Medicare General Enrollment Period (2020)
What is the General Enrollment Period for Medicare (GEP)?
If you do not sign up for Medicare during your Initial Enrollment Period, you can still sign up for Original Medicare (Part A and Part B) during the General Enrollment Period (GEP).
The GEP takes place from January 1 through March 31 every year. If you enroll during the GEP, your coverage will start on July 1.
What happens if you don’t sign up for Medicare at 65?
For most people, their Initial Enrollment Period takes place during a 7-month window sandwiched around when they turn 65. This includes three months before and three months after the month they celebrate their birthday.
If you don’t sign up during your IEP, you could face late enrollment penalties.
If you are already covered under another health insurance policy, you can sign up for Original Medicare without paying a premium penalty if you qualify under a Special Enrollment Period provision.
How the General Enrollment Period Works
While the GEP gives you flexibility if you didn’t sign up when you were first able to do so, you may have to pay late enrollment penalties if you join during this period.
For Part A, penalties can increase by 10% for twice the number of years that you decided to opt-out of coverage. So, if you did not sign up for Part A coverage during your IEP and waited two years, you might have to pay a 10% penalty for four years.
Can You Delay Signing Up for Medicare Part B?
You have the freedom of choice when it comes to signing up for Part B Medicare. Just be aware that if you delay, unless you meet requirements that exempt you, such as qualifying for a Special Enrollment Period, or getting payment help, you could pay more for the same coverage.
If you delay for Part B, the premium penalty goes up 10% for every 12 months you were eligible but did not sign up. If you delayed signing up by two years, you would pay a 20% enrollment penalty for as long as you are enrolled in Part B going forward.
Can you sign up for Part B Medicare anytime?
No. You can enroll in Part B during the GEP, but you are restricted to other certain periods when you can sign up for Part B. For details, see the enrollment period information below.
General Enrollment Period for Medicare Advantage Plans (Part C)
The GEP does not include the option of enrolling in a Medicare Advantage Plan. However, you can enroll in a Medicare Advantage Plan if you enroll in a Part B plan during the GEP. Before you can enroll in a Medicare Advantage Plan, you must already be enrolled in Part A and Part B.
You can enroll in a Medicare Advantage plan only at other specific times throughout the year. This includes your Initial Enrollment Period, and the Medicare Open Enrollment Period taking place from October 15 through December 7 annually.
If you qualify for a Special Enrollment Period (SEP), you can make changes or add a Part C plan during that time as well. See details below on how to qualify for an SEP, which can take place at any time, depending on your individual circumstances.
The only other time you can join a Medicare Advantage Plan is if you have end-stage renal disease (ESRD), but only if it is a Special Needs Plan that specifically accepts people who have ESRD.
How the General Enrollment Period works Prescription Drug Plans (Part D)
You can enroll in a Prescription Drug Plan as a stand-alone action or when you enroll in a Medicare Advantage Plan, but you can do so only at designated times of the year.
The only way you can enroll for a Prescription Drug Plan at any time is if you qualify for Extra Help, which is for people with low incomes and limited assets.
If you enroll in Part A and/or Part B plan during the GEP, you can enroll in a Prescription Drug Plan from April 1 through June 30, with coverage beginning on July 1. Otherwise, you can enroll in a Part D plan during your IEP or an SEP.
How the General Enrollment Period Works with Medicare Supplement Plans (Medigap)
You can buy a Medigap policy during your Medigap Open Enrollment Period, which is a six-month period that starts the month you turn 65, and you are enrolled in Medicare Part B.
After this, you may still be able to buy a policy, but it could cost more due to past or present health problems. So, if you buy a Medicare Part B plan during the GEP, you’ll qualify to buy a Medigap policy as well.
General Enrollment Period and Medicare Savings Programs
You can qualify for Medicare financial assistance at any time during the year, including the GEP.
Medicare Savings Programs (MSP) help you pay for Part A and Part B premiums, copays, deductibles, and coinsurance costs if you have limited income and assets. The threshold varies for each of the three programs, which include:
- Qualified Medicare Beneficiary Program (QMB)
- Specified Low-Income Medicare Beneficiary Program (SLMB)
- Qualified Individual Program (QI)
If you receive Medicare benefits and meet Medicaid eligibility requirements for your state, you may qualify for both programs (known as dual-eligible).
If you qualify for any of the MSPs, then you also automatically qualify for Extra Help, which helps you to pay for your prescription drugs.
What are the different Medicare enrollment periods?
There are several enrollment periods for various parts of Medicare. It can be a bit confusing and overwhelming if you’re not familiar with the requirements that apply to your particular situation.
Initial Enrollment Period (IEP)
-include: “first time” “birthday month” “medicare initial enrollment period.”
Your Initial Enrollment Period (IEP) is the first time you can sign up for Medicare. For most people, this is when they turn 65.
Your IEP begins three months before the month you turn 65, includes the month you turn 65, and the three months following the month of your 65th birthday. During this 7-month window, you can sign up for Medicare Part A and Part B, and add a Part C and/or Part D plan as well.
If you’re already getting Social Security benefits when you turn 65, you’ll be automatically enrolled in Part A and Part B. There is a cost for Part B coverage, so you’ll be given the opportunity to opt-out if you prefer. You can also decline Part A coverage, but since it’s free for most people, there’s no downside to doing so.
If you don’t qualify for free Part A coverage (usually because you haven’t paid enough Medicare taxes during your working years), you can still sign up during your IEP, but you may have to pay a premium. The amount will depend on how long you worked and paid Medicare taxes.
Special Enrollment Period (SEP)
Your Special Enrollment Period (SEP) can take place at any time during the year.
If you delayed enrolling in Part B because you already had coverage, but that coverage ends, either through your employer terminating your healthcare benefit (including COBRA coverage) or you lose your job, you can take advantage of a SEP that lasts 8 months. This includes coverage either through you or your spouse.
If you can enroll for Part B during a SEP, you won’t have to pay a late enrollment penalty that might otherwise be due.
For Part C and Part D coverage, there are several circumstances when a SEP will apply, including:
- If you move to a new place and you have different insurance options, you can use a SEP to change plans or revert back to Original Medicare.
- If coverage ends through your employer or your union group health plan, you have a 2 month SEP for Part C and Part D that starts the month after your coverage ends.
- If you’re eligible for Medicaid benefits, a SEP that allows you to enroll or change Part C or Part D plans at any time. When you lose your Medicaid benefits, you have a 3 month SEP to switch to a Part C and Part D plan starting with the month you’re notified that you’re losing Medicaid eligibility.
- If you qualify for Extra Help (for Part D coverage), you have an open-ended SEP for as long as you qualify for Extra Help. When you no longer qualify for Extra Help, you have a 3-month SEP beginning with the month you’re notified you are losing your low-income subsidy.
- If you live in an area with a Part C or Part D plan that has an overall plan performance rating of 5 stars, you can join that plan from December 8 through November 30.
There are other instances that allow you to use SEPs to enroll in Part C and Part D coverage.
Contact Medicare directly if you have questions about whether you qualify or not.
Medicare Advantage Open Enrollment Period
The Medicare Advantage (Part C) OEP runs January 1 through March 31 annually.
During this time, beneficiaries already enrolled in a Part C plan to make a one-time change.
Specifically, you can switch from one Part C plan to another, disenroll from a Part C Plan and return to Original Medicare (Part A and Part B) with or without a Part D prescription drug plan.
Beneficiaries often make changes during this period because they didn’t fully understand their benefits when they signed up for a Part C plan initially, or their doctors are leaving their network, or the network has offered more restrictive coverage.
Annual Enrollment Period (AEP)
The Annual Enrollment Period (AEP) takes place from October 15 through December 7 each year.
During the AEP, you can change, drop, or add Medicare Part C and Part D coverage for the coming year. Changes you make go into effect on January 1 of the following year.
You are made aware of what those changes are in advance. Each September enrolled, participants receive an Annual Notice of Change letter. Once you have this letter, you have accurate information you can use to compare existing and new coverage to see if a different plan makes more sense for you.
Specific changes you can make during the AEP include:
- Change to or from a Medicare Part C plan from Original Medicare, Part A, and Part B.
- Change from one Medicare Advantage plan to another.
- Add a Medicare Supplement Plan.
- Enroll in a Part D prescription drug plan.
- Change from one Medicare Part D plan to another.
- Completely drop out of Medicare Part D coverage.
Medigap Open Enrollment Period (OEP)
If you want the best prices on a Medicare Supplement (Medigap) plan, the best thing to do is to buy on while you’re eligible during your Open Enrollment Period (OEP).
If you’re 65 or older, your Medigap OEP is a six-month period that starts the first day on the month you’re enrolled in Medicare Part B.
During this time, you can buy any policy sold in your state, and you can’t be denied coverage, even if you have pre-existing health issues. You also must be sold that policy at the same price a healthy person would be able to buy it.
If you attempt to buy a Medigap policy at a later time, you could be denied coverage if you don’t meet their underwriting requirements in most cases. And even if you do qualify, you could end up paying more.
You will get more choices and better prices if you buy a Medigap policy when you’re first eligible during your 6-month Medigap Open Enrollment Period. In fact, you can buy any policy sold in your state during this time.
If you’re under 65, federal law does not require insurers to sell you a policy, although it is a requirement according to some state laws.
If you have employer group insurance and you put off buying Part B coverage for that reason, your OEP would begin at the later date when you finally do enroll in Part B.
Some states also allow you to buy a Medicare SELECT policy. This type of policy requires you to use in-network hospitals and, in some cases, in-network doctors to enjoy full benefits.
How do I change my Medicare plan?
Medicare beneficiaries have several chances to change coverage throughout the year if they qualify under the terms of specific enrollment periods. You can enroll, switch, add, or disenroll from coverage depending on how your health insurance needs change.
Your medical coverage and health care needs may be significantly impacted by qualifying events such as job loss, retirement, plans no longer being offered in your service area, and many other similar situations.
Depending on your situation, you may need to contact Medicare directly or work with an experienced agent who can walk you through the steps.
What you need to know about Medicare enrollment
You need to meet specific requirements before you can enroll in the various parts of Medicare. In general, these include:
- You must be 65 or older or under 65 with a qualifying disability or condition.
- You must be a U.S. citizen. You are also eligible for Medicare if you are a permanent legal resident who has lived in the United States for at least five consecutive years.
- You are already receiving Social Security benefits or Railroad Retirement Board benefits.
- You are disabled and receiving SSDI or Railroad Retirement Board disability insurance benefits. You do not need to be 65, but in many cases, there is a two-year waiting period after you start receiving disability benefits before you can receive Medicare benefits.
- You have end-stage renal disease (ESRD). This can be at any age. To qualify for Medicare, your kidneys must no longer function, you need regular dialysis, or you have had a kidney transplant.
- You have amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS). If you suffer from ALS, there is no two-year waiting period. Medicare benefits kick in when your SSDI benefits begin.
- To receive free Part A benefits, you or your spouse normally would have had to pay 40 quarters (10 years) of Medicare taxes during your working life. If you paid into the system less than that threshold, you can still get Medicare, but you’ll probably have to pay for Part A benefits.
If you have limited income and assets, you may be able to qualify for a Medicare Savings Program (MSP). These are administered by state agencies and can help pay for premiums, copays, deductibles, and coinsurance costs.
Three MSPs help you pay for Original Medicare and Part B costs. They are:
- Qualified Medicare Beneficiary Program (QMB)
- Specified Low-Income Medicare Beneficiary Program (SLMB)
- Qualified Individual Program (QI)
Each of these has different assets and income limits, which may be slightly higher in Alaska and Hawaii.
If you qualify for an MSP, you also automatically qualify for Extra Help (also known as Part D Low Income Subsidy). This program assists by paying for your prescription drug costs.
How to apply for Medicare in 2020
Part A and Part B
If you’re over 65 or you’re turning 65 within the next three months, you can enroll in Part A and/or Part B online through Social Security or in person at your local Social Security office.
You can also call Social Security at 1-800-772-1213 (TTY users 1-800-325-0778), Monday through Friday, from 7 am to 7 pm.
If you worked at a railroad, enroll by calling the Railroad Retirement Board at 1-877-772-5772 (TTY users 1-312-751-4701). Assistance is available Monday through Friday, from 9 am to 3:30 pm.
Part C and Part D
Because there are dozens of options to choose from, you should compare plans and enroll in the one that best meets your particular needs. We suggest working with an expert agent who will provide the guidance you must have to make the right choices.
The Medicare website has a Medicare eligibility and premium calculator to help you sort through your options and eligibility.
For general information on Medicare, including more details on how to enroll, visit the Medicare website.