August 9, 2010

Enrollment Periods for Medicare Insurance Plans

Medicare has four parts (Part A, Part B, Part C / Medicare Advantage, and Part D).

Medicare Parts A & B

U.S. citizens and legal permanent residents (residing in the U.S. for five continuous years) who are within Three months of their 65th birthday may enroll in Medicare Part A. If you already receive Social Security benefits or the Railroad Retirement benefits, you will be automatically enrolled in Medicare Part A the first day of the month in which you turn 65 years old. Your Medicare card will be mailed to you about three months before your 65th birthday. You are also eligible to enroll for Medicare Part B the month in which you turn 65.

If you are receiving neither Social Security nor Railroad Retirement pension or disability benefits, you are eligible to enroll in Medicare Part A and Part B up to three months before the month of your 65th birthday. This Initial Enrollment Period continues through the three months after the month of your birthday. To enroll during this period, you must submit your Medicare application to the Social Security Administration.

Individuals under the age of 65 are eligible to enroll in Medicare Parts A and B if they meet one of the following conditions:

  • You have a qualifying disability such as blindness or a qualifying medical condition
  • You received disability payments from Social Security or the Railroad Retirement Board for the past 24 months
  • You are a disabled widow or widower between age 50 and age 65 but have not applied for disability benefits because you’re already getting another kind of Social Security benefit
  • You have permanent kidney failure and you receive dialysis and/or have received a kidney transplant and you (or your spouse or parent if you are a dependent) meet certain work conditions

Medicare Advantage Health & Drug Plans

Individuals who have Medicare Part A and Part B may enroll in a Medicare Advantage plan from November 15th through December 31st in 2010. In 2011, this Annual Coordinated Election Period changes to October 15th through December 7th.

Starting in 2011, an individual enrolled in a Medicare Advantage plan (Part C) may disenroll from his or her Medicare Advantage plan and return to Original Medicare and a stand-alone Part D prescription drug plan during the first 45 days of the calendar year. A Medicare Advantage enrollee, however, cannot switch from his or her existing Medicare Advantage plan to a different plan during this period.

As is the case for Medicare Part D, Medicare Advantage plans allow for Special Enrollment Periods (SEP) for qualifying individuals. Some of the conditions that can qualify you for a Special Enrollment Period are:

  • Your 65th birthday
  • Any time you move to a new coverage area
  • If you suffer from certain chronic medical conditions
  • You are enrolled in the Extra Help from the government or qualify for this program
  • You are enrolled in Medicaid

During a Special Enrollment Period, an individual may enroll or disenroll from a Medicare Advantage plan.

Part D

In 2010, the Annual Enrollment Period (AEP) for Medicare Part D runs from November 15th through December 31st. Any Medicare Part A recipient can enroll in a Part D plan or switch Part D plans at this time. Individuals can also enroll in a Part D plan if they qualify for a Special Enrollment Periods (SEP). Part D has identical qualifications for a Special Enrollment Period as those listed above in the Medicare Advantage section of this page.

In 2011, the annual enrollment period for Medicare Part D is renamed the "Annual Coordinated Election Period." This enrollment period shall run from October 15th through December 7th. As was the case with the Annual Enrollment Period, any Medicare recipient can enroll in a Part D plan or switch Part D plans at this time.

Medicare Supplement

Anyone who has both Medicare Part A and Part B may enroll in a Medigap program at any time during the year. However, the optimal time in which to enroll in a Medigap plan is during the Open Enrollment Period (OEP). Your individual Medigap Open Enrollment Period is 6 months long and begins on the first day of the month in which you are at least 65 years old and enrolled in Medicare Part B. During this period you have a guaranteed issue right to buy a Medigap policy. This means the insurance company may not subject you to medical underwriting (a review of your medical history and the potential risk level it represents to the insurance company). However, outside of this Open Enrollment Period, your enrollment application to a Medigap plan would be subject to medical underwriting. In this scenario, you may be denied coverage or you may be charged more because of particular health problems.

* By submitting this form you agree that a licensed sales rep may contact you to discuss the specific types of products listed above. The sales rep that will be discussing plan options with you is either employed or contracted by a Medicare health plan or prescription drug plan that is not the Federal government, and they may be compensated based on your enrollment in a plan. Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan. A Medicare Advantage plan is a health insurance plan provided through a private insurer and delivers Medicare Part A and Part B benefits. A Part D Drug plan is a prescription drug insurance plan provided through a private insurer and delivering Medicare Part D benefits. By submitting this form, you acknowledge that you have read and understand PlanPrescriber's Terms and Conditions.