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Medicare Enrollment Periods Explained

Enrollment Periods Explained

Universal Enrollment Periods

  • Annual Enrollment Period– This is the period from October 15 to December 7 when people can switch from Medicare Advantage to Original Medicare plus enroll in a Medicare Part D plan and apply for a Medicare supplement policy. Also, Medicare Advantage members can change to different Medicare Advantage plan. Plans will take effect on January 1st.
  • General Enrollment Period-Every year from January 1 – March 31, people who didn’t enroll in Medicare during their Initial Enrollment Period and are not eligible for a Special Enrollment Period may enroll in Original Medicare during this time. Please note there will likely be late enrollment penalties.

Individual Enrollment Periods

  • Initial Enrollment Period (IEP)– The seven-month period when clients first can enroll in Medicare (three months before they turn 65, the month of their birthday, and the three months afterward).
  • Special Enrollment Period (SEP)– A time other than the Annual Enrollment Period or Initial Enrollment Period when people may join, change, or drop a Medicare plan. An SEP can be triggered by certain events such as a change in residence or leaving an employer’s group plan. Rules about when you can make changes and the type of changes you can make are different for each SEP.

Enrollment Periods at a Glance

 Enrollment Period                 Who               Duration  Guaranteed-Issue?
Annual Enrollment Period People switching from Medicare Advantage to a Medigap plan or changing Medicare Advantage plans October 15 – December 7 If the plan is no longer available within area or if member moves out of area
General Enrollment Period First-Time  Enrollees who  missed their IEP  and aren’t eligible  for SEP   January 1 –March 31                Yes
Initial Enrollment Period  First-Time Enrollees Seven-month period beginning three months prior to birthday month to three months following birthday month                 Yes
Special Enrollment Period First-Time Enrollees who had other coverage that is ending (such as through an employer) or if they moved out of the area                 Varies                  Yes
  • Keep in mind, these are general guidelines and do not capture every situation possible, as it is nearly impossible to do here. These guidelines provide popular situations your client may be experiencing.

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