Medicare Enrollment Periods
This article was updated on: 03/08/2016
New to Medicare: Initial Enrollment Period
When you turn 65, you will automatically be enrolled in Medicare Part A and Medicare Part B if you are receiving benefits from Social Security or the Railroad Retirement Board.
If you are 65 and not yet receiving Social Security or Railroad Retirement Board benefits (because you’re still working), Medicare enrollment may work differently. If you aren’t already getting retirement benefits when you turn 65, you won’t be automatically enrolled in Medicare Part B and will need to sign up during your Initial Enrollment Period. If you have coverage through active employment and choose to delay enrollment in Medicare Part B, you will be given a Special Enrollment Period that starts when you stop working or your employer-sponsored health insurance ends. If you don’t sign up during this time, you can do so during the General Enrollment Period, but may owe a late-enrollment penalty (see below for more details).
On the other hand, Medicare Part A enrollment if you’re still working at 65 will depend on if you have enough work history to get Part A without a premium. If you’ve worked at least 10 years (40 quarters) and qualify for premium-free Medicare Part A, you’ll be automatically enrolled in Part A when you turn 65 even if you’re still working at the time. However, if you don’t have enough work quarters to get Medicare Part A without a premium, you’ll also need to manually enroll in Part A.
If you need to sign up for Part A and/or Part B, you can sign up during the following times:
- Initial Enrollment Period — When you are first eligible for Medicare, you have a seven-month period to sign up. This seven-month period begins three months before your 65th birthday, includes the month you turn 65, and ends three months after you turn 65.
- General Enrollment Period — If you miss your Initial Enrollment Period, you can sign up between January 1 through March 31 each year. Your coverage will begin July 1. You may have to pay a higher premium for late enrollment.
- Special Enrollment Period — If you or your spouse (or family member if you are disabled) is currently working and you are covered by a health insurance through an employer or union, you will have a Special Enrollment Period when your coverage ends. There is also a Special Enrollment Period for international volunteers if you are serving as a volunteer in a foreign country.
For example: If your 65th birthday is October 20, 2014 and you automatically qualify for Medicare, your Medicare effective date would be October 1, 2014. If your birthday is on the first day of the month, Medicare Part A and Part B will be effective on the first day of the prior month. So then, if your 65th birthday is October 1, 2014, your Medicare effective date would be September 1, 2014.
If you are under age 65 and receiving Social Security or Railroad Retirement Board disability benefits, you automatically get Part A and Part B after you get disability benefits from Social Security or certain benefits from the RRB for more than 24 months. You will get your Medicare card in the mail three months before your 65th birthday or your 25th month of disability.
If you have ALS (amyotrophic lateral sclerosis, also called Lou Gehrig’s disease), you automatically get Part A and Part B the month your disability benefits begin.
If you have end-stage renal disease (ESRD), different rules apply. You can contact the Social Security Administration to learn more about Medicare eligibility because of end-stage renal disease by calling 1-800-772-1213, Monday through Friday, from 7AM to 7PM (TTY users can call 1-800-325-0778).
Changing plans: Annual Election Period
The Annual Election Period, which is when you can change your Medicare health or prescription drug coverage, is October 15 through December 7. You coverage will begin January 1 of the following year, as long as the plan gets your enrollment request by December 7. In most cases, you must stay enrolled for the calendar year.
|October 15 through December 7|
|If you currently have this type of Medicare coverage:||You can:|
|Original Medicare||Switch to a Medicare Advantage plan with prescription drug coverage.|
|Switch to a Medicare Advantage plan without prescription drug coverage.|
|Join a Medicare prescription drug plan, if you do not have one.|
|Drop your Medicare prescription drug coverage completely, if you have one.|
|Switch from one Medicare prescription drug plan to another Medicare prescription drug plan.|
|Stay with your current plan.|
|Medicare Advantage plan||Switch to Original Medicare.|
|Switch from one Medicare Advantage plan to another Medicare Advantage plan.|
|Switch from a Medicare Advantage plan that doesn’t offer drug coverage to another Medicare Advantage plan that offers drug coverage.|
|Switch from a Medicare Advantage plan that offers drug coverage to another Medicare Advantage plan that doesn’t offer drug coverage.|
|Stay with your current plan.|
Note: Individuals in a Medicare Advantage plan can also make changes during the Medicare Advantage Disenrollment Period that runs from January 1 through February 14. During this time, you can leave your Medicare Advantage plan and return to Original Medicare. If you use this election period to disenroll from a Medicare Advantage plan, you are also given a Special Election Period to enroll into a stand-alone Medicare prescription drug plan.
If you think you may want to switch Medicare plans, the Annual Election Period is the time to do so.
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