Who Qualifies and Election Periods
MEDICARE ELIGIBILITY:
- You must be a U.S. citizen or meet the lawful presence and residency requirements for five consecutive years
- You or your spouse have worked and have paid into your Medicare Taxes for 40 quarters (10 years)
- If you have are younger than 65 and have specific disabilities receiving Social Security payments for 24 months
- If you have End Stage Renal Disease or Lou Gehrig’s disease also known as ALS
ELECTION PERIODS:
Initial Election Period
Initial Election Period is when you are first eligible to receive Part A and/or Part B typically when you turn 65 years old.
If you are eligible, you have 7 months Initial Enrollment Period (IEP) to sign up for Part A and/or Part B. It begins 3 months before the month you turn 65, your birthday month, and ends 3 months after the month you turn 65 total 7 months.
If you sign up the first 3 months before you turn 65, your effective date will be the 1st day of your birthday month. If you sign up on the month of your birthday or the 3 months after you turn 65, your effective date will be the 1st day of the following month.
Annual Enrollment Period starts October 15 and ends December 7
Every year your Medicare health plan may change. If you would like to review the plan options for the upcoming year and possibly make changes or enroll in a different plan, you may do this during the Annual Enrollment Period. Every person who is eligible for Medicare is entitled to make changes to their plan coverage during this time of year. The changes to your plan will be effective on January 1st.
Open Enrollment Period starts January 1 and ends March 31
You may make a one-time plan change if you are not satisfied:
- Switch from current Medicare Advantage plan to another Medicare Advantage plan which will become effective the 1st day of the following month.
- You can drop your Medicare Advantage plan and return to Original Medicare and join a Medicare Prescription Drug Plan.
General Enrollment Period starts January 1 and ends March 31
If you miss your Initial Enrollment Period, you can sign up during Medicare General Enrollment Period and your coverage will start July 1. There might be a coverage gap meaning you will not have a Medicare health coverage for a certain period of time and may have to pay a higher premium.
Special Enrollment Period
When your Initial Enrollment Period ends, you may be able to sign up for Medicare during Special Enrollment Period if you have a qualifying life events. These life events may include losing your current health coverage, moving, diagnosis of a specific chronic illness, qualification for or loss of qualification for your state’s financial assistance programs or Medicaid.