Enrolling in Medicare Plans
There are a variety of times you can enroll in or change Medicare plans and supplements. Ads may announce it is Medicare Open Enrollment time, but it might not be true for your type of plan, your circumstance, or even where you live (yes, it can vary by state). Additionally, it is best to take advantage of opportunities for “guaranteed issue” on your new policy – that means that you can’t be denied coverage based on your medical history.
We can help you review your options! But, here are some basic guidelines on Medicare Enrollment Periods that allow people to enroll or switch plans without the possibility of being declined coverage:
When you are first eligible for Medicare, you can apply for coverage on any supplemental or prescription drug plan during the three months before and three months after your 65th birthday month. You cannot be denied coverage during that time.
If you remained on an employer’s plan after turning 65 and are now leaving that job, you have two months after leaving to apply for Part B and any supplemental coverage, also without the possibility of being denied coverage. (Note: you can only stay on an employer’s plan if there are at least 20 employees. Otherwise, you must enroll in Medicare when you are first eligible.)
Changing your Medicare Part D plan can be done from Oct. 15 to Dec. 7 and the change will take effect Jan. 1.
Moving to or from a Medicare Advantage Plan from original Medicare can be done from Oct. 15 to Dec. 7 and takes effect Jan. 1. If you are in a Medicare Advantage Plan and want to enroll in a different one, it can also be done during the annual enrollment period during first quarter of the year.
If you changed plans and are unhappy, you generally have to wait until the next available period. However, if you switched to a Medicare Advantage plan for the first time and are not satisfied, you can usually switch back to Original Medicare within the first 12 months.
Part A/Part B general enrollment is Jan. 1 – March 31 for those who did not sign up when first eligible. The coverage usually begins in July of that year. You can apply for supplemental coverage during that time as well.
It’s your birthday, and you want to change Medicare Supplement plans. In California, your birthday creates a 60-day window during which you can chance to another plan with equal or lesser benefits without medical underwriting. The Birthday Rule originated in California, but variations are now in 9 other states. The concept recognizes that rates go up as you get older and rates at that age may be lower with another carrier. (In states without a birthday or anniversary rule, you can only change Medicare Supplement plans if you are approved by underwriting.)
Additionally, an insurance company or the government may declare a special enrollment period that provides a new opportunity. For example, one insurer offered guaranteed enrollment for Medicare Supplements for a few months. Natural disasters often lead to a special enrollment period too.
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We are not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent nine organizations which offer 21 prescription drug plans and countless other products in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program to get information on all of your options. The purpose of this communication is the solicitation of insurance.