Once you’ve decided you’re ready to enroll in a Medicare Part D plan or make changes to your existing plan, it still may not be as easy as simply applying. Like all Medicare plans, you can only enroll or make changes during certain periods throughout the year. It’s important that you are familiar with all of the enrollment periods for Medicare Part D to ensure you don’t have a gap in coverage.
Initial Enrollment Period
Your first chance to sign up for Medicare Part D Prescription Drug coverage is called the Initial Enrollment Period (IEP). The Initial Enrollment Period begins 3 months before the month you turn 65 and ends 3 months after the month you turn 65.
If you are enrolling in Medicare under the age of 65 because of a qualifying disability you will have a similar Initial Enrollment Period; however, the period will begin 3 months before your 25th month of receiving Social Security or Railroad Retirement Board benefits and end 3 months after. Even if you enroll in the 3 months prior to the 25th month, you will not receive benefits until then.
Annual Enrollment Period (AEP)
Did you pass up on enrolling in a Medicare Part D Prescription Drug plan when you turned 65 or do you dislike the plan you’re currently in?
Don’t worry, you have an opportunity to enroll and make changes during the Medicare Annual Enrollment Period (AEP). The Annual Enrollment Period is open from October 15 to December 7 every year, with plans going into effect on January 1 of the following year. The Annual Enrollment Period is also when you can drop Medicare Prescription Drug coverage entirely.
Special Enrollment Periods (SEP)
If you missed the opportunity to enroll during either your IEP or AEP, you may still be able to enroll or make a change. There are a variety of circumstances that can allow you to become eligible for a Special Enrollment Periods (SEP).
In addition to qualifying for a Special Enrollment Period, you must also meet all other applicable Medicare Part D eligibility criteria. Each Special Enrollment Period has different rules regarding when changes can be made and the type of changes available. Notifying your plan as far in advance as possible can help increase the amount of time you have to make changes.
Some common circumstances that may qualify for a Special Enrollment Period include:
- Residency changes can impact your Medicare coverage. You might move to an area outside of your plan’s service area, or maybe your new location has opened up additional plan options. In either situation, you have the opportunity to switch to a different plan during the Special Enrollment Period that begins either the month before or during your move and is open for the following 2 months.
- If you’re moving back to the United States you’ll be able to join a Medicare Prescription Drug Plan or Advantage Plan for 2 full months from the time you arrive.
Loss of coverage
- If you’ve recently left a job, or your previous coverage is no longer considered “creditable”, you will have 2 full months from the time your coverage ends, or from the time you are notified, to enroll in a Medicare Part D prescription drug plan.
Other coverage opportunities
- If you are wanting to enroll in other coverage through your employer or union you can terminate your Medicare Prescription Drug Plan to do so whenever your employer or union allows changes to be made.
- If you have or are going to enroll in other coverage that is as good as Medicare, you can drop your current Medicare Prescription Drug Plan at any time.
Contract changes with your plan
- If Medicare chooses to terminate the contract for the Prescription Drug Plan you are currently enrolled in you will have 2 months before and 1 month after the contract ends to switch to another plan.
- If your Medicare Prescription Drug Plan is not renewed for the following coverage year, you will be able to join another plan between December 8 and the last day in February.
- If Medicare issues a sanction because of an issue with your plan, affecting your coverage, you will have the opportunity to switch to another plan. The time frame to do so varies with every situation. Medicare will notify you of the Special Enrollment Period dates.
There are numerous special situations that can qualify for a Special Enrollment Period.
Plan Advisors can help make sure you understand the correct guidelines to avoid delays or discontinuation of your coverage during each of these enrollment periods. Reach out to an advisor today to determine what enrollment dates you need to get on your calendar.