UNDERSTANDING MEDICARE ADVANTAGE (PART C)
ENROLLMENT TIMES
Enrolling in Medicare Advantage Plans is limited to certain times.
You can’t always sign up when you want, so it’s important to know when you can enroll in the different parts of Medicare.
When can I sign up?
There are specific times when you can sign up for a Medicare Advantage Plan (like an HMO or PPO), or make changes to coverage you already have:
During your Initial Enrollment Period (IEP)
when you first become eligible for Medicare or when you turn 65 or
Medicare Annual Enrollment Period (AEP)
October 15–December 7 (Changes will take effect on January 1.)
How does Medicare's Annual Enrollment Period work?
October 15th -December 7th
Who’s it for?
The Annual Enrollment Period (AEP) is for anyone enrolled in Medicare Parts A and/or B, including those who may already be enrolled in a Medicare Advantage or Part D plan.
What can I do during Medicare Annual Enrollment?
You can join, switch, or drop a health and/or drug plan.
These are the actions you can take:
What is the Medicare Advantage Open Enrollment Period (MA-OEP)
January 1st -March 31
The Medicare Advantage Open Enrollment Period is when Medicare Advantage plan members can make changes to their existing plan or disenroll from their current plan and return to Original Medicare.
It runs from January 1 to March 31.
The changes you can make during Medicare Advantage Open Enrollment are similar to those you can make during the Medicare Annual Enrollment Period. It basically gives you another opportunity to get the coverage you want and need.
The major difference is that you can not change a Medicare Part D Prescription Drug plan.
However, If you decide to go back to "Original Medicare" at this time you can add Part D plan.
Medicare's Open Enrollment Period vs. the Medicare Advantage Open Enrollment Period:
What’s the difference?
The main difference between Medicare Advantage Open Enrollment and Medicare Annual Enrollment is who can use each one.
Medicare Annual Enrollment is when anyone who has Medicare can make coverage changes for the upcoming year, while Medicare Advantage Open Enrollment is only for people who are currently enrolled in a Medicare Advantage plan.
Another difference between the two is the timing.
Medicare Annual Enrollment is October 15 - December 7,
while Medicare Advantage Open Enrollment is January 1 - March 31. Both happen every year.
The Two ways the Annual Enrollment period and the Medicare Advantage Open Enrollment Period differ
In additional to the above periods you may qualify for a Special Enrollment Period (SEP), like:
There are actually two kinds of Medicare Special Enrollment Periods. A Medicare Special Enrollment Period allows you to switch plans or sign up for Medicare outside of the standard Medicare enrollment periods.
If you don’t yet have Medicare: For people who qualified to delay Medicare because they had creditable coverage – usually from an employer – there is an 8-month Special Enrollment Period for enrolling in Medicare Parts A, B, C and D
What qualifies for a Medicare Special Enrollment Period to switch plans?
People who already have Medicare may qualify for a 2-month Special Enrollment Period with certain qualifying life events. This Special Enrollment Period lets you switch to a different Medicare Advantage or Part D prescription drug plan.
You may qualify for a 2-month Medicare Special Enrollment Period in the following situations:
For people who work past 65 and qualify to delay Medicare with creditable employer coverage, there is an 8-month Special Enrollment Period that allows you to enroll in Part A (if you haven’t yet), Part B , Part C and Part D without late penalties.
This Special Enrollment Period is tricky though. Why? Because while you have the whole 8 months to get Parts A & B, you only get the first 2 months to enroll in Part C or Part D without penalty. If you enroll after the two-month mark, you’ll face late enrollment penalties for Part D (regardless of whether you end up with a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage).
To qualify for the Part B Special Enrollment Period, you must have creditable employer or union health coverage based on current employment. Your Special Enrollment Period will begin eight months after your employer coverage ends or you leave your job, whichever happens first.
SPECIAL NOTE: You must have Medicare Part A and Part B to join a Medicare Advantage Plan and you must continue to pay any premiums to maintain that coverage
ENROLLMENT TIMES
Enrolling in Medicare Advantage Plans is limited to certain times.
You can’t always sign up when you want, so it’s important to know when you can enroll in the different parts of Medicare.
When can I sign up?
There are specific times when you can sign up for a Medicare Advantage Plan (like an HMO or PPO), or make changes to coverage you already have:
During your Initial Enrollment Period (IEP)
when you first become eligible for Medicare or when you turn 65 or
Medicare Annual Enrollment Period (AEP)
October 15–December 7 (Changes will take effect on January 1.)
How does Medicare's Annual Enrollment Period work?
October 15th -December 7th
Who’s it for?
The Annual Enrollment Period (AEP) is for anyone enrolled in Medicare Parts A and/or B, including those who may already be enrolled in a Medicare Advantage or Part D plan.
What can I do during Medicare Annual Enrollment?
You can join, switch, or drop a health and/or drug plan.
These are the actions you can take:
- Change from original Medicare to a Medicare Advantage Plan.
- Change from a Medicare Advantage plan to original Medicare.
- Switch from one Medicare Advantage plan to another.
- Join a Medicare drug plan.
- Switch from one Medicare drug plan to another.
What is the Medicare Advantage Open Enrollment Period (MA-OEP)
January 1st -March 31
The Medicare Advantage Open Enrollment Period is when Medicare Advantage plan members can make changes to their existing plan or disenroll from their current plan and return to Original Medicare.
It runs from January 1 to March 31.
The changes you can make during Medicare Advantage Open Enrollment are similar to those you can make during the Medicare Annual Enrollment Period. It basically gives you another opportunity to get the coverage you want and need.
The major difference is that you can not change a Medicare Part D Prescription Drug plan.
However, If you decide to go back to "Original Medicare" at this time you can add Part D plan.
Medicare's Open Enrollment Period vs. the Medicare Advantage Open Enrollment Period:
What’s the difference?
The main difference between Medicare Advantage Open Enrollment and Medicare Annual Enrollment is who can use each one.
Medicare Annual Enrollment is when anyone who has Medicare can make coverage changes for the upcoming year, while Medicare Advantage Open Enrollment is only for people who are currently enrolled in a Medicare Advantage plan.
Another difference between the two is the timing.
Medicare Annual Enrollment is October 15 - December 7,
while Medicare Advantage Open Enrollment is January 1 - March 31. Both happen every year.
The Two ways the Annual Enrollment period and the Medicare Advantage Open Enrollment Period differ
- They are held at different times of the year. Medicare’s Annual Enrollment Period is from Oct. 15-Dec. 7. And the Medicare Advantage Open Enrollment is from Jan. 1-March 31.
- They both offer different opportunities for adjusting your coverage. During Medicare Open Enrollment, enrollees can make a wider range of changes. Medicare Advantage Open Enrollment gives people with Medicare Advantage (Part C) plans one additional chance to change plans or switch back to original Medicare and add a Part D Plan.
In additional to the above periods you may qualify for a Special Enrollment Period (SEP), like:
There are actually two kinds of Medicare Special Enrollment Periods. A Medicare Special Enrollment Period allows you to switch plans or sign up for Medicare outside of the standard Medicare enrollment periods.
- Special Enrollment Period – Qualifying Life Events: 2 months
- Special Enrollment Period – Working Past 65: 8 months
If you don’t yet have Medicare: For people who qualified to delay Medicare because they had creditable coverage – usually from an employer – there is an 8-month Special Enrollment Period for enrolling in Medicare Parts A, B, C and D
What qualifies for a Medicare Special Enrollment Period to switch plans?
People who already have Medicare may qualify for a 2-month Special Enrollment Period with certain qualifying life events. This Special Enrollment Period lets you switch to a different Medicare Advantage or Part D prescription drug plan.
You may qualify for a 2-month Medicare Special Enrollment Period in the following situations:
- You move out of your plan’s service area.
- Your plan closes, stops serving the area where you live, significantly reduces its provider network or your plan consistently receives low Medicare star ratings.
- You want to enroll in a 5-star plan at any time or drop your first Medicare Advantage plan within 12 months of enrolling.
- You move into or out of a qualified institutional facility, like a nursing home.
- You are enrolled in or lose eligibility for a qualified State Pharmaceutical Assistance Program.
- You have Medicare financial assistance such as Medicaid, a Medicare Savings Program or Extra Help, or you gain or lose eligibility for any of these.
- You enroll in or leave the Program of All-Inclusive Care for Elderly (PACE).
- You gain or lose eligibility for a Special Needs Plan.
For people who work past 65 and qualify to delay Medicare with creditable employer coverage, there is an 8-month Special Enrollment Period that allows you to enroll in Part A (if you haven’t yet), Part B , Part C and Part D without late penalties.
This Special Enrollment Period is tricky though. Why? Because while you have the whole 8 months to get Parts A & B, you only get the first 2 months to enroll in Part C or Part D without penalty. If you enroll after the two-month mark, you’ll face late enrollment penalties for Part D (regardless of whether you end up with a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage).
To qualify for the Part B Special Enrollment Period, you must have creditable employer or union health coverage based on current employment. Your Special Enrollment Period will begin eight months after your employer coverage ends or you leave your job, whichever happens first.
SPECIAL NOTE: You must have Medicare Part A and Part B to join a Medicare Advantage Plan and you must continue to pay any premiums to maintain that coverage
Want to Understand Medicare Advantage
and Medicare Part D Enrollment Periods?
Download the booklet from Medicare
and Medicare Part D Enrollment Periods?
Download the booklet from Medicare
