Understanding Medicare Enrollment Periods

We often hear about the Annual Election Period (AEP), but what about the other important enrollment periods for Medicare? Understanding these can help ensure you’re taking full advantage of your options and timelines. 

Special Election Periods (SEPs) 

If you missed AEP, you might qualify for a Special Election Period (SEP), depending on your circumstances. SEPs allow beneficiaries to make changes outside the usual enrollment windows under specific conditions. Examples include: 

• Change of Address: Moving out of your plan’s service area. 

• Loss of Coverage: Losing employer or union coverage. 

• Medicaid/LIS Eligibility Changes: Gaining or losing Medicaid or Low-Income Subsidy status. 

• Institutional Status: Moving into or out of an institution, such as a nursing home. 

• Natural Disasters: SEPs may be granted for beneficiaries affected by declared disasters. 

Medicare beneficiaries can determine if they qualify for an SEP by reviewing their current circumstances and consulting Medicare’s official resources or speaking with a licensed Medicare agent. Each SEP has specific rules and timelines, so it’s crucial to act promptly to avoid losing coverage options.  

Initial Enrollment Period (IEP) or Initial Coverage Election Period (ICEP) 

The IEP is a seven-month window starting three months before your 65th birthday, including your birthday month, and ending three months after. During this time, you can: 

• Enroll in Medicare Parts A and B. 

• Choose between a Medicare Supplement (Medigap) plan or Medicare Advantage (Part C). 

• Add Prescription Drug Coverage (Part D). 
  
  

Medigap Open Enrollment Period 

This six-month window begins when you turn 65 and are enrolled in Part B. During this time, you can: 

• Enroll in a Medigap plan without medical underwriting. 

• Receive standard premium rates regardless of health conditions. 
  
  

Guaranteed Issue Rights for Medigap 

If you miss your Medigap Open Enrollment, you may still qualify for certain plans under Guaranteed Issue Rights. This applies if you lose other creditable coverage or delay Part B enrollment due to employer coverage. However, your plan options may be limited. 

General Enrollment Period (GEP) 

The General Enrollment Period runs from January 1 to March 31 each year. It is for individuals who did not enroll in Part A and/or Part B during their IEP. For example, someone might have missed their Initial Election Period due to a lack of awareness about eligibility timelines or because they were covered by an employer group plan and assumed it was sufficient.  

• After enrolling in Part B during GEP, you can sign up for a Medicare Advantage plan between April 1 and June 30 for coverage starting July 1. 

Medicare Advantage Open Enrollment Period (OEP) 

From January 1 to March 31, beneficiaries already enrolled in Medicare Advantage plans can: 

• Switch to a different MA/MAPD plan. 

• Disenroll from their MA/MAPD plan and return to Original Medicare (and add a Part D plan). 

This period is not for those on Original Medicare wanting to switch to a Medicare Advantage plan or enroll in Part D. 

Annual Election Period (AEP) 

AEP occurs from October 15 to December 7 each year. During this time, beneficiaries can: 

• Enroll in or switch Medicare Advantage (Part C) or Prescription Drug (Part D) plans. 

• Review and make changes based on upcoming plan changes for the next year. 

Any changes made during AEP become effective January 1 of the following year. Beneficiaries are encouraged to review their Annual Notice of Change (ANOC) to avoid being surprised by plan changes. 

Why is AEP Important? 

AEP is a critical time to evaluate your plan. Health and prescription needs can change, as can plan benefits and costs. Reviewing your options ensures you’re in the best plan for your needs. 

If you make a choice during AEP and later realize it doesn’t suit your needs, you can make adjustments until December 7. After that, you may need to wait for the OEP or qualify for an SEP. 

Questions? 

Are you turning 65 soon? Are you considering changes to your Medicare coverage? Do you anticipate a move or other life changes that might qualify you for an SEP? Let’s talk and explore your options! 

If you have questions or need assistance finding a health plan, call one of our Licensed Agents at Trusted Senior Specialists.

There is no cost or obligation for a consultation! 

We are available Monday through Friday from 8 AM to 8 PM CST,
and on Saturday by appointment.
You can reach us by calling: 1-855-952-1941 TTY: 711
 By calling this number you may be connected with a licensed agent