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If you are turning 65 and getting ready to retire soon, it’s time to start thinking about Medicare insurance. It's important to explore your options and avoid waiting until the last minute to enroll so you can avoid a late-enrollment penalty. Knowing when to sign up for new health insurance can be confusing, but with a little information you will be able to mark your calendar for these important Medicare enrollment deadlines!
At Premier Benefit Consultants, one of the things we do is help seniors transition from employer coverage to Medicare. We are happy to answer your questions about enrollment deadlines and help you find the right Medicare options for your needs.
Important Medicare Enrollment Deadlines
Initial Enrollment Period (IEP)
Medicare Parts A and B:
Medicare Part A and Medicare Part B are at the heart of Medicare insurance. Whether you choose Original Medicare or a Medicare Advantage plan, you will be enrolled in both Medicare Part A and Medicare Part B. Part A is hospital insurance that helps cover inpatient care in hospitals, home health care, hospice care, and care in skilled nursing facilities. Part B is medical insurance for outpatient care that helps cover home health care, durable medical equipment such as wheelchairs, walkers, and hospital beds, and many preventive services such as cancer screenings and vaccines.
Most seniors should enroll in both Medicare Part A and Medicare Part B as part of Original Medicare or a Medicare Advantage plan during their IEP, which is a seven-month window around the 65th birthday. This seven-month period starts three months before and ends three months after the month you turn 65. Coverage can’t start earlier than the month you turn 65.
For disabled Americans: if Medicare enrolls you after 24 months of receiving Social Security Disability Insurance (SSDI), you can expect to get your card in the mail about three months before your 25th month of disability benefits.
Medicare Part D:
Medicare Part D is private prescription drug coverage that can be purchased alongside Original Medicare or a Medicare Advantage plan that does not cover prescription drugs.
Medicare Part D prescription drug coverage has the same initial enrollment period as Medicare Part A (three months before through three months after your 65th birthday month).
Seniors may be assessed a Part D late enrollment penalty for going 63 or more days without prescription drug coverage from Medicare Part D or another source.
Medicare Supplement (Medigap) Open Enrollment Period
Medicare Supplement insurance plans, or Medigap, are used by seniors enrolled in Original Medicare to cover some of Medicare's cost-sharing requirements.
The Medigap enrollment period is different from the other parts of Medicare in that you need to be enrolled in Part B before you can enroll in a plan. During this Medicare Supplement Open Enrollment Period, seniors get a six-month window* to buy a supplement plan without being asked any questions about preexisting health conditions. In other words, insurance companies that offer Medigap plans are not allowed to use medical underwriting during this window. Once Medical underwriting is allowed, you can be denied coverage or charged a higher rate based on any existing health conditions.
*If you are enrolled in Medicare Part B on the date you turn 65, that is the day your Medicare Supplement Open Enrollment Period begins.
General Enrollment Period (GEP)
If you miss your IEP, then you can enroll in Medicare during the GEP, which takes place every year between Jan. 1 and March 31. Starting in 2023, coverage kicks in the month after you sign up during the GEP but you may still be assigned a late-enrollment penalty.
Special Enrollment Period (SEP)
If you continue working past the age of 65 and have group coverage, you will have a SEP to enroll in Medicare without paying a late enrollment penalty. The SEP is an eight-month time frame that starts the month after the job ends or the month after the group health plan through the job ends. Coverage generally starts the month after enrolling.
There are other reasons that a person may qualify for a special enrollment period. Click here to learn more.
The Annual Enrollment Period (AEP)
The AEP (commonly referred to as open enrollment) runs every year between October 15 and December 7. During this period, seniors can enroll in, drop, or switch their Medicare coverage. Current Medicare enrollees can switch Medicare Advantage plans or go back to Original Medicare with a Medicare supplement plan. Those on Original Medicare can switch to a Medicare Advantage plan. Seniors can also choose a different Part D prescription drug plan. Plans go into effect the following January 1.
Note: If you missed your IEP and are enrolling in Medicare for the first time during AEP, you may be assessed a late enrollment penalty.
Don’t Panic if you’ve missed a Medicare enrollment deadline
If you miss a deadline, you may have to wait up to a year to apply for coverage or make a change in your plan but it isn’t the end of the world. If you miss a Medicare deadline, the best thing to do is contact a Medicare insurance agent who can go over your enrollment options.
Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. We are the only insurance agency in Hawaii contracted with EVERY Medicare Advantage plan, which means we are able to offer unbiased advice; all at no cost to our clients.
At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.
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