Your Insurance … with Michele Campbell: Understanding Medicare enrollment periods and what they mean to you

Published in the March 6 – 19, 2019 issue of Gilroy Life

Michele Campbell

Each year there are set times a person can enroll in Medicare or change existing Medicare plans. There are separate enrollment periods for Medicare Parts A and B (Original Medicare) and Medicare Part C (Medicare Advantage).

Enrollment periods include:

• Initial Enrollment Period (IEP) — the first time an eligible person can enroll in Medicare Parts A and B. This timeline begins three months before the month of a person’s 65th birthday and continues through the three months after a person’s 65th birthday. This could also be for someone younger than 65, who is disabled for 24 months and is newly qualified for Medicare.
• Initial Coverage Election Period (ICEP) — the first time a newly eligible person can enroll in a Medicare Advantage plan. This often coincides with the Initial Enrollment Period.
• General Enrollment Period (GEP) — runs Jan. 1 through March 31 each year and provides an enrollment opportunity for individuals who didn’t sign up for Original Medicare (Part A and Part B) when they were first eligible. Individuals may have to pay a late enrollment penalty for not enrolling when first eligible and coverage will not start until July 1 of that year.
• Annual Enrollment Period for Medicare Advantage and Prescription Drug Plan (AEP) — current Medicare recipients can change or enroll in Medicare Advantage coverage during this period that runs Oct. 15 through Dec. 7.
• Special Enrollment Period (SEP) — certain life events can lead to an individual being eligible for enrolling in Original Medicare or enrolling in or changing Medicare Advantage coverage.

Opportunities for a Medicare Advantage Special Enrollment Period include:

• Moving to a new location where new plan options are available
• Losing employer coverage
• Being diagnosed with a qualifying chronic condition, such as diabetes or chronic heart failure
• Moving in or out of a skilled nursing facility or long-term care hospital

The Medicare Advantage Open Enrollment Period (OEP) runs from Jan. 1 through March 31 and is new in 2019.

Beneficiaries in a Medicare Advantage only or Medicare Advantage Prescription Drug plan as of Jan. 1 can make a one-time change to:

• Switch to a different Medicare Advantage Plan
• Drop Medicare Advantage and return to Original Medicare (Part A and Part B)
• Sign up for a stand-alone Medicare Part D Prescription Drug plan, if an individual elects to return to an Original Medicare plan

The Medicare Advantage OEP is only accessible for current Medicare Advantage policyholders. During Medicare Advantage OEP, Original Medicare policyholders cannot:

• Switch from Original Medicare to a Medicare Advantage plan
• Join a Medicare Prescription Drug plan (Part D)
• Switch Medicare Prescription Drug plans

Michele Campbell is the owner of Michele Campbell Insurance. Reach her at (408) 848-2271 or email [email protected]. There is no cost for their services.