Many Medicare deadlines are critical for your senior clients. Forgetting or missing them could involve a coverage gap or penalty that will follow your client for the rest of their life.
Whether you're a brand new agent learning the ropes or an experienced agent looking for a cheat sheet, this is the ultimate guide to every important Medicare enrollment period and deadline.
Initial Enrollment Period (IEP)
When: 7-month window that includes three months before, the month of, and three months after your client's 65th birthday
What your client can do: Your client can enroll in Medicare Parts A, B, and D for the first time. If they have other credible coverage, such as an employer group plan if they're still working, they don’t have to sign up for Medicare yet.
Note: If their birthday falls on the 1st of the month, Medicare treats it as if their birthday happened the month prior. For example, if a birthday is February 1st, Medicare counts it as a January birthday month. The whole 7-month window would shift back a month.
Initial Coverage Election Period (ICEP)
When: 7-month window, beginning three months before your client's Part B coverage takes effect
What your client can do: Your client can sign up for a Medicare Advantage plan or Medicare Part D plan. For most people, their ICEP is the same window of time as their IEP. However, if they join Medicare after age 65, their ICEP will begin three months before their Part B coverage takes effect.
Medigap Open Enrollment Period
When: 6-month window that begins the month your client turns 65 and is enrolled in Medicare Part B
What your client can do: During this 6-month window, your client can buy any Medigap policy (also known as Medicare Supplement) sold in their state without having to answer any health questions. After this enrollment period, they will have to go through medical underwriting and risk being declined if they have declinable health problems.
Enrolling in Medicare After Working Past Age 65
When: 8-month window that begins the month after your client's employment ends or the month after their group health plan insurance based on their current employment ends
What your client can do: During this 8-month special enrollment period, they can sign up for Part A and/or Part B of Medicare without any late enrollment period.
When: 12-month period after dropping a Medigap policy to join a Medicare Advantage plan for the first time
What your client can do: If your client had a Medigap policy and dropped it to join a Medicare Advantage plan for the first time, they have 12 months to change their mind and switch back to their prior Medigap policy (if the same insurance company still sells it). If their former Medigap policy isn’t available, they can buy a Plan D or G sold by any insurance company in your state.
Note: The Trial Right does not apply to Medicare Medical Savings Accounts (MSAs), a type of Medicare Advantage plan.
5-Star Enrollment Period
When: December 8-November 30 of the following year
What your client can do: If a Medicare Advantage plan, Medicare Part D drug plan, or Medicare Cost plan with a 5-star rating is available in your client's area, they can use this window of time to switch from their current plan to that 5-star plan.
Notes: You can only use this 5-star enrollment period once in your lifetime. 5-star plans are identified with this icon on Medicare.gov:
Annual Notice of Change (ANOC) Mailing
When: Sometime during September
What your client can do: If your client has a Medicare Part D drug plan or any type of Medicare Advantage plan, they'll receive their ANOC in September. Private plans are required to send this letter, which outlines any changes they’ve made to the plan. Those outlined changes would go into effect on January 1 of the following year.
Next Year’s Part D and Medicare Advantage Plans Announced
When: October 1
What your client can do: Medicare Part D drug plans and Medicare Advantage plans for the next year are announced on October 1st. Your client can't enroll in any plans yet, but they can browse the available plans for next year on Medicare.gov. As an agent, you can start marketing next year's plan on October 1. MA and PDP marketing materials for the following contract year also don't have to be gated anymore – they can be visible in a public place.
The Annual Enrollment Period (AEP)
When: October 15-December 7
What your client can do: Your client can make changes to their Medicare Part D drug plan or Medicare Advantage plan during this window of time in the fall. Outside of special circumstances and turning 65, this is the only time of year they're allowed to switch or enroll in a drug plan or Medicare Advantage plan.
Coverage Begins from AEP Enrollments
When: January 1
What your client can do: If your client signed up for a Medicare Part D drug plan or a Medicare Advantage plan during AEP, that coverage will begin on January 1st. If they didn't make any changes, their current plan will be automatically renewed on January 1st.
Medicare Advantage Open Enrollment Period (MA OEP)
When: January 1-March 31
What your client can do: If your client has a Medicare Advantage plan, they're allowed to switch to a different Medicare Advantage plan or go back to Original Medicare.
Note: The MA OEP does not apply for Medicare Medical Savings Accounts (MSAs), a type of Medicare Advantage plan. Clients have to wait until the next AEP to make changes.
General Enrollment Period (GEP)
When: January 1-March 31
What your client can do: If your client missed signing up for Medicare for the first time, they can sign up for Medicare Part B during this window of time. The Medicare Part B premium penalty will apply, and coverage would begin July 1st.
Drug Plan Enrollment After GEP
When: April 1-June 30
What your client can do: If your client enrolled in Part B during the GEP, they can sign up for a Medicare Part D drug plan between April 1-June 30.
Coverage Begins from GEP Enrollments
When: July 1
What your client can do: If your client signed up for Medicare during the General Enrollment Period, their coverage will start on July 1. Remember: they may have to pay the Part B late enrollment penalty.
Have a cheat sheet handy for Medicare enrollment periods and deadlines!
Be sure to download our Medicare Deadlines Tip Sheet for quick reference, and help your clients avoid penalties and coverage gaps.