In Medicare terms, the word “election” means enrollment. A Medicare election period refers to the time when a person can enroll in the programs.
A person may sign up for Medicare parts A and B during the initial enrollment period, when they first become eligible for Medicare. This is determined by the person’s birthday.
Another option is the general enrollment period, which is from January 1 to March 31 of every year.
For Medicare Advantage or Part D, a person can join during the initial enrollment period or the open enrollment period, which extends from October 15 to December 7 of each year.
Below, we look at each enrollment period in detail, discuss the penalties for signing up late, and describe how to sign up.
The initial enrollment period, also called the initial Medicare election period, refers to the 7-month time frame when a person first becomes eligible for Medicare.
During this period, a person can enroll in original Medicare. This includes Part A, which covers care in facilities such as hospitals, and Part B, which covers services and supplies, including outpatient services.
If a person wants to also enroll in Part D, which is prescription drug coverage they can do so during this time.
Instead of enrolling in original Medicare, with or without Part D, some people opt for Medicare Advantage, which is sometimes called Part C.
Advantage plans are an all-in-one alternative to Medicare Parts A, B, and D. A person can enroll in an Advantage plan during the initial enrollment period.
The initial 7-month enrollment period includes:
- the 3 months before a person turns 65
- the month in which they turn 65
- the 3 months after they turn 65
If someone was not able to sign up for original Medicare during the initial enrollment period, they can do so during the general enrollment period. This runs from January 1 to March 31 every year.
Medicare offers two open enrollment periods each year. One is from January 1 to March 31, and the other is from October 15 to December 7. The rules for signing up during these periods differ.
From January 1 to March 31, a person may:
- change from one Advantage plan to another
- switch from Medicare Advantage to original Medicare and add Part D, if desired
From January 1 to March 31, an individual may not:
- change from original Medicare to an Advantage plan
- buy a Part D plan if they have original Medicare
- switch from one Part D plan to another
In the second open enrollment period, from October 15 to December 7, which is also called the annual election period, a person may:
- change from original Medicare to an Advantage plan and vice versa
- switch from one Advantage plan to another
- buy a Part D plan if they have original Medicare
- drop a Part D plan
There are some special circumstances that a person may need to consider.
Special enrollment periods for original Medicare
Medicare offers special enrollment periods during which a person can sign up for original Medicare.
A person is eligible under the following conditions:
- They or their spouse is working.
- They are insured with a group health plan or union through the employer.
A special enrollment period lasts 8 months. It starts the month after the end of an individual’s employment or the end of their group health plan insurance.
Special enrollment periods for Advantage plans or Part D
A person can make changes to their Advantage plan or Medicare Part D under various circumstances during the special enrollment periods.
The length of each of these periods is often 2 months after an individual experiences any situation that qualifies.
For example, one situation is a change of address, due to:
- a move to a new location that is not within the plan’s service area
- a move to a new location where more plan options are available
- a move back to the United States after having lived abroad
- a move into or out of an institution, such as a skilled nursing facility
- release from prison
Some other situations include:
- having lost healthcare coverage
- having the opportunity to get other coverage
- changes to a current plan’s contract with Medicare
Find other special circumstances here.
The best time to enroll in Medicare is when a person first becomes eligible. If a person enrolls later, they may encounter penalties.
If a person enrolls late in Part A, they may have to pay a monthly premium that is 10% higher.
This higher premium may be in effect for twice the number of years that the individual did not have Part A. For instance, if someone is eligible for Medicare for 3 years before they sign up, they may have to pay the higher premium for 6 years.
The penalty for enrolling in Part B late may be a premium increase of 10% for every 12-month period that a person was eligible but did not enroll.
This penalty is usually permanent, lasting as long as the individual has Part B coverage.
At this point, it may be helpful to note that Part C is Medicare Advantage, discussed elsewhere.
Medicare calculates the penalties for enrolling late in Part D in a different way.
If someone goes without prescription drug coverage for at least 63 continuous days following the end of the initial enrollment period, they may face a penalty.
To calculate it, Medicare multiplies 1% times the national base monthly premium. Then, they multiply this figure by the number of months that the person went without this coverage.
A person may enroll online for Medicare Parts A and B on the Social Security Administration’s website. They may also sign up via the phone by calling 1-800-772-1213. A third option is visiting a local social security office.
To sign up for Medicare Part D or an Advantage plan, an individual can use this online tool to choose from plans offered in their area. After selecting a plan and insurance company, a person can:
- apply on the company’s website
- fill out a paper enrollment form and mail it to the company
- phone the company
- call 1-800-MEDICARE (1-800-633-4227)
A Medicare election period is another name for a Medicare enrollment period.
A person can enroll in any Medicare program during the initial enrollment period, which is determined their birthday. This period is when a person first becomes eligible for Medicare.
It is best to sign up during the initial period. Doing so later on may require a person to face late penalties in the form of higher premiums.
Due to various circumstances, an individual may miss signing up when they first become eligible.
If this happens, they may sign up for Medicare parts A and B during the general enrollment period, from January 1 to March 31.
They may also sign up for Part D or an Advantage plan in the open enrollment period, from October 15 to December 7.