Medicare Timelines


When you can sign up for Medicare and when you should sign up for Medicare will produce two very different answers. In this article, we'll address the timelines around when you can sign up for Medicare, but we will touch on when you should sign up for Medicare in another article. 

Now, before we get too far into this, if you only remember one thing from this article, remember this:
Regardless of when you decide to enroll in Medicare, start the process 90 days from when you plan to take the benefit.

Enrolling in Medicare isn't something you can do just before you head off to bed on the last day of the month before you need coverage starting tomorrow.

It doesn't work that way.

Start the process 90 days before you plan on retiring or taking Medicare.

When to Enroll in Medicare

There are four different enrollment periods and we will discuss each one.

  • Initial Enrollment Period (IEP)

  • Special Enrollment Period (SEP)

  • General Enrollment Period (GEP)

  • Annual Election Period (AEP)
The Initial Enrollment Period

If you're looking to enroll in Medicare once you turn 65, you can enroll:

  1. Up to three months prior to your birthday month.
  2. During your birthday month, or...
  3. Up to three months after your birth month.
    You need to be careful if you plan on enrolling during the three months after your 65th birthday, because you could have up to three additional months of waiting period before your Medicare actually kicks in.

That's the initial enrollment period, and you will know that this period is approaching because of the seemingly countless phone calls, physical mailings, and emails you will receive.

You see, insurance companies and marketing agencies out there know when you are approaching your 65th birthday and they will bombard you with sales and marketing materials in an attempt to get you to enroll in a Medicare plan with them. This isn't something you can stop. Just be aware that it's coming and be ready for these promotional items. 

During this time, there is only one piece of mail out of the hundreds filling up your mailbox that you need to look out for and that is your red, white, and blue Medicare card that looks like this:

Medicare Card

Do not throw this away!

This would come from the Department of Health and Human Services. It would arrive 60-90 days before your 65th birthday if you are already taking Social Security benefits prior to age 65.

What about the penalties?

Now, there are penalties under certain conditions if you decide to skip signing up for Medicare Part B during the Initial Enrollment Period.

As a Medicare-specific insurance agency, the number one question that we hear from people calling in is about the penalties. The conversation often sounds something like,

"I'm calling you because my friend, my coworker, my brother-in-law, somebody at church, my neighbor, my HR person... They all found out that I'm turning 65 and I haven't signed up for Medicare yet. They have all scared me to death by telling me about this penalty I'll have for the rest of my life." 

We hear this every single day.

The reality is yes, there could be potential penalties for delaying your enrollment in Part B, but if we were to talk to a thousand people who have delayed Part B, we'd be willing to bet that 999 of them will never have a penalty, and here's why:

You may delay your enrollment in Part B for two very common reasons and never experience a penalty. 

  1. You delayed Part B by staying on your employer's health insurance plan.
  2. You delayed Part B by staying on your spouse's health insurance plan through your spouse's employer.

An important note:  You or your spouse must be actively employed in the two scenarios above. COBRA coverage does not apply the same way and, depending on how long you have been on COBRA, you could still be subject to a penalty. Contact us if you are on COBRA or thinking of taking COBRA until you become Medicare eligible. 

Those two scenarios are the most common reasons for delaying Part B, and you're not going to have a penalty if that's why you're delaying your enrollment in Part B. You could delay your enrollment in Part B and retire at 90 years old and then go onto Medicare at that point, and you would still not have a penalty, which brings us to the next enrollment period.

The Special Enrollment Period

Should you choose to retire after age 65, which means outside the Initial Enrollment Period (because you were covered by a group plan), you would be considered qualified for what is called a Special Enrollment Period.

If you have a qualifying event, meaning you retired from work and are moving off your employer's (or spouse's employer) group plan, you have up to eight months to pick up your Part B without penalty.

What we're trying to say is, don't listen to your neighbor's friend's cousin's former roommate. Call us and any one of our team members, who happen to be Medicare experts, will make sure you avoid any penalties and remove any of the panic that the other people in your life may have caused. That is, the panic related to Medicare. We can't help with the other craziness people bring into your life. 

When the penalty does apply

Now, let's talk about that one person out of a thousand who delays Part B enrollment because they say to themselves, "I don't ever go to doctors. Why do I want health insurance? Why do I want to pay for that when I never go to a doctor?" 

If this person decides not to enroll in Part B, the penalty for delaying without a qualified reason is 10% of the monthly premium per year they postpone enrolling in Part B. This penalty lasts for the rest of their life. 

As an example, should they choose not to enroll in Part B for two years after their Initial Enrollment Period or a Special Enrollment Period, their monthly premium would be 20% more than the standard Part B premium, for the rest of their life. 

Should they decide it's now time to sign up for Part B outside the Initial Enrollment Period and outside the Special Enrollment Period, they would now have to sign up for Part B during the General Enrollment Period. 

The General Enrollment Period

The General Enrollment Period is January 1 to March 31st of each year with coverage beginning on July 1st of that year. 

When does Medicare start once I enroll?

Now that we've covered the basics of when you can sign up for Medicare, it's important to understand when your Medicare coverage would begin once you enroll. 

Medicare always starts on the first day of a month.

It will never start any other day other than the first day of a month. Now, some people actually have a first of the month birthday, and if that's the case, your Medicare coverage would start on the first day of the month prior to your birthday month.

Keep this in mind if you are dropping off employer coverage on a day other than the last day of a particular month. Medicare will not start mid-month, so plan for that or talk to us and we'll help you with these timelines. 

What if I'm on Medicare and want to make changes?
Annual Election Period (AEP)

The annual election period is from October 15th - December 7th of each year. During this time, individuals who are on Medicare Advantage plans and/or Part D prescription drug plans may make changes to their existing plans. These changes would go into effect on January 1 of the upcoming year. 

This is also the time when someone may choose to enroll in a Part D prescription drug plan if they had not already enrolled previously. 

You will know it is AEP season because of all of the television commercials with celebrities talking about Medicare plans that offer free, free, free! 

Again, insurance companies are trying to lure you into purchasing from them with free perks that usually are not free. 

Wrapping it up

As we mentioned at the beginning of this journey, when you can enroll and when you should enroll are two very different things. Be sure to follow us to get an alert when we post our article on when you should enroll in Medicare. 

Please remember to start the Medicare sign up process 90 days from when you plan on taking Medicare.

We will help you with this. If you ever have questions about any Medicare topic, reach out to our team. We will take any time you need to answer your Medicare questions. And, should you decide to use us to enroll in Medicare so you can avoid the convoluted and overly-complex system the government has set up for enrollment, remember that all of our services are no cost to you. Ever. 

Senior Benefits Insurance Services

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