ENROLLMENT & RENEWAL DATE INFO/TIPS

This information is NOT exhaustive.  Enrollment times can get complicated fast and often requires double checking.  However, general guidelines, like the one below, can be very helpful when taken in context.  For certainty, we ask that you contact us to analyze your specific situation.

Medicare Supplement

Despite essentially all other parts of Medicare having specific rules about enrollment times, Medicare supplements are an exception.  There is no enrollment time for Medicare supplements.  In essence they are month to month and can be changed at any time for any reason.  Because of that we prefer to make changes outside of the fall "annual election period" rush.  And if you switch in the middle of the year, you don't pay the Part B deductible again.

EXCEPTION: Of course, there is a point of confusion here.  Medicare supplements require passing health questions to get accepted.  However, when you first enroll they make an exception during the 6 months after you first become enrolled in part B (whether at 65 or later).  Again, at that time, you can get any supplement you want with no health questions and it is guaranteed renewable forever.  This enrollment window is known as the "Medicare Supplement Open Enrollment" period.  This window doesn't change the fact that you can change your supplement at any time for any reason.  It only means there is a window you can have no health questions (called guaranteed issue).

Medicare Advantage

These enrollment windows are unique compared to both Medicare Supplements and Medicare Prescription Drug Plans (PDP's).  Generally speaking, you can only enroll during the fall "annual election period" of Oct 15 to Dec 7 of each year (plans take effect on Jan 1) or when you are new to Medicare part B.  However, unlike PDP's, there is a unique window called Medicare Advantage Open Enrollment on Jan 1 to March 31 that is available ONLY if you are already enrolled in a Medicare Advantage plan (MA plan).  Essentially, this allows you to change plans from one MA plan to another.

ODDITY: You can enroll any time of the year if you have diabetes and or most cardiovascular problems (excluding high blood pressure) in certain MA plans.

EXCEPTION: If you have one of the two more common low income programs available to those on Medicare, then you can change anytime outside of the fall (Jan 1 thru September 30) as a Special Election Period (SEP).  The two programs are Medicaid or Partial Medicaid (just the one for people on Medicare like QMB, SLMB, & QI) and Extra Help With Medicare Prescription Drug Plan Costs (aka 'Extra Help').

NOTE:  There are many other SEP for special circumstances like moving out of the plan service area, living in a long-term care facility, losing group insurance, emergency disaster declarations, etc.

Medicare Prescription Drug Plans (PDP's)

Generally speaking, you can only enroll during the fall "annual election period" of Oct 15 to Dec 7 of each year (plans take effect on Jan 1) or when you are new to Medicare part B.  There are fewer exceptions than there are for Medicare Advantage.  It is best to beware since most people find themselves stuck in their plan if they don't change by Dec 7.

EXCEPTION: If you have one of the two more common low income programs available to those on Medicare, then you can change anytime outside of the fall (Jan 1 thru September 30) as a Special Election Period (SEP).  The two programs are Medicaid or Partial Medicaid (just the one for people on Medicare like QMB, SLMB, & QI) and Extra Help With Medicare Prescription Drug Plan Costs (aka 'Extra Help').

NOTE:  There are many other SEP for special circumstances like moving out of the plan service area, living in a long-term care facility, losing group insurance, emergency disaster declarations, etc.

ACA Subsidized Health Insurance 

ACA (Affordable Care Act) is limited to enrollment during the fall Nov 1 thru Dec 15.  However, there is a proposal to expand that 30 extra days (presumably Oct 1 thru Dec 15).  Unlike Medicare, you get window to enroll (aka election period) if you experience a qualifying event.  Examples include losing health insurance, any change in household size (like having a baby), moving out of the area (exactly how far doesn't seem to be specified but certainly out of state counts and moving to different regions within a state usually works), significant income changes which significantly changes your subsidy (once again, exactly how much is not specified).  The uncertainty I just mentioned is clarified by doing an application and the computer determines qualification or not.  In most cases, qualifying events allow you 60 days to enroll.  Federally recognized tribal members generally can enroll anytime.

NOTE: Enrollment in Short Term Major Medical Insurance is open to anyone at anytime aged 18 to 64 1/2 years old.  For some this is a better option.  For others, this is the only option since they don't have an election period to get ACA Subsidized Health Insurance.

Non Restricted Enrollment (Enroll Anytime)

Term & Whole Life Insurance:

Dental & Vision:

Critical Illness (Cancer, Heart Attack, & Stroke):

Hospital Indemnity (Cash):

Limited Benefit Health Insurance:

Group Health:

Accident only plans:

Disability:

Getting Medicare Itself (Part A & B)

Forgetting the add on Medicare insurance (Medicare Supplements, PDP's, and MA Plans), there is the issue of when and how to get Medicare.  Also known as original Medicare, part A & B is available for enrollment upon turning 65 regardless of your income or immigration status (provided you are legal) as long as you have 40 work credits which generally works out to 10 years of work in the USA.  Also, those under 65 can get Medicare A & B if they receive Social Security Disability payments for 24 months (quicker in some limited cases). 

DELAYED PART B: Many people elect NOT to take Medicare at 65 because they are still working or somehow have group insurance that is not terminating at 65.  In those cases, they are known as 'Delayed Part B' enrollees.  That is, their part B starts later than their part A.  An application for Delayed Part B is very different that getting A & B at the same time.  It required two Social Security forms, one for you to sign, and one for your employer to sign.  If you are not employed or otherwise have group insurance, then the only way to enroll is to wait until Jan 1 thru March 31 and coverage won't begin until July 1.

Once you are eligible for Medicare, enrollment is usually automatic for those already receiving Social Security income.  A letter will come from Social Security (they are responsible for enrolling people in Medicare) 1-3 months before your eligibility month telling you that you are enrolled in both A & B.  However, for those who don't want B (it costs money while A is free), then you sign the included form and mail it back to Social Security.  For those not recieving social security or for those not autoenrolled for some other reason, then you have to enroll in Part B by calling social security at 800-772-1213 or going to SSA.gov or going down to your local Social Security office (they are generally closed to foot traffic since COVID).

START DATE, TURNING 65: If your birthday is the 2nd or later in the month and you take Medicare A & B at 65 your Medicare will start the 1st of the month you turn 65.  In the same scenario, but your birthday is the 1st, then your Medicare will start the 1st of the month BEFORE the month you turn 65.

START DATE, NOT TURNING 65:  For those starting Medicare before turning 65 due to disability or after turning 65 for any reason, it is tricky to explain the start dates and it can depend on when your group insurance ends or when you request it.  However, for getting Medicare due to disability, the start date is whatever Social Security says it is (it generally starts the 24th month after your SS disability starts but they add the backpay months (lump sum) if you get that.

NOTE: Part B always has a premium (there are ways for low income people to get help with that through their state Medicaid office).  Part A is almost always free and automatic.  That is right, you generally can't help getting Part A upon eligibility.  I hear sometimes people 65 or older tell me they don't have Part A and it's essentially never true so much that I always remind people that Part A is free and automatic and you can't not get it (unless you didn't work 10 years in the USA and pay payroll taxes).