Medicare Questions & Answers: Enrollment Periods
Enrollment Periods Q&A
Showing 51 questions
If a senior is turning 65 but still working, should they enroll in Medicare or delay it?
If you have employer-based health insurance through your or a spouse's current employment, where there are more than 20 employees, and you're happy with the costs, such as monthly deductions/premiums and coverage, like potential out-of-pocket costs, you can delay Medicare enrollment without accruing penalties. If this is you, it's best to schedule a quick call so we can discuss your situation. Chad
I am on disability insurance Medicare now I will be 65 in October do I have to to sign up for Medicare again?
Since you’re already on Medicare due to disability insurance and will turn 65 in October 2025, you do not need to sign up for Medicare again. When you turn 65, your Medicare coverage will continue seamlessly, but your eligibility reason shifts from disability to age. This happens automatically—no need to reapply.
I just moved to a new state. Do I need to do anything with my Medicare coverage?
Yes, you will have 60 days to make a change upon arrival into your new state. This will vary by the type of plan you are enrolled in. Consult with an agent to avoid any penalties and missing deadlines.
I'm turning 65 soon, when can I enroll in Medicare?
3 months before your 65th birthday. And up to 3 months after. You may delay enrollment if you have a job that gives you creditable coverage if you want to delay signing up for Medicare. Normally if you are receiving Social Security you will be signed up automatically.
I'm turning 65 in three months but still working with employer coverage. Do I need to sign up for Medicare right now or can I wait?
You can wait as long as you are maintaining employer coverage. Medicare part A will still get assigned to you but (as long as you are not receiving SS benefits) not part B. When you do choose to leave employer coverage make sure you visit SSA.gov and “apply for Medicare part B only”. Keep in mind this may take at least a few weeks and you may have to collect some signatures from your employers HR dept so start this process at least a month before you plan on quitting/ leaving employer coverage.
I'm planning to delay Social Security until age 70, but I'm turning 65 soon. How does this affect my Medicare enrollment?
You can still enroll at 65. You will need to do this from the SSA website or by visitin your SSA office.If you don't enroll at 65 and don't have coverage through a group plan you will be penalized 1% per month for each month you don't have coverage.
You will be billed by Medicare for your part B premium 3 months at a time.
I thought I signed up for both Part A and B when I got my Social Security, but now I'm getting bills for Part B. Did I miss something during the enrollment period?
Yup. If you don't speak to an experienced and honest agent, you won't know what your monthly payments will be. For example, there is a premium for the Part B, for the Part B one-time per year deductible, possibly a Medigap plan along with a Part D(rug) plan. If you want better coverage for the more expensive Dental, Vision & Hearing procedures, that can also be an extra cost per month. Sounds like you tried to get around using an agent whereas YOU are not paying for the agent's commission since the firm you chose pay the agents!
I'm confused about when I can change my Medicare plan. Can you clarify the different enrollment periods for me?
Medicare Advantage Plans (Part C) can be changed during the Annual Enrollment Period - October 15th to December 7th, or during the Open Enrollment Period - January 1st to March 31st. There are also some Special Election Periods that can be used, such as:* You change where you live
* You lose your current coverage
* You have a chance to get other coverage
* Your plan changes its contract with Medicare
* Other special situations
Medicare Supplement plans can be changed at any time throughout the year if you qualify medically. Some states even have guaranteed issue periods such as 60 days following your birthday, loss of creditable coverage through employer or another plan, or if the plan exits the market.
Prescription Drug Plans (Part D) can only be changed during the Annual Enrollment Period - October 15th to December 7th, unless there is a Special Election Period that would allow you to change.
I'm worried about choosing the wrong plan and being stuck with it. How often can I change my Medicare coverage?
What makes more sense? Do I do Medicare A and B, which is Original Medicare? Do I add a Medicare Supplement, which supplements A and B in my out-of-pocket costs? Or do I go for a Medicare Advantage Plan, which I can change every year, and they change every year?
So, do yourself a favor. Before you make any decisions, sit down with someone who knows this stuff inside and out so that you can make a great decision. Age 65 and Medicare decisions are hugely important. Let us help you!
I changed my plan during Open Enrollment and now I can't see my regular specialist. Isn't this what the whole review period is supposed to prevent?
The agent should have checked all of her doctors before they switched their policy. The client should of been aware of all of the benefits the new policy afforded her.
What should I do if I miss the Medicare Open Enrollment period, and I want to change my plan?
If you have a Medicare Advantage plan and you have missed your opportunity to make a change in the Open Enrollment Period, then perhaps you might have the ability to make a change using one of the several Special Enrollment Periods (SEP) that are allowed by Medicare.Some of the SEP's include things like the following:
1) Have you moved to another county or state? Have you recently moved back to the United States after living abroad? Have you moved into or out of a skilled nursing facility?
2) Have you lost Medicaid? Or lost the Extra Help for prescription drugs? Did you lose the PACE program?
3) Have you recently been granted Medicaid or Extra Help with prescriptions? Do you have a Chronic condition like diabetes or heart disease?
4) You could join a 5-star rated plan
5) Were you affected by a FEMA disaster?
There are many other SEP's that you might possibly qualify for. So, talk to a local Medicare Insurance Broker to know all your options.
I want to switch to Medicare Advantage this year. How do I do this?
During the Annual Election Period (Oct 15-Dec 7) contact your local agent to enroll and your new plan will become effective January 1, 2026. If you are switching from a medicare supplement, its important to note that you'll have to call and cancel the supplement yourself it will not automatically happen.I missed my Medigap window by a few months and now no one will cover me without underwriting. Why isn't this rule more well known?
The first thing that comes to mind is that you probably did not meet with a long-time Medicare professional agent who knows the ins & outs of its very quirky rules. In my opinion, enrolling with Medicare yourself online means that you may be bypassing the rules concerning the different periods during the year when one can enroll AND make changes.The only thing for you to do at this point is to enroll with a Medicare Advantage plan temporarily (you HAVE the right to do this at anytime since you've never enrolled before by picking up Medicare Part B with a monthly premium). Then, when the Open Enrollment begins on October 15th thru Dec. 7th (to become effective on Jan. 1st of the following year), you have what is known as "a trial right", meaning since you have your very 1st Medicare plan for less that 12 months, you will be able to apply for a Medigap (a.k.a., Med. Supp.) without having to answer any medical questions concerning pre-existing conditions.
Using any online information only yields the more well-known tenets of Medicare. The best advice I could ever give anyone regarding THE most important aspect of your life: HEALTH, is to be certain to get a 2nd & even 3rd opinion from an independent rep who is also known as a broker. However, in using a "Captive Agent": one who only has allegiance to one insurance firm, is foolhardy since all companies who offer Medicare-compliant Advantage plans can vary the rules to a certain extent. Though I truly hope that most agents are honest/reliable and can cover the gamut of the regulations, as an instructor myself, I will deliberately "over"-emphasize the more important areas/rules to all of my clients. Good luck and if needed, call 1-800-MEDICARE so that the person on the other end who's trained for this, confirms what a trial right means.
When is the best time of the year to start looking at Medicare options?
For seniors turning 65 - its best to start reviewing options 3 month prior to your birthday month. For Senior already receiving Medicare Benefits, it's important to review your Part D Prescription drug plans during Annual Enrollment Period, October 15 - December 7th. I encourage clients to review their Medicare Supplement rate annually after the first of the year.
I have Medicare Part A and B since 06/01/2006 because of disability. My husband retired on 4/1/2024, and I now have no other coverage except for Medicare Parts A and B because I missed open enrollment for insurance coverage. Note: SS dropped SSI and changed it to straight SS. Please help.
I assume you are still under age 65 and that you implied that you had Medicare Part A&B PLUS your husband's employer provided healthcare (as additional coverage). Since he's now retired, and you've lost his coverage, you may have "guaranteed rights" to purchase additional private medicare supplemental insurance (like a medicare supplement), as long as you can prove that you had creditable coverage from his employer all this time. Any insurance company is going to want additional written evidence to prove this information. I suggest you reach out to a local medicare agent directly for more details and instruction.
Can I enroll in Medicare if I've never paid into Social Security due to working overseas?
Yes, you can enroll in Medicare even if you've never paid into Social Security due to working overseas. However, your eligibility and costs will depend on your residency status and work history.Medicare Eligibility Without U.S. Work History
To qualify for Medicare, you must be either a U.S. citizen or a lawful permanent resident who has lived in the U.S. for at least five continuous years before applying.
While most people receive Medicare Part A (hospital insurance) premium-free by earning 40 work credits (approximately 10 years of work paying into Social Security), you can still enroll in Medicare by paying premiums if you haven't met this requirement
Costs Without Work Credits
Part A (Hospital Insurance): If you have fewer than 30 work credits, you'll pay the full premium for Part A. For 2025, this premium is up to $505 per month.
Social Security
Part B (Medical Insurance): Part B requires a monthly premium for all enrollees, regardless of work history. In 2025, the standard Part B premium is $185 per month
How does moving to a new state affect my Medicare enrollment timeline?
When you move out of a service area, whether from one county to another, or a different state, you must change plans if you have a Medicare Advantage (MA) or Prescription drug plan (PDP). The ability to change plans after a move falls under a Special Enrollment Period (SEP).If you don't notify your plan before you move, you have the month you move and 2 months after (3 months total) to change plans. If you notify your plan before you move, you have the month before, the month of, and 2 months after (4 months total) to make a change.
Plans vary greatly by service area, so don't be surprised if you have different benefits, including maximum out-of-pocket, deductibles, co-pays, and co-insurance. Extra benefits may also differ from area to area.
Be advised that some counties with low populations don't have MA plans, so adding a supplement and a PDP may be your only option. Medicare Supplement SEPs are similar but exclude the month before a move. You can join a Medicare Supplement plan the month you move and up to 2 months after. Guaranteed issue is available ONLY if there is no MA plan available in your new service area.
Sound complicated? Contact me and I'll walk you through it.
When will my provider send my Annual Notice of Change?
Usually the last few days in September or the first week in October. Be sure to ask your agent for any recent updates to your plan too!
When can I change my Medicare Advantage Plan?
The next are special enrollment periods that can vary throughout the year. Maybe you lost employer group coverage, or you got Medicaid or extra help for your prescription drug costs. There are many different reasons. I would check with your broker or your agent, and they can help you figure out if you're eligible to change plans at that time. I hope this helps.
What is the Medicare Advantage 5-Star Special Enrollment Period? Is this different from '"OEP'" and "AEP"?
Why do so many seniors wait until the last minute to enroll in Medicare, and how can agents help prevent bad decisions?
Why Seniors Delay Enrollment:1. Lack of Awareness or Understanding
Many seniors aren’t fully aware of their Medicare Initial Enrollment Period (IEP), the penalties for late enrollment, or the options they have. They might assume they’ll automatically be enrolled or think they don’t need to worry until a later time.
2. Fear or Overwhelm
The Medicare system can feel overwhelming with its various parts (A, B, C, D, Medigap). The fear of making the wrong choice often leads to procrastination.
3. Health or Work Factors
If seniors are still working or have employer-provided health insurance, they may think they can delay Medicare enrollment without consequences. However, this can be risky if their employer insurance isn’t considered "creditable" (as good as Medicare).
4. Waiting for a "Perfect" Plan
Some seniors wait until they are sure about which plan is best, hoping to get more information or thinking they’ll figure it out later. However, waiting can often result in missed opportunities or more limited choices.
Can I switch from a Medicare Advantage plan to Original Medicare with a Medigap plan mid-year if I’m diagnosed with a serious illness?
The short answer is no. Medicare advantage changes are generally only allowed during (AEP) annual enrollment period (Oct 15 - Dec 7). Then you get another chance to make one more change during (OEP) open enrollment period (Jan 1 - Mar 31). Any changes outside these dates need a special enrollment period (SEP) and a diagnosis of an illness isn’t necessarily a reason for one.Medigaps are underwritten. If you have a serious illness you may not qualify. If you are still in your initial enrollment period (3 months before your birthdate, the month of, and 3 months after) of 7 months.
Harold Randolph
MI KY IN OH
When is a good time to start preparing for AEP?
The new Medicare plans become available for general public knowledge October 1st but no applications can be submitted until October 15th. I think a great time to start preparing for AEP would be in September just to make sure plans are in place, however, at the very least start October 1st.
What happens if I am unable to provide creditable coverage?
If you are unable to provide credible coverage after 63 days then you will begin to accrue a late enrollment penalty. This penalty will be attached to your part d plan for the remainder of your lifetime unless you receive Medicaid or LIS for lower earners.
I am moving to a different county in my same state, should I look at getting a new Medicare plan?
If you are on an Advantage you should check with them to be sure they are in your new countyIf not you will need to change plans, also be sure to notify SSA with your new address
Can I backdate my Medicare enrollment if I missed my initial window due to a medical emergency?
If you missed your initial Medicare enrollment window because of a medical emergency, I’m sorry you had to go through that—unfortunately, Medicare doesn’t typically allow backdating for missed deadlines unless you qualify for a Special Enrollment Period (SEP), like if you were hospitalized or incapacitated during your sign-up time. The rules are strict, but if you can show proof—like hospital records or a doctor’s note—explaining how the emergency prevented you from enrolling, you might appeal to CMS for a retroactive adjustment, though approvals are rare and case-by-case. Without that, you’d face a late penalty on Part B premiums—10% per year missed, added for life.
Is Guaranteed Issue available after the Medicare Open Enrollment period ends?
Guaranteed Issue is available for up to 6 months after your Part B becomes effective, and it doesn't have to coincide with with the Medicare Open Enrollment Period. There are also other situations in which Guaranteed Issue applies, but consult with a local independent health broker to determine if your situation applies.Do I qualify for SEP if my health dramatically gets worse out of nowhere?
You might be able to switch your plan to a chronic condition advantage plan if your health concerns are upon those qualified. These are allowed to switch 1x per year (for each chronic condition) and might actually reduce the copayments and medication costs of the specific chronic condition. You would want to check with your local independent broker to see what is available and how it would cover.
If someone enrolls in a MAPD C-SNP and gets disenrolled for not providing a CCV form within 60 days, is there a SEP to enroll in another MAPD plan?
Yes, if someone is disenrolled from a Medicare Advantage C-SNP for failing to provide a required Chronic Condition Verification (CCV) form, they generally have a Special Enrollment Period (SEP) to enroll in another MAPD plan. This SEP typically begins when the individual is notified of their disenrollment and lasts for two months.Thanks for reaching out.
Dawn Young
HealthMarkets Insurance Agency
How often can I change my Medicare Plan?
It depends on the type of Medicare plan that you have. If you have a Medicare advantage plan or prescription drug plan, you can change that plan between October 15 and December 7. This is the annual enrollment period. Between January 1 and March 31 you can change your Medicare advantage plan one more time, but you must already be enrolled in a Medicare advantage plan to make that change. If you have a Medicare supplement plan, you can change that plan anytime however, with few exceptions, you will have to answer medical questions and could be denied if you do not pass underwriting.
Do I need to do anything for Annual Enrollment Period (AEP)?
I always advise my clients to review their doctors and medications against their plan if they want to verify coverage. If you have any questions, contact your Broker/Agent.As a courtesy to your Broker/Agent (they are processing 100s or 1000s of clients during AEP), if you are happy with your current plan for next year, drop them a line and let them know. They also will probably want you to update your Scope of Appointment with you so they can legally reach out to you during the year.
I started taking a new prescription this year. Do I need to change my Medicare plan?
Did you know? Prescription formularies (i.e., the list of medications your plan does/does not cover) can change year over year? What's covered this year... might not be covered next year. If it is covered, the price you're used to paying... could change.It's always best to have your agent verify your latest list of prescriptions during the Annual Enrollment Period (AEP). This takes place 10/1 - 12/7 each year.
NOTE: A growing trend with carriers is refusing to pay agents commissions on Prescription Drug Plans (PDPs)... That said, make sure your agent cares more about your best interests than the commissions.
Are Medicare agents paid by specific insurance to sign up clients to their plans only
The insurance companies pay the agents for enrolling you in certain plans. Almost all agents are paid a commission on each enrollment
What Medicare penalties are most common?
Other people will say, "I don't take medications, I don't need a drug plan." Well, you're required to have a drug plan, and a care only covers Part B hospital and your medical services. So if you don't have a drug plan, you are going to get a penalty.
And the other thing is changing your plans. It's important that you understand what you need to do either when you're aging into Medicare at 65 or when you actually have to do your roaming, and also when you're leaving your employer. It's very, very important that when you're leaving your employer, you sit down with a licensed Medicare agent. Don't try to do it on your own unless you know what you're doing. It's important to know when you have a qualifying event. So hopefully that answers your question.
When should my plan be reviewed?
You should review every year, before Dec 7th.You should also make sure all your doctors take that plan
I have Medicare A and B, which was secondary to my large group health plan. My spouse passed away in late June 2025, and his company is providing COBRA coverage for six months, through January. If I wait until then, will I still have guaranteed issue for a Medicare supplement, or do I have only 63 days from June 30 (until Sept 1) to enroll? I'm in CO
You must enroll within 63 days from the termination of your spouse's coverage to qualify for guaranteed issue. You lost your creditable coverage when the plan was terminated. you must Enroll within 63 says
If I switch plans to cover a brand-name eye drop my current plan won’t cover, but my new doctor later takes me off that medication after open enrollment ends, do I have any way to change my plan again?
Yes you may change AEP decision in Jan, Feb and March. During oep. It runs from Jan 1-Mar 31. Might want to ck with your Dr as to why he took you off that Medicine.What’s the best time of year to change my Medicare plan if I develop a new diagnosis?
Those changes depend. The only time to make changes for the upcoming year is during AEP, from October 15 through December 7. There may be other opportunities to change. I recommend meeting with a licensed Medicare agent to review your options.
What is the Medicare Advantage (Part C) Open Enrollment period?
So that period is, it's a real thing. It is a real thing. Medicare Advantage has its own open enrollment after AEP, the annual enrollment period. It's called open enrollment. I know it's crazy, but it's from January 1st to March 31st. If you're on an Advantage plan, you can change to another Advantage plan. If you're under an Advantage plan, you can go back to original Medicare and do a drug plan, so you can change. If you're on original Medicare and on a supplement, you can't change to it.
Also, January through March is the general election period. If you didn't go on Part A or B and you're already retired and just hanging out there, and you need to go on it, that's when you go on one of those parts. But January to March, so if you made a mistake during open enrollment, boom, you can correct it one time here, January to March. If you missed open enrollment, boom, you get another, you get a secondary chance for your Advantage to change your Advantage.
So that's Medicare Advantage open enrollment period, January 1st to March 31st. After that, it's a special election period. So you got to be cautious if you need to make a change. Make a change now. All right, hope that helps. If you have any questions, we'll send out an agent to help you out. Have a good day.
Can I drop my employer health insurance and switch to Medicare instead?
For foreign travel, a Medigap policy (plans G, N) or specific Medicare Advantage plans can cover emergency care, which often covers 80% of costs up to a $50,000 lifetime limit.
Is there a penalty for switching from Medicare Advantage back to Original Medicare?
There is no penalty for switching from Medicare Advantage to Traditional Medicare. There are some things to be aware of though. Remember, if your Advantage plan had drug coverage, you now need to add a stand a lone Part D Drug plan. Also, you can only make the switch during one of the approved enrollment periods.
Do I need to notify Medicare or Social Security if I move to a new address?
Yes, you should notify both Social Security Administration and Centers for Medicare Services when you move to a new address. Updating your address helps make sure you continue receiving important Medicare and Social Security notices, bills, and plan information without interruption.
How do I change my Medicare plan during open enrollment?
To change your Medicare plan during Open Enrollment, you can contact your current agent or broker or contact us.If you call the company direct, they will enroll you in one of their plans.
If you call an agent who works for a company, they will enroll you in their specific company’s plan.
However, if you contact a Medicare Broker, we will shop the carriers to find the best plan for you.
Thanks for asking
Can my Medicare Advantage plan drop me, and what happens if it does?
There are circumstances where a Medicare Advantage plan can you drop you as a member, but it is regulated and can't be due to your health or increased utilization. Typically it is due to non-payment of premium, moving outside of covered service area, you become no longer eligible and enrolled in Part A and Part B as required, or the plan exits the market that you are living in, or the plan no longer meets the requirements to offer the plan through Medicare.If you are dropped it will trigger a Special Enrollment Period (SEP) and you will be able to enroll in a new plan without waiting for Annual Enrollment Period (AEP) or Open Enrollment Period (OEP).
Are Medicare Advantage plans guaranteed issue?
Yes — Medicare Advantage plans are generally guaranteed issue as long as you are enrolled in Medicare Part A and Part B and live in the plan’s service area. Unlike Medigap plans, Medicare Advantage plans typically do not use medical underwriting, so you cannot be denied because of health conditions.However, you must enroll during a valid enrollment period, such as your Initial Enrollment Period, Annual Election Period, or a qualifying Special Enrollment Period.
The main exception is for people with End-Stage Renal Disease (ESRD), though most ESRD restrictions have been removed in recent years.
Can I change my Medicare plan after open enrollment ends?
Yes, if you have LIS low income subsidy or extra help. If you moved to a new county or state. If you newly receive Medicaid. If you lose your Medicaid benefits, these all things that open you up to SEP Special Enrollment periods. If need help or advice call us today.
How do I switch back to Original Medicare from a Medicare Advantage plan, and will I face any penalties or coverage gaps?
You can switch back to Original Medicare by disenrolling from your Medicare Advantage plan during designated federal enrollment windows. While you will not face financial penalties for switching back, you may experience significant gaps in supplemental coverage (Medigap) or face a Medicare Part D late-enrollment penalty if you do not orchestrate the transition correctly.
How long do I have to change my Medicare plan after I move to a new area?
If you move out of your current Medicare plan’s service area, you usually get a Special Enrollment Period to make changes. In most cases, you can switch plans starting the month before your move and up to two months after you update your address. Working with a Medicare agent can help make sure you don’t miss the timing or end up with a gap in coverage.
Can I change my Medicare Part D plan anytime, or only during certain enrollment periods?
You generally cannot change your Medicare Part D plan anytime; most people can switch only during specific enrollment periods. The main time is the annual Open Enrollment Period, October 15 to December 7, and changes take effect January 1 of the next year.When you can change
• Annual Open Enrollment: You can join, switch, or drop a Part D plan.
• Special Enrollment Periods: You may be able to change outside Open Enrollment if you have a qualifying life event, such as moving, losing coverage, or becoming eligible for Extra Help.
• Extra Help / LIS: If you get Extra Help, you may be able to switch more often, including once per quarter during part of the year.
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