AEP – Annual Enrollment Period

AEP – Annual Enrollment Period – October 15th to December 7th of every year. Can make any necessary changes to your Medicare plan during this time. Effective date January 1st of the following year.

• Can switch from Original Medicare to Medicare Supplement or Medicare Advantage Plan
• Can switch from Medicare Advantage Plan to Original Medicare or w/ Medicare Supplement
• Can add Medicare Part D to any Original Medicare plan

OEP – Medicare Advantage Open Enrollment Period

OEP – Medicare Advantage Open Enrollment Period – January 1st to March 31st of every year. Only for beneficiaries in a Medicare Advantage Plan for a one-time change.

• Switch to a different Medicare Advantage plan
• Switch from Medicare Advantage to Original Medicare and add a Medicare Part D plan

IEP – Initial Enrollment Period

IEP – Initial Enrollment Period – 3 months prior, the month of, and 3 months following your 65th birthday.

• Part A effective 6 months retroactive
• Part B effective 1st of the next month. (No longer a Part B effective delay!)

GEP – General Enrollment Period

GEP – General Enrollment Period – January 1st to March 31st every year. Individuals can enroll in Medicare Part B for the first time if they missed their T65 IEP.

• Part B effective date 1st of next month after enrollment (no longer waiting until July 1st!)
• Still subject to Part B late enrollment penalties

SEP – Special Enrollment Period

SEP – Special Enrollment Period – Special life events that impact an individual’s Medicare Advantage and Medicare prescription drug coverage. There are many ways individuals can quality for an SEP throughout the year, as specified by medicare.gov.

• If you…

Move out of your plan’s service area

• • • You Can…
      • Switch to a new Medicare Advantage plan or Medicare PDP
      • Choose to return to Original Medicare (you’ll be disenrolled from your Medicare Advantage plan and into Original Medicare if you do not choose a new Medicare Advantage plan in the time window.)
    • When…
      • Inform the carrier before you move – SEP begins the month before you move and continues fo 2 months after you move.
      • Inform the carrier after you move – SEP begins the month you tell the plan, plus 2 more full months after you move.

Move to a new address in the plan’s service area, but now have new plan options in that new location

• • • You Can…
      • Switch to a new MA plan or Medicare PDP
    • When…
      • Inform carrier before you move – SEP begins the month before you move and continues for 2 months after you move.
      • Inform carrier after you move – SEP begins the month you tell the plan, plus 2 more full months after you move.

Move back to the U.S. after living outside the country

• • • You Can…
      • Join a new MA plan or Medicare PDP
    • When…
      • SEP begins when you move back to the U.S. and lasts for 2 full months

Move into or out of an institution (like a nursing home or Long-Term Care Facility)

• • • You Can…
      • Join a new Medicare Advantage plan or Medicare PDP
      • Switch from your current plan to another Medicare Advantage plan or Medicare PDP plan
      • Drop your Medicare Advantage plan and return to Original Medicare
      • Drop your Medicare PDP coverage
    • When…
      • SEP begins when you move into the institution, lasts as long as you live in the institution, and for 2 months after you leave the institution.

Are released from jail

• • • You Can…
      • Join a new Medicare Advantage plan or Medicare PDP
    • When…
      • If you kept paying for your Medicare Part A & Part B coverage while you were in jail, you have 2 full months after your release date to join a plan. You must sign up for Medicare before you can join a plan.

Lose your current coverage by no longer being eligible for Medicaid

• • • You Can…
      • Join a new Medicare Advantage plan or Medicare PDP
      • Switch from your current plan to another Medicare Advantage plan or Medicare PDP
      • Drop your Medicare Advantage plan and return to Original Medicare
      • Drop your Medicare Advantage Plan
    • When…
      • SEP begins the date you are no longer eligible or notified (whichever is later) and lasts for 3 full months.

Lose your current coverage by leaving your employer’s coverage or union (including COBRA coverage)

• • • You Can…
      • Join a new Medicare Advantage plan or Medicare PDP
    • When…
      • SEP begins when your previous coverage ends, and lasts for 2 full months

Lose your current coverage by involuntarily losing other drug coverage that’s as good as Medicare drug coverage (creditable coverage), or other coverage changes and is no longer creditable

• • • You Can…
      • Join a new Medicare Advantage plan or Medicare PDP
    • When…
      • SEP begins the month after your previous creditable coverage ends (or when notified), and lasts for 2 full months

Lose creditable drug coverage by leaving a Medicare Cost Plan

• • • You Can…
      • Join a Medicare PDP
    • When…
      • SEP begins when you drop your Medicare Cost Plan, and lasts for 2 full months.

Lose coverage by dropping a Program of All-Inclusive Care for the Elderly (PACE) Plan

• • • You Can…
      • Join a new Medicare Advantage plan or a Medicare PDP
    • When…
      • SEP begins when you drop your PACE plan, and lasts for 2 full months

Have a chance to enroll in other coverage offered by an employer or union

• • • You Can…
      • Drop your Medicare Advantage plan or Medicare PDP to enroll in the private plan offered by the employer or union
    • When…
      • SEP begins when your employer or union allows you to make changes in your plan

Enroll in other creditable drug coverage like TRICARE or VA Coverage

• • • You Can…
      • Drop your Medicare Advantage plan or Medicare PDP
    • When…
      • SEP begins anytime

Enroll in a Program of All-Inclusive Care for the Elderly (PACE) Program

• • • You Can…
      • Drop your Medicare Advantage plan or Medicare PDP
    • When…
      • SEP begins anytime

Lose coverage because the carrier loses its contract with Medicare through a “sanction”

• • • You Can…
      • Switch your Medicare Advantage plan or Medicare PDP
    • When…
      • SEP is determined by Medicare on a case-by-case basis

Lose coverage because Medicare terminates your plan’s contract

• • • You Can…
      • Switch your Medicare Advantage plan or Medicare PDP
    • When…
      • SEP begins 2 months prior to when the plan ends, and 1 month after the plan ends