Missing a Medicare deadline can have important long-term financial consequences. It may mean more money out of pocket for care, or higher penalty premiums for the rest of your life.
Initial Enrollment Period
Your initial enrollment period starts three months before the month in which you turn 65, and lasts until the end of the third month after the month in which you turn 65. Missing this initial enrollment window may result in late-enrollment penalties, unless you qualify for a special enrollment period.
Enrollment is automatic for Parts A and B, but if you want to enroll in a Medicare Advantage program or a Medicare Part D (prescription drug) plan, it's important to meet this deadline. But, don't wait until the month in which you turn age 65 to enroll. If you wait beyond the end of the month before you turn 65 to enroll in Part B, your Part B coverage could be delayed. This would result in a gap in your coverage. If you have a medical event before your Part B coverage kicks in, you could then face significant out-of-pocket expenses.
You can sign up at the Social Security office, or apply online at www.SocialSecurity.gov.
Medicare Supplement (Medigap) Deadlines
Medicare Supplement plans, also known as "Medigap" policies, also impose enrollment deadlines. These are additional insurance policies from private carriers that help cover deductibles, copays and additional services that aren't covered under Medicare.
Typically, you have six months from the time you enroll in Medicare to purchase a Medigap policy and still get guaranteed acceptance, regardless of your medical condition. If you aren't in good health, your carrier could deny coverage altogether if you're not enrolled.
General Enrollment Period
If you don't sign up for Part A and Part B during your initial enrollment period, you can do so during the general enrollment period, which is between January 1 and March 31 each year. You'll have to pay additional penalty premiums, and your coverage won't begin until July 1.
Special Enrollment Period
You may be able to avoid late Medicare enrollment premiums and penalties under certain limited circumstances.
You may qualify for a special enrollment period if:
You or your spouse (or other family member if you're disabled) are working; or
You're covered by a group health plan (excluding COBRA and retiree health plans).
If you want to join or switch your Medicare Advantage (Part C) or prescription drug (Part D) plan, you generally need to do so during the open enrollment period for these plans, from October 15 through December 7.
During this period, you can choose to do the following:
Switch from Original Medicare (Part A and B) to Medicare Advantage;
Switch from Medicare Advantage back to Original Medicare;
Switch from one Medicare Advantage plan to another;
Switch from a Medicare Advantage plan that doesn't offer drug coverage to one that does;
Switch from a Medicare Advantage plan that offers drug coverage to one that doesn't;
Join a prescription drug (Part D) plan;
Switch between Part D plans; or
Drop your Medicare prescription drug coverage altogether.
Note: If you want to switch from Medicare Advantage back to Original Medicare, you can do so from January 1 through March 31 You can also add prescription drug coverage to Original Medicare, but you have to do so before February 14.
Navigating the Medicare system isn't easy. If you're in doubt, call us.
We can help you make sense of the choices, evaluate the pros and cons, and help you make sure you're making the right decision.