One of the most important things to understand about Medicare is when you’re eligible to enroll. For some Medicare plans, if you miss out on your enrollment window, it can make it difficult or even impossible to sign up for the plan you’re interested in. If you are able to sign up even though you’ve missed the deadline, late sign-up penalties could end up costing you a significant amount of money, potentially forever.
In certain circumstances, some people automatically get Medicare without having to enroll. If you think you fall into this category, double-check! You really don’t want to miss your enrollment periods.
Initial Enrollment Period For Original Medicare and Medicare Part D
This is arguably the most important date you need to keep in mind when it comes to your Medicare plans. The initial enrollment period is when you’re eligible to sign up for Medicare Part A, Medicare Part B, and Medicare Part D for the first time. This enrollment period lasts for seven months. It begins three months before you turn 65 and includes the month you turn 65, as well as three months after you turn 65. This initial enrollment period also applies to Medicare Advantage Plans.
If you don’t enroll in Medicare Part B during the initial enrollment period, you will likely have to pay a late enrollment fee. That fee is 10 percent for every 12 months that you were eligible to enroll in Medicare Part B but didn’t. It’s also important to note that this late fee lasts forever, so you will be paying ten percent more in penalties on each payment for as long as you have Medicare Part B.
If you don’t qualify for premium-free Part A and miss your enrollment window, you will be charged a late penalty of ten percent for twice the number of years that you could have had coverage but didn’t. For example, if you didn’t have Part A for two years even though you were eligible, you will pay a ten percent premium penalty for four years.
General Enrollment Period for Original Medicare
If you miss your initial enrollment period to sign up for Original Medicare, there is a general enrollment period each year that begins on January 1st and ends on March 31st. However, if you have to enroll during this general enrollment period, you will be subject to late penalties. In addition to late fees, your coverage will also be delayed until July 1st, which means you may end up being without coverage for months.
Additional Enrollment Periods for Medicare Part D
Medicare Part D has other important enrollment periods as well. If you are still working and receive health insurance from your employer, you can delay enrolling in Part D without a penalty. If you miss your enrollment period, you should be able to sign up for Part D from October 15th until December 7th during the Annual Election Period. However, in this circumstance, your prescription drug coverage won’t begin until January 1st.
Additionally, if you miss your Part D enrollment window (but you don’t have health insurance from your employer), your premium will be higher. The late penalty is an increase of 1% per consecutive month that you did not have coverage but could have. Enrolling in Medicare at the appropriate time will ensure that you don’t accrue any late fees and penalties.
Initial Enrollment Period for Medicare Supplement Plans (Medigap Plans)
As you may already know, Medicare Parts A and B do not cover one hundred percent of your healthcare costs. With Original Medicare as your only insurance, you will be responsible for twenty percent of your bills. As a way to bridge this gap, many people enroll in Medigap plans. Just like Original Medicare, it’s incredibly important to enroll on time. Your Medigap open enrollment period begins the month that you are 65 years or older and enrolled in Medicare Part B. This enrollment period lasts for six months.
During this enrollment period, Medigap companies are prohibited from turning you down for coverage. They are not allowed to ask you questions about your past or current health status, and they must offer you a policy at the best available rate. They are not permitted to increase your rates or deny coverage based on pre-existing health conditions.
If you miss your open enrollment period for a Medicare Supplement Plan, you risk not being given a plan or being given a plan at a substantially higher price. Outside of the enrollment period, the companies are permitted to ask you questions about your health status, including pre-existing conditions. They are also allowed to deny coverage based on your answers. If they do offer you coverage, there are often long waiting periods before the plan actually kicks in and starts offering you coverage.
Medicare Special Enrollment
Special enrollment allows people to make changes to their coverage due to a special circumstance. Special enrollment is very individualized and will be triggered by your specific circumstances. This window lasts for two months. For example, if you move outside of your plan’s geographical area and lose coverage, this will trigger a special enrollment period and you will be eligible to change plans. If you signed up for a Medicare Advantage Plan, you will also be permitted to switch to a different Advantage plan, or you can enroll in Original Medicare without any penalties during the Special Enrollment period.
Who Gets Medicare Automatically?
If you receive benefits from social security or the Railroad Retirement Board (RRB) at least four months before you turn 65 years old, you should automatically get Medicare Parts A and B. Coverage starts the day you turn 65 years old. In this case, you should receive your Medicare card three months before your 65th birthday.
Additionally, if you’re under the age of 65 but have a disability, you will automatically get Medicare Parts A and B in the following circumstances:
- You have been receiving Social Security Benefits for 24 months; OR
- You’ve been receiving certain disability benefits from the RRB for 24 months.
In this case, you will also receive your Medicare cards three months before you turn 65.
If you have been diagnosed with Lou Gehrig’s Disease (ALS), you will automatically get Medicare Parts A and B the month you begin receiving disability benefits.
Enroll On Time! Enroll Medicare Can Help.
It’s so important to enroll on time so you don’t face expensive penalties or denials of coverage. If you need help determining if and when you’re eligible, please call us. Our knowledgeable team is here to help you with all of your Medicare-related questions!