria. This includes:

• Failure to enroll during the initial enrollment period
• If you are not eligible to sign up during a special enrollment period

Annual Enrollment Period

During the annual enrollment period, everyone has the opportunity to enroll in a Medicare plan. You can also make changes to an existing plan during this time. The annual enrollment period begins on October 15th and continues until December 7th.

Open Enrollment Period

There are two different types of open enrollment periods-Medicare Supplement Open Enrollment and Medicare Advantage Open Enrollment.

Medicare Supplement

Medicare supplement plans piggyback off of your Medicare insurance and offer coverage to help with additional medical costs. The best time to purchase a Medicare Supplement plan is during the initial enrollment period that allows coverage to begin on the first day of the month you turn 65.

It is important to note that you will not be able to sign up for a Medicare Supplement Plan unless you have already enrolled in Medicare Plan B. In addition, if you choose not to sign up for a Medicare Supplement during the Open Enrollment Period, you may not be able to sign up for one at all.

Medicare Advantage

Medicare Advantage Plans are bundled, all-in-one plans that can offer more medical coverage and often include prescription drug coverage. They are provided by private insurers like Aetna, Humana, and many others.

The Medicare Advantage Open Enrollment Period takes place each year between January 1st and March 31st. During this timeframe, individuals have the option of switching to a Medicare Advantage Plan. If you are already receiving benefits through a Medicare Advantage Plan, you may want to switch back to Original Medicare. That can also be done during this period.

The new coverage that you choose will begin on the first day of the following month.

Special Enrollment Period

There are some special circumstances that will allow you to enroll, change, or end benefits through a Medicare Advantage Plan. These circumstances include moving to a new area that is no longer in your plan’s service area or losing coverage due to a change in employment.

Your situation is unique. For more help understanding your Medicare eligibility requirements and choosing the best enrollment period, reach out to one of our highly trained professionals by filling out this simple online form.