Medicare Advantage Enrollment: When and How to Join a Plan
Medicare Advantage (also known as Medicare Part C) is a popular alternative to Original Medicare, offering coverage through private insurance companies approved by CMS. These plans often include additional benefits like dental, vision, hearing, and prescription drugs. For anyone considering Medicare Advantage enrollment, it’s essential to understand the different enrollment periods and special situations that may qualify you for coverage; including the Medicare Advantage Trial Right.
Enroll in Medicare Advantage
There are a few windows when beneficiaries can sign up for a Medicare Advantage plan:
1. Initial Enrollment Period (IEP)
When an individual first becomes eligible for Medicare, they have a 7-month window to enroll:
- Begins 3 months before the month they turn 65
- Includes their birthday month
- Ends 3 months after their birthday month
When an individual qualifies for Medicare due to a disability, their IEP will begin three months before the 25th month of disability benefits and end three months after that month.
2. Annual Enrollment Period (AEP): October 15 – December 7
During AEP, anyone with Medicare can:
- Join a Medicare Advantage Plan
- Switch from one plan to another
- Drop their Medicare Advantage Plan and return to Original Medicare
Changes made during AEP take effect on January 1 of the following year.
Watch a YouTube Video on Medicare AEP Marketing Rules
3. Medicare Advantage Open Enrollment Period (MA OEP): January 1 – March 31
This period is for individuals who are already enrolled in a Medicare Advantage Plan. During MA OEP, you can:
- Switch to a different Medicare Advantage Plan
- Drop your plan and return to Original Medicare (with or without a Part D plan)
Note: You cannot use this period to join a Medicare Advantage Plan if you’re not already enrolled in one.
Click here to learn more about MA OEP
Special Enrollment Periods (SEPs)
Life happens and Medicare understands that. That’s why certain life events qualify beneficiaries for a Special Enrollment Period (SEP), allowing you to make changes outside the usual windows.
You may qualify for an SEP if:
- You move to a new address that isn’t in your plan’s service area
- You lose other coverage, such as employer, union, or Medicaid coverage
- Your plan is no longer available
- You get coverage through Medicaid or a State Pharmaceutical Assistance Program (SPAP)
- You’re diagnosed with certain conditions, allowing you to enroll in a Special Needs Plan (SNP)
- You’re released from incarceration
- You live in, move into, or move out of a nursing home or other long-term care facility
Each SEP has its own rules and timeframe, typically lasting 2 to 3 months around the qualifying event.
Medicare Advantage Trial Right
The Medicare Advantage Trial Right is a special protection for those trying a Medicare Advantage Plan for the first time. Here’s how it works:
Who Qualifies:
You qualify if:
- You joined a Medicare Advantage Plan when you were first eligible for Medicare at age 65, and
- Within the first 12 months, you decide you want to go back to Original Medicare
- You dropped a Medigap (Medicare Supplement) policy to try a Medicare Advantage Plan for the first time, and within 12 months you want to switch back.
What You Can Do:
- Return to Original Medicare
- Enroll in a Part D prescription drug plan if needed
- In most cases, buy the same Medigap policy you had before, even if the insurance company normally wouldn’t sell it to you
Note: The Trial Right is only available once in your lifetime. It’s designed to offer peace of mind for those unsure whether a Medicare Advantage Plan is the best choice.
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How to Enroll
Enroll in a Medicare Advantage Plan:
- Online at Medicare.gov
- Directly with a carrier – there are a couple ways to do this including: online or over the phone
- Through a licensed Medicare agent or broker, who can help compare options and guide you through the process. This is our favorite option and the service is free!
Be sure to have:
- Your Medicare number
- The effective dates for Parts A and B
Medicare Advantage Plans offer convenience, extra benefits, and sometimes lower costs, but it’s important to choose the plan that fits health needs and lifestyle. Knowing enrollment rights and timing windows helps avoid penalties, gaps in coverage, or being locked out of better options.
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