If you’ve become eligible to join the federal Medicare program in 2021, you’re probably wondering how you can do this.
We’ve put together a guide to help you learn about the upcoming Medicare Open Enrollment Period and how you can use it to enroll.
Learn about your enrollment options, enrollment exceptions, enrollment penalties, and how you can get Medicare health coverage in 2022.
The Fall Medicare Open Enrollment runs each year and lets people make changes to their coverage without paying extra fees.
Dates for Fall Medicare Open Enrollment Period
Dates: October 15th to December 7th every year.
Changes take effect: January 1st of the following year.
|Change from Original Medicare to a Medicare Advantage Plan.||Apply for Medigap without risks of medical underwriting.|
|Change from Medicare Advantage to Original Medicare.||Sign up to Medicare for the first time.|
|Pick a new Medicare Advantage or Part D plan — this includes getting prescription drug coverage.||Change a Medicare Supplement Insurance plan.|
Original Medicare Part A provides you with inpatient coverage and home health care.
For example, if you were admitted to hospital for surgery your expenses would fall under Part A.
Medicare Part B deals with outpatient or general care and can include medical tests, services, or items that you receive while not an admitted patient.
For example, if you went to the doctor to get your leg bandaged, the associated costs would be Part B expenses.
Medicare Advantage Plan: Also known as Part C, this plan gives you all the coverage of Original Medicare with some additional benefits not covered by Parts A and B, such as vision care, dental cover, and sometimes even prescription drug coverage.
Medicare Part D has to do with prescription drugs coverage and covers the cost of medication you take at home or which is self-administered.
|I am a citizen or lawful resident of the U.S.||Yes/No|
|I am 65 or turning 65 in the next three months; OR I have a disability or suffer from ESRD (End-stage Renal Disease).||Yes/No|
|I know my Medicare contribution status (Medicare taxes)||Yes/No|
If you've answered no to any of the above questions, speak to one of our consultants to find out what you need to do to enroll in the federal government Medicare program.
With the total number of Medicare beneficiaries increasing every year, it's crucial that you learn when you should enroll and how this can impact your health cover.
The IEP is your first chance to sign up for Medicare once you are eligible.
During your Initial Enrollment Period, you can sign up for:
Original Medicare (Parts A and B)
A Medicare Advantage Plan
A Medicare Part D Prescription Drug Plan
Your Initial Enrollment Period begins three months before your 65th birthday month and ends three months after.
In total, you have seven months to apply — this includes the month you turn 65 and the three months before and after you turn 65.
For example, if you turn 65 in April, this means that the enrollment period starts on January 1st and ends on July 31st.
Use this table to see when your Initial Enrollment Period starts and ends.
|Your Month of Birth||Start of Your Initial Enrollment Period||End of Your Initial Enrollment Period|
|January||October (last year)||April|
|February||November (last year)||May|
|March||December (last year)||June|
|October||July||January (next year)|
|November||August||February (next year)|
|December||September||March (next year)|
You will have to pay specific penalties to get Medicare coverage if you don't enroll in Medicare when you are eligible.
Medicare (Part A, B, and D) has different penalties for not enrolling. Find out what you might have to pay if you don’t enroll at the right time for Medicare cover.
Part A coverage is free if you have contributed to Medicare through payroll taxes for at least forty quarters (ten years). If you have done this, you can enroll in Part A at any time after you become eligible.
However, if you are eligible for Medicare Part A, have not contributed through Medicare taxes, and don’t enroll, you may have to pay a penalty rate to join.
The penalty is a 10% increase in your monthly premiums and lasts for double the period you didn't enroll.
For example, if you did not enroll for two years, you will have to pay the penalty rate for four years. If you delayed enrollment by three months, you would pay the penalty rate for six months.
Signing up late for Medicare Part B will mean facing penalties that can stay with you for a while.
You could pay up to 10% above premium cost for every 12-month period you were late. For example, if you enroll 36 months after the deadline, you will pay a 10% penalty fee for the next three years.
Monthly premiums range from $170.10 to $578.30, depending on your income. If your Part B premium is $170.10 per month, you will have to pay an extra $17.01 each month, making your new premium $187.11.
People eligible for Medicare but covered by employer-sponsored or union health insurance are not subject to Part B penalties if they join after their Initial Enrollment Period.
Employer-sponsored or union health insurance is health coverage provided by a company or union which offers similar benefits to Medicare.
You have an eight-month window (Special Enrollment Period) from when your job's health coverage ends to enroll in Medicare to avoid penalties.
You will pay 1% of the standard monthly premium ($33.37 in 2022) multiplied by the number of months you were late.
For example, if you don't enroll for twelve months your penalty rate will be 12%.
If you don't register for sixty months, your penalty cost will be 60%.
You will not have creditable prescription drug coverage, meaning you will pay more during your monthly Part D premiums.
Creditable prescription drug cover is coverage from your employer or union, which pays similar amounts as Medicare drug coverage and is considered to be as good as or better than Part D cover.
If you sign up for Part A, you have the option of enrolling in Part B as well. You will then need to sign up for a standalone Part D plan if you want to get prescription drug coverage.
Medicare Advantage plans already include Part A and B coverage. Your Medicare Advantage Plan usually has Part D prescription drug coverage and you are not allowed to sign up for standalone Part D coverage.
If you want a Medicare Supplement Insurance Plan, you must enroll in Medicare Part A and B before this. Your Medicare Supplement Insurance Plan will also provide partial or full Part D cover.
Dates: January 1st - March 31st every year.
Changes take effect: July 1st of the year of enrollment.
|Sign up for Medicare Part A and B (Original Medicare).||Make changes to your current coverage plans.|
|Sign up for Medicare Advantage Plan if you missed the Advantage Plan Enrollment Deadline.||Purchase Medigap without medical underwriting.|
After you enroll in Part A or B during the General Enrollment Period, you will have a separate Part D Special Enrollment Period to get prescription drug coverage.
You will have from April to June to enroll in this, and coverage will also begin from July 1st. The same applies to Medicare Advantage.
A separate form will have to be completed and mailed to the Social Security office.
Medicare Supplement Insurance plans are insurance policies that cover additional Medicare costs. If you’d like to learn more about these types of Medicare cover options, read our guide to Medicare Supplement Insurance Plans.
Enrolling during your Medicare Supplement Insurance Open Enrollment Period means that you will be able to purchase any Medigap policy, no matter your health status or prior medical history.
The Supplement Insurance Open Enrollment Period begins on the first day of the month when you enroll in Medicare Part B and lasts for six months.
For example , suppose you enroll in Part B on December 31st. In that case, your Supplement Insurance Open Enrollment Period will last until July 1st the following year.
If you enroll on February 7th, your Supplement Insurance Open Enrollment Period will last until August 7th in the same year.
During your Medicare Supplement Insurance Open Enrollment Period:
You will not be charged more based on your medical history.
Companies cannot refuse to sell you Medigap policies.
Your application will not be subjected to medical underwriting.
|You will be able to have a wide variety of Medigap policies that will suit your needs.||Apply for Medicare Part A and B.|
|You will not be charged more based on your medical history.||Apply for Medicare Advantage.|
|Companies that offer Medigap policies cannot refuse to sell you one.||Change between Original Medicare and Medicare Advantage, or back.|
|Your application will not be subjected to medical underwriting.|
This enrollment period applies to you if you enrolled in a Medicare Advantage plan:
During the Initial Enrollment Period
During the Annual Medicare Open Enrollment Period
Should you need to join a Medicare Prescription Drug Plan, you can do so during this period.
Dates: January 1st - March 31st
Changes take effect: The first day of the month after the request for the new coverage is received by your Medicare Advantage provider.
|Change to a different Medicare Advantage Plan that has drug coverage.||Join a Medicare Prescription Drug Plan if you are already on Original Medicare.|
|Cancel your Medicare Advantage Plan and go back to Original Medicare.||Go from Original Medicare to a Medicare Advantage Plan.|
|Join a Medicare Prescription Drug Plan.|
The graph above showcases the rise of enrollment in Medicare Advantage. From 2005 onwards there has been a steady increase, with many people using the Medicare Advantage Open Enrollment Period. Source: JamaNetwork
There are certain situations when you can enroll outside of the regular enrollment periods, known as Special Enrollment Periods.
Here are some specific situations when you might be eligible for a Special Enrollment Period:
If your insurance company discontinues your Medicare coverage.
If you are moving states and would like to change your coverage to a better option not available in your previous state of residence.
If your healthcare coverage under an employer ends.
If your healthcare provider didn't inform you that your previous drug coverage does not provide Medicare coverage, and you would like to enroll.
If you are released from jail.
The dates for this vary from person to person and are dependent on the circumstance. They usually last for eight months from the time your current coverage has ended.
If you are unsure whether you are eligible for a Special Enrollment Period, contact a Medicare expert from PolicyScout to find out the exact details.
Use these forms to complete your Part B enrollment or to apply for your Special Enrollment Period.
Forms for different Medicare Advantage, Medicare Supplement Insurance, and Part D coverage vary from provider to provider. Send PolicyScout an email to get the best Medicare plans in your area or to learn more about the Medicare Open Enrollment Period.
If you'd like to learn more about health care, Medicare, or insurance, reach out to one of PolicyScout’s Medicare consultants to get assistance.