When and How You Can Enroll in Medicare

Benefits

The staggering number of people entering Medicare each day (10,000+) has us eager to share some detailed information that could prove useful.

Contrary to what you may read or hear, not everyone HAS to sign up for Medicare A & B prior to their 65th Birthday. There are circumstances that allow some to be eligible ahead of 65, (typically due to Social Security Disability) and many enroll after age 65 when they retire and lose credible coverage through their employer. Penalties do not apply when you have current credible coverage and continue to work. The option to remain on your employer’s group plan instead of transitioning to Medicare coverage is certainly a viable one.

Let’s look at the three main enrollment periods that occur:

Initial Enrollment Period (IEP):

This is a seven-month enrollment period for those who are about to become eligible for Medicare. It begins three months before the month of your 65th birthday, includes the month of your 65th birthday, and ends three months after your 65th birthday month.

Annual Enrollment Period (AEP):

This period begins October 15th and runs through December 7th of each year. During this time, you can join, drop or switch plans with an effective date of January 1st of the following year.

Special Enrollment Period (SEP):

Certain life events can allow you to make plan changes outside of the other enrollment periods. Some of these qualifying events include:

  • Loss of employer Group Coverage or Trust Fund sponsored coverage
  • Becoming dual-eligible (Medicare and Medicaid)
  • Qualification for extra help with drug plan costs
  • Your current plan ends its contract with CMS
  • You permanently move out of your health plan’s service area
  • A plan in your area is awarded 5 stars by CMS. This opens an enrollment that begins December 8th and ends November 30th of the following year.

As you near your decision to enroll in Part A & B, which may be done separately or together, it’s best to begin working on your electronic or paper application 3 months ahead of your 65th birthday or the qualifying event you are set to experience (i.e. leaving employer’s credible coverage). This will allow adequate time for paperwork to be processed and applications to be completed for the coverage you will choose to move to. Making the informed decisions can be easier if you have a Medicare Advocate, and Summit uniquely offers a dedicated specialist to help facilitate the steps beginning to end with you upon request.

Jennifer Zimmerman

Senior Account Executive/Medicare Specialist