When Can I enroll in Medicare?

There are two life events that trigger Medicare eligibility:

  • 1st event is when you turn the age of 65. You may join original Medicare A & B three month before the month you reach the age of 65, the month of your 65th birthday and 3 months after your 65th birthday. During this 7 months Initial Enrollment Period (IEP), you can also enroll in stand-alone prescription drug coverage – Medicare Part D, Medicare Advantage – Part C or Medicare Supplement – Medigap.

  • 2nd event is after you have been receiving social security disability income for 24 months. Then you qualify for Medicare even though you may be younger than 65.

What is Medicare Advantage?

Medicare Advantage, sometimes called Medicare Part C or MA plans are offered by private insurance companies approved by Medicare. These plans may cover expenses not covered by Original Medicare like deductibles and coinsurance. Many of the plans also offer extra benefits like prescription drug coverage (Part D), vision, dental, and hearing or wellness programs. Medicare advantage plans have hospital and doctor networks. It is very important to make sure the doctor you currently seeing is included in the Medicare Advantage plan you may be considering. 

 What is Medigap?

Medigap, also called Medicare Supplemental insurance is a plan sold by private insurance companies, designed to cover part or all the health care cost not covered by Original Medicare like deductible, copay, and coinsurance. Medigap doesn’t cover extra benefits like Medicare Part D, long term care or dental and vision insurance. There are no networks associated with the plans. As long as the doctor accepts Medicare patients he/she should accept Medicare Supplemental Insurance.

Can I delay Medicare part B enrollment?

In some cases, you can delay Medicare part B enrollment without paying higher premiums. For example, if you are 65 or older but still working for a company that provides employer coverage, you can postpone your part B enrollment as long as the employer provides health benefits equal or greater than what’s provided by Medicare. When you ready to retire and your employer coverage ends you qualify for an 8 month special enrollment period. During that time you can enroll in Medicare Part B and Medicare Part C or Medigap.

How often can I change Medicare plan?

The best time to change Medicare Advantage or Medicare Part D plan is during Annual Enrollment Period (AEP), also called Medicare Open Enrollment, which runs October 15th – December 7th each year. Another time that triggers plans change eligibility is Special Enrollment Period (SEP). Some examples of SEP are: moving to a different city, county or state where your current plan is no longer available, losing your current coverage or gaining eligibility for Medicaid. It is always wise to contact an Agent to help you navigate the Medicare options available in your area.