Enrolling in Medicare can only happen at certain times, and you can only make changes to your plan outside those periods if you’ve had certain life events, similar to standard health insurance plans.
Read on as we discuss Medicare Enrollment and Special Enrollment Periods.
Some people will be automatically enrolled in Original Medicare when they reach the appropriate age, and they can choose to keep or decline Medicare Part B (medical insurance).
This Initial Enrollment Period lasts seven total months, beginning three months before you turn 65. If you qualify for the premium-free Part A, your coverage will begin the first of the month in the month you turn 65. For those eligible due to disabilities, their IEP begins three months before their 25th month of Social Security Disability benefits.
If you miss your IEP, you may have to wait to sign up or pay a monthly late-enrollment fee for Part B coverage. This is a lifetime penalty that goes up the longer you wait, so it’s important to understand if you want Part B coverage before your IEP ends.
If you miss your Initial Enrollment Period, you can sign up during the General Enrollment Period. The GEP each year is January 1st-March 31st with coverage beginning July 1st. If you enroll in Part B during the GEP, you may have to pay a penalty.
A Medicare Special Enrollment Period allows you to change your plan or sign up for coverage outside the standard periods. There are two kinds of SEPs for Medicare: one for those who work past 65 and one for qualifying life events.
People who skipped their Initial Enrollment Period and did not sign up for Medicare because they or their spouse were still working and had an employer-sponsored group health plan are eligible to enroll in Medicare Parts A, B, C or D for eight months after they stop working or end their employer-sponsored health coverage. You have the entire eight months to enroll in Parts A or B but only the first two months to enroll in C or D without a penalty.
Employer coverage for retirees or through COBRA does not count as current employment and is not eligible for an SEP, so if you choose COBRA or another non-Medicare health plan, you still only have the initial eight-month period after your original employer-sponsored coverage ends.
If you are under 65 and eligible for Medicare because of a disability, you may delay enrollment in Part B if you are covered by a family member’s employer-sponsored health plan. However, if the company has fewer than 100 employees, Medicare is the primary payer and you will not have an SEP to enroll in Part B.
For those looking to change their Medicare plans because of a change in life, the SEP is two months. The SEP allows you to switch to a different Medicare Advantage or Part D plan.
Qualifying life events include but are not limited to: