Understanding Medicare Enrollment Periods

August 14, 2023


If you’re considering changing your Medicare health plan or Part D drug plan, it’s important to be aware of the specific enrollment periods set by Medicare. Unlike regular health plans, Medicare allows changes only during designated periods. These enrollment periods are crucial for making changes to your plan for various reasons, including special circumstances.

Special Enrollment Periods (SEP) are available for individuals to make changes for many different reasons. In some cases, Medicare grants unique special enrollments due to hazards or catastrophes, such as fire, drought, or severe weather events.

It’s worth noting that there’s an exception when you have a Medicare Supplement plan. In California, there’s an Open Enrollment period during your birthday timeframe, which enables you to change your Medicare Supplement without having to answer medical underwriting questions.

The main enrollment periods mentioned here are applicable specifically to Medicare Advantage and Part D Prescription Drug plans:

  1. Initial Enrollment Period (IEP) – This period allows new Medicare enrollees to add a Medicare health plan and/or drug plan (PDP). It spans 7 months, beginning three months before the person’s 65th birthday month, includes the birthday month itself, and continues through the three months following the 65th birthday.
  2. Annual Enrollment Period (AEP) – This period, running from October 15 to December 7, is for current Medicare recipients to change or enroll in Medicare Advantage and Prescription Drug Plans.
  3. Special Enrollment Period (SEP) – Eligible individuals can enroll in Original Medicare or change Medicare health plans and/or drug coverage during this enrollment period, which extends throughout the year. Some examples of qualifying life events include moving to a location with new plan options, losing employer coverage (due to retirement or being laid off), being diagnosed with a qualifying chronic condition (e.g., diabetes or chronic heart failure), moving into or out of a skilled nursing facility or long-term care hospital, and gaining or losing MediCal.
  4. Medicare Advantage Open Enrollment Period (MA-OEP) – From January 1st to March 31st, those already enrolled in an Advantage plan can make one change during this 3-month period. They can switch to a different Advantage plan or return to Original Medicare and add a drug plan. Adding a Supplement during this period may require going through underwriting, and approval is not guaranteed.

Being aware of these enrollment periods is essential for making informed decisions about your Medicare health plan and Part D drug coverage. Take advantage of the appropriate enrollment period that aligns with your specific circumstances to make the necessary changes to your Medicare plan.

If you need any help, please feel free to call us at 408-848-2271 or email michele@mcInsurance.com.

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