Your initial opportunity to enroll in Medicare is during your Initial Enrollment Period (IEP). Generally, this is when you turn 65. Your opportunity to enroll lasts for 7 months. This time is from 3 months before you turn 65, your birthday month, and 3 months after your birthday month. But what if you missed your window to enroll in Medicare? Unfortunately, people who miss their opportunity to enroll in Medicare and are stuck without Part B coverage. Unless you qualify for a Special Election Period, then you must wait until Medicare’s General Enrollment Period to enroll. You may also be you may be subject to a late enrollment penalty.
What is the General Enrollment Period?
The Medicare General Enrollment Period (GEP) is the annual opportunity for those who missed their initial opportunity to enroll in Medicare. This includes Part B and/or Premium-Part A. The GEP runs from January 1st through March 31st every year. Beneficiaries who miss their enrollment period can sign up during this time. Their coverage will start the month after they sign up.
If you qualify for premium-free Part A, then you can enroll in part A any time after you turned 65. You do not have to wait for the Medicare General Enrollment Period. However, if you DO NOT qualify for premium-free Part A then you may need to wait for the General Enrollment Period. This depends on the state you live in, and whether you qualify for the Medicare Savings Program (MSP) for Part A premium assistance. If you qualify for the MSP, then some states will allow you to apply for Conditional Part A anytime. These states are known as Part A buy-in states. Below is the list of states that allow you to enroll in conditional Part A at any time. If you live in any other state, you can only enroll in Premium Part A during the GEP. This is true even if you qualify for the Medicare Savings Program.
| Alaska | Maryland | Oregon |
| Arkansas | Massachusetts | Pennsylvania |
| Connecticut | Michigan | Rhode Island |
| Delaware | Minnesota | South Dakota |
| District of Columbia | Mississippi | Tennessee |
| Florida | Montana | Texas |
| Georgia | Nevada | Vermont |
| Hawaii | New Hampshire | West Virginia |
| Idaho | New York | Washington |
| Indiana | North Carolina | Wisconsin |
| Iowa | North Dakota | Wyoming |
| Louisiana | Ohio | |
| Maine | Oklahoma |
Can I enroll in a Medicare Advantage, Part D, or a Supplement plan during the GEP?
You will receive a Special Election Period to enroll in a Medicare Advantage (MA/MAPD), and possibly a Part D plan (PDP). This Special Election Period continues for the first 2 months of your Part B enrollment. If you are enrolling in Part A and Part B during the GEP, then you may enroll in a standalone PDP or a Medicare Advantage (MA/MAPD) plan. However, if you already had Part A and are using the GEP to enroll in Part B only, then you cannot enroll in a PDP plan unless you have a different Special Election Period. If you want to enroll in a Medicare Supplement, you have 6 months from your Part B effective date to enroll without underwriting.
EXAMPLE: Fred became eligible for Part A and Part B when he turned 65 March. Since he was retired and already receiving social security, he was automatically enrolled in his Part A. He did not realize he had to enroll in Part B on his own and missed his opportunity to enroll. He also did not enroll in a Part D plan when his Part A was effective. It is now August, and he wants to enroll in Part B, as well as a Medicare Advantage plan. Fred was no longer working or receiving group benefits at the time of his 65th birthday.
Fred missed his Initial Enrollment Period so must wait until January 1st to enroll in Part B. If he enrolls in January, his coverage effective date will be February 1st. He can enroll in an MAPD during this time and can do so before the end of April (2 months from his Part B effective date). His MAPD will be effective the month after he enrolls.
| GEP for Part B (Premium-part A) | Coverage start date | MAPD | PDP | Medicare Supplement |
|---|---|---|---|---|
| January 1st – March 31st | Month after signup | Enroll 2 months from Part B effective date. | Cannot enroll if Part A was in effective prior to GEP. | Enroll 6 month from Part A/ Part B effective date |
Reminder About Late Penalties
If you missed your Initial Enrollment Period, you may be charged penalties. Per Medicare.gov, Medicare eligible recipients will “have to pay a penalty for as long as they don’t have Part B. This may increase the monthly premium for Part B 10% for each full 12-month period that they could have had Part B, but didn’t’ sign up for it.” For more information on Part B late enrollment penalties, see the Medicare.gov explanation.
If you are still unsure about the Medicare General Enrollment Period dates, please reach out to our friendly, licensed agents HERE.
