One of the many things that confuses people about Medicare is knowing when they can enroll in a Medicare health or drug plan and when they can make changes to the plan that they have. Medicare has created several different Election Periods that people can use to enroll in plans. These enrollment periods primarily regulate Medicare Advantage Plans and Medicare Drug Plans (Part D). Outside of the election periods, changes generally cannot be made. Here are the basics of what you need to know.
Initial Election Period (IEP)
When you first receive Medicare Part A, even if you don’t have Medicare Part B yet, you are eligible to enroll in a Part D Prescription Drug Plan. This is your Initial Election Period. You are not required to enroll in a Part D plan, but if you don’t have other prescription coverage, you may be penalized if you enroll in a plan at a later date.
When you first receive Medicare Part B to go along with your Medicare Part A (most receive them at the same time), you Initial Election Period to enroll in either a Medicare Advantage Plan or a Part D Prescription Drug Plan.
Your Initial Election enrollment window is:
- Three months prior to when your Medicare begins
- The month your Medicare begins
- Three months after the month your Medicare begins
Don’t be confused. Even if your Initial Election Period begins in the middle of the year, you don’t have to wait until the Fall to enroll during the Annual Election Period.
Annual Election Period (AEP)
The Annual Election Period is probably the best known enrollment period. It happens every year, and is the time when Medicare beneficiaries can enroll in plans or make changes to their existing plans. New plans go into effect January 1 of the following year. If you already have a Medicare Advantage or Part D plan, you should receive information from your current plan near the beginning of the Annual Election Period, so you’ll be able to learn of any changes to your plan and decide if you want to shop plans or enroll in a different plan.
The Annual Election Period is
- October 1 – October 14 is Pre-AEP when you can begin to shop plans for the following year.
- October 15- December 7 is when you can enroll in new plans or make changes to your current plan.
Open Enrollment Period (OEP)
The Open Enrollment Period is a new election period that many beneficiaries don’t know about. You are limited about what you can do during the OEP, but in some ways it is an extension of the AEP. The OEP begins January 1st and ends March 31st.
During the Open Enrollment Period you can:
- Leave one Medicare Advantage Plan and Enroll in another Medicare Advantage Plan
- Leave a Medicare Advantage Plan and return to Original Medicare. You can enroll in a Part D Prescription Drug Plan if you do this.
This enrollment window is available to anyone and is not based on income status or other factors.
Special Election Periods (SEP)
Sometimes people need to enroll or make changes to their plans outside of the Annual Election Period or Open Enrollment Period. Medicare has created a number of Special Election Periods that people can use if they fall into certain parameters. Here is a list of some of the most common SEPs.
- Move – If you move from one county to another, you may need to change to or become eligible for new plan in your new area.
- Loss of Creditable Drug Coverage – Folks who have Medicare A & B but get prescription drug coverage through an employer or other plan can enroll in a Medicare plan when they lose their drug coverage.
- Medicaid – People who have both Medicare and Medicaid can enroll or change plans once per quarter.
- Low-Income Subsidy – Those who are part of Social Security’s program to assist with prescription drug costs, can enroll or change plans once per quarter.