MEDICARE

Enrollment
Periods
When can I enroll
in Medicare?

 For most people, the first time you

can enroll in Medicare is around your
65th birthday. You can also qualify to
enroll in Medicare with a qualifying
disability or medical condition.
 You can enroll in a Medicare plan in
4 different ways and times, during
your IEP, GEP, applying for SEP or
having a qualifying disability that will
allow you to enroll to a plan before
turning 65.
How Automatic Enrollment in
Medicare Works?

You will be enrolled automatically in Original Medicare Parts A and B

if:
 You are turning 65 and are getting Social Security or Railroad
Retirement Board benefits.
 You are under 65 and have received disability benefits for 24
months.
 You have ALS and start getting disability benefits.
 You will get your Medicare card in the mail a few months before
your 65th birthday or before your 25th month of getting disability
benefits. You’ll get it immediately if you have ALS.
Initial Enrollment Period (IEP)

 The Initial Enrollment Period is a 7-month window around your 65th

birthday. It covers your birth month, plus the 3 months before and
the 3 months after.
General Enrollment Period (GEP)
 When is the GEP?
The General Enrollment Period is available to you if you didn't sign up
during your IEP. The GEP runs January 1 to March 31 each year.
 When can I get additional coverage?
If you enroll in Original Medicare during the GEP, you can add a
Medicare Advantage (Part C) plan or a Medicare prescription drug
(Part D) plan between April 1 and June 30 of the same year.
Coverage starts from July 1st.
Special Enrollment Period (SEP)
 When is the SEP?
The Special Enrollment Period lets you enroll in Original Medicare
outside of your IEP due to certain life changes. For example, you might
wait to enroll if you're still working. Timing depends on when those life
changes happen.
 What if I retire after I'm 65?
You have 8 months to enroll in Original Medicare without a late
penalty. The 8-month period begins after the month your employment
or employer coverage ends, whichever comes first. This is also true if
you are covered under your spouse's employer coverage.
Special Enrollment Period (SEP)
 When can I get additional coverage?
 If you want a Medicare Advantage (Part C) plan or a Medicare
prescription drug (Part D) plan after an SEP, you need to act quickly.
You have just 2 months after the month your employment or
employer coverage ends to enroll in a Medicare Advantage (Part
C) or Medicare prescription drug (Part D) plan—but you have to
enroll in Original Medicare first.
Thinking about changing plans?

 1. You don't have to keep your current coverage forever. If

you're considering changing plans, be sure to think about your
health care and budget needs

 2. Consider the KEY ENROLLMENT PERIODS

• AEP – Annual Enrollment Period: Oct 15th – Dec 7th each year
• SEP – Special Enrollment Period: +2 months after notifying plans
For example moving to a different location with no coverage, losing
your job
• Medicare Supplement Open EP: +6 months after turning 65
Medicare When Working Past 65

 If an employer has 20 or more employees, generally you can choose to

delay Medicare enrollment, drop your employer cov erage for Medicare, or
have both Medicare and employer cov erage.
 If an employer has fewer than 20 employees, generally you will need to
enroll in Medicare during your Initial Enrollment Period.
 If you have health coverage through a spouse’s employer, you may be able
to delay or you may need to enroll at age 65. You can have both Medicare
and the employer cov erage. What you can do will depend on the
employer’s rules.
 Ev en if you plan to keep working, you still have a 7-month Initial Enrollment
Period (IEP) when you turn 65. If an employer has fewer than 20 employees or
your spouse’s employer requires you to get Medicare to remain on their plan This Phot o by U nknow n aut hor is licensed under CC BY-SA.
as a dependent, you will need to enroll during your IEP to av oid late
enrollment penalties. You may also decide enrolling in Medicare is your best
choice ev en if you can delay, and in this case, enrolling during your IEP is a
good idea
 Special case: Disabilities
➢ 1. If you have a disability for over 24 months (2 years)

• You'll be automatically enrolled in Original Medicare

• Coverage starts the month you receive your 25th disability check
• You still have an IEP, your 25th month of disability, 3 months prior and
3 months after
➢ 2. You are diagnosed with ALS or ESRD
• ALS: automatically enrolled the month your benefits kick in
• ESRD: you must be eligible
 Amyotrophic lateral sclerosis (ALS): A nervous system disease that
weakens muscles and impacts physical function.
 End-stage renal disease (ESRD): is the last stage of chronic kidney
disease. When your kidneys fail, it means they have stopped
working well enough for you to survive without dialysis or a kidney
transplant.