Understanding the Different Types of Enrollment Periods

Whether you are turning 65 or are already on Medicare, it’s important to be aware of the different Medicare enrollment periods. That’s right, Medicare enrollment is not a one size fits all solution. Different Medicare enrollment periods affect people in different circumstances. Let’s take a closer look at the different types of enrollment:

Automatic Enrollment

Automatic enrollment occurs typically when you are aging in to Medicare (Age 65). Some people are enrolled in Part A and Part B automatically. If you’re already receiving benefits from Social Security (such as disability) or benefits from the Railroad Retirement Board (RRB) you will automatically be enrolled in Parts A and B on the first day of the month that you turn 65.

If your birthday falls on the 1st of the month then you’ll be enrolled the first day of the previous month. Otherwise, you’ll be enrolled in your birthday month.

You’ll know you’re automatically enrolled in Original Medicare when you receive your red, white, and blue Medicare card in the mail. If you don’t want to be enrolled in Part B (and don’t want to pay the Part B premium) you must return the card by following the instructions that came with it.

Sometimes it’s better to delay your Medicare Part B coverage, particularly if you’re already covered through an employer or union. If you are employed and considering whether or not to keep Medicare Part B coverage, contact your current benefits administrator to learn more about your options.

Annual Enrollment Period

You can also enroll in Medicare Part A and B coverage, enroll in a Medicare Advantage Plan or a Supplement, or change Medicare Advantage Plans or Supplement plans during Medicare’s Annual Enrollment Period, which occurs October 15 through December 7 of each year for coverage effective January 1 of the following year.

The Annual Enrollment Period is the only time of year when you can change your coverage to a different Medicare Advantage or supplement plan. If you do not have an enrollment period that will give you the ability to leave your current plan for another plan, you still have the option of changing your coverage back to Original Medicare with or without Part D prescription drug coverage. You only have this option from January 1 through February 14 of each year. To change back to Original Medicare AND a prescription drug plan you must have originally enrolled in a private health plan with drug coverage like a Medicare Advantage Part D Plan.

Elective Enrollment

If you’re not automatically enrolled then you must elect to enroll in Medicare Part A and Medicare Part B when you’re ready and eligible. To sign up, simply call your local Social Security office, visit them in person, or go online.

Initial Enrollment Period

The period of time from the first 3 months before, the month of, and 3 months after your 65th birthday is called your Initial Enrollment Period. While you are automatically enrolled in Medicare Part A and Part B, you must enroll in a Medicare Advantage or Supplement plan during that time if you want additional coverage to begin on or within 3 months of your birthday month. If you want to delay coverage for any reason, such as if you’re covered under a group plan through an employer, spouse, etc., then you don’t have to sign up during your Initial Enrollment Period and can wait until later.

Special Enrollment Period

When you delay Medicare Part A and Medicare Part B enrollment due to other coverage you already have, but then decide you do want to enroll in Part A and B later, that creates a Special Enrollment Period (SEP). This SEP includes any time that you’re still covered by your group health plan or 8 months after your employment ends or you leave that coverage. You can also get a SEP through other means, such as if you move out of your plan’s service area, if you have Medicaid, if you qualify for Extra Help, or if you live in an institution. You will not pay a late enrollment penalty if you sign up during a SEP, despite the delay in Original Medicare coverage.

General Enrollment Period

You can also enroll between January 1 and March 31 of each year if you did not enroll during your Initial Enrollment Period in what is called the General Enrollment Period. If you enroll during this time your coverage will begin July 1. This type of election period doesn’t occur often, because other elections tend to precede it, but it is a possibility.

It’s easy to feel confused about the different types of enrollment/ election periods. If you have any questions, contact Viva Medicare at 1-888-830-VIVA or visit a Viva Health Café in Birmingham, Hoover, Montgomery, Mobile or at the Shops at Grand River in Leeds.