Your Medicare Enrollment Questions, Answered

How Does Medicare Enrollment Work?

The question on every soon-to-be retirees mind is “how does Medicare work?” Well, that’s a complicated question, but luckily there are a number of great resources available that strive to give seniors and their families as much info as possible about the U.S.A’s federally-regulated health insurance program.

MedicareInsurance.com is one such resource. From there, you can discover a number of important details about Medicare, what is and is not covered in various scenarios, Medicare news, and much more.

Courtesy of our friends at MedicareInsurance.com, today we’re covering Medicare enrollment. This is your basic guide to enrolling in Medicare. Let’s get started. 

Understanding Medicare Enrollment Periods

When considering Medicare for the first time, it’s important to know the ins and outs of one of Medicare’s most important structures: the various Medicare enrollment periods. What are the Medicare enrollment periods, when are the Medicare enrollment periods, and how do they differ? Let’s find out.

Medicare Initial Enrollment Period

The first Medicare enrollment period any senior is likely to encounter in the Initial Enrollment Period (IEP). This enrollment period typically begins three months before you turn 65 years old, lasts the entire month of your 65th birthday, and continues for three months following your 65th birthday. Additionally, you can otherwise qualify for Medicare following the diagnosis of certain disabilities or diseases. 

During this IEP period, you will be automatically enrolled in Medicare Part A and can enroll in a Medicare Part B or Medicare Part C (Medicare Advantage) right away. Enrolling in Medicare Part D: Prescription Drug Plans and/or Medigap plans can also occur during this seven month window.

Medicare Annual Enrollment Period

The Medicare Annual Enrollment Period (AEP) takes place between October 15th and December 7th at the end of every year. During this period, eligible Medicare beneficiaries can join different parts of Medicare, and freely switch or drop a Medicare Advantage or Medicare Part D plan.

For most seniors, AEP is the ideal time to get coverage, change coverage, and compare plans in your area that may be more beneficial to your exact scenario.

Medicare Advantage Open Enrollment Period

The Medicare Advantage Open Enrollment Period (OEP) allows Medicare enrollees who already have existing Medicare Advantage plans to make necessary coverage changes as they see fit.

The Medicare Advantage OEP runs from January 1st to March 31st at the start of each year. During the Medicare Advantage OEP, you can switch between Medicare plans with no penalty, but you cannot enroll in a Medicare or Medicare Advantage plan for the first time.

Medicare Special Enrollment Period

A Medicare Special Enrollment Period (SEP) is sort of the oddball of the bunch. This enrollment period allows you to swap your Medicare or Medicare Advantage plan as a necessary result of a major life event, such as a recent move to a new area, marriage, divorce, death of a spouse, etc.

Certain other factors, such as the recent availability of a 5-Star Medicare plan in your area, may also qualify you to take part in an SEP.

How to Enroll in Medicare: Step-by-Step

Now that the gritty details are out of the way, it’s time to take a look at how to enroll in Medicare, one step at a time. 

Step 1: Determine Your Eligibility

The first step in enrolling in Medicare or Medicare Advantage is simply to determine whether or not you are eligible to do so in the first place. As stated above, you must be turning 65 years of age or have recently been diagnosed with a qualifying condition in order to be eligible for first-time Medicare enrollment.

Alternatively, you may also decide that you wish to delay enrollment in Medicare Part B if you are still working and eligible for employer-sponsored health insurance, if you already receive Railroad Retirement Board benefits in the lead up to your 65th birthday. 

Keep in mind, however, that deferring Medicare enrollment during your IEP and then deciding to enroll outside of your enrollment window at a later date may result in financial penalties.

Step 2: Sign Up for Original Medicare

If you already receive Social Security retirement benefits, congratulations — you are automatically enrolled in Original Medicare Parts A and B with no further action required. If this is the case, your coverage begins on the first day of the month of your 65th birthday.

If you have not yet begun to receive Social Security, then there are a few different ways to sign up for Medicare Part A and Medicare Part B. The simplest way to do so is by filling out an online application via the SSA’s official website, but you may also enroll by phone by calling Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), 7 a.m. to 7 p.m. Monday through Friday. In addition, you can also enroll in Original Medicare in person at your local Social Security office.

Step 3: Explore Additional Medicare Options

Contrary to popular belief, Medicare (despite its federally-regulated status) is not a one-size-fits-all program. In fact, many seniors find that Original Medicare Coverage alone is simply not sufficient coverage to meet all of their individual healthcare needs. This is where Medicare Advantage comes in.

Essentially, a Medicare Part C or Medicare Advantage plan boosts the types of Medicare coverage that the Original Medicare program already offers to millions of American seniors.

In other words, these private plans take on or exceed Medicare’s coverage for medically necessary services. By enrolling in a Medicare Advantage plan, you may receive additional coverages for treatments and services not covered by Original Medicare, including but not limited to:

  • Vision care
  • Hearing care
  • Dental care
  • Transportation to and from appointments

Our friends at MedicareInsurance.com employ highly specialized, friendly, experienced, and licensed insurance agents that can help you explore and compare Medicare Advantage options in your area today. Simply give them a call at (800) 950-0608 today to get started!