What is an Enrollment Period? There are only a few specific times each year and a few special situations when you can enroll in a Medicare Advantage, or Prescription Drug Plan. There are also strict rules during these time periods in regards to changing your health plans. For example, switching from a Medicare Advantage Plan to a Medicare Supplement, or adding Prescription Drug coverage to an existing plan, or dropping coverage altogether.
This guide will help you determine if and when you can make changes to your current health insurance coverage.
Initial Enrollment Period (IEP)
For most people this begins three months before turning 65, it continues through the month you turn 65 and ends three months after. During this time, you can enroll in a Medicare Advantage Plan (MA), or Prescription Drug Plan (PDP). You can only enroll in both at the same time if your MA Plan is a Private-Fee-For-Service (PFFS), and does not offer drug coverage.
If you are provided prescription drug coverage through a Medicare Advantage Plan, that type of plan is called an MAPD.
Your IEP is also the best time to enroll in a Medicare Supplement plan because there is no medical underwriting. This is your “Guarantee Issue Right”
You can also purchase a standalone PDP with your Medicare Supplement.
Annual Election Period (AEP)
This enrollment period occurs every year between October 15th and December 7th. At this time, you can make changes to your current coverage that will go into effect January 1st of the following year.
During the AEP you can:
Enroll in a Medicare Advantage or Prescription Drug Plan for the first time
Switch Medicare Advantage or Prescription Drug Plans
Switch from a Medicare Supplement to a Medicare Advantage Plan
Medicare Advantage Disenrollment Period (MADP)
This enrollment period is from January 1st until February 14th every year.
During this time, you can drop your Medicare Advantage Plan and return to Original Medicare. If the plan you dropped were an MAPD, you could also purchase a standalone PDP to replace your lost drug coverage. If you return to Original Medicare, you can also buy a Medicare Supplement, but it will not necessarily be guaranteed issue.
Special Election Period (SEP)
These are particular situations which can trigger this type of enrollment period. Here are some of the most common circumstances that will qualify you for an SEP.
You move out of your plan’s are of service
You move into an institution, for example, a nursing home
Your plan’s contract with Medicare ends or it’s terminated
If you qualify for extra help
Another type of SEP is a 5-star Special Election Period.
Medicare Advantage and Prescription Drug Plans are rated using a scale from 1-5, with 5 being the very best or “excellent”. Medicare gives a rating based on customer satisfaction surveys and provider feedback.
With this enrollment period, you can switch from any plan that doesn’t have a 5-star rating to one that does. You can exercise this option only once per year between December 8th and November 30th.
If you think you are eligible for an SEP, you can confirm by calling 1-800-MEDICARE.