Planning for enrollment: don’t miss these medicare deadlines

Medicare open enrollment begins soon, and it is an important part of your overall financial plan. But the program’s complexities – and even the Medicare deadlines – can be intimidating. Don’t fret.

If you are approaching or recently turned 65 and don’t have health insurance through your employer, sign up for Medicare during your seven-month window. 

If you are already on Medicare, most plans will automatically renew each year. But it may be wise to compare plans each year to help ensure that you are purchasing the most appropriate and cost-effective type of coverage for your needs in the upcoming year.

We’ve outlined the upcoming Medicare open enrollment dates and deadlines so you can be prepared. First, read through these enrollment period definitions and choose the one that applies to you. Then, skip down to the corresponding enrollment section to learn more.

1. Initial Enrollment: First-time sign-up if you are approaching 65 or just turned 65.
2. Special Enrollment: If you are 65 and have employer-based coverage, you can sign up for Medicare parts A and B anytime, or sign up during a Special Enrollment Period.
3. General Enrollment: If you miss the Initial Enrollment Period, you can sign up for Medicare Part A and/or Part B during this time.
4. Medicare Advantage Open Enrollment: Anyone already enrolled in a Medicare Advantage plan has a one-time election to switch to another Medicare Advantage plan or switch from a Medicare Advantage plan to Original Medicare and a standalone Part D plan.
5. Medicare Open Enrollment: If you currently have a policy, you can change certain types of plans during this time.

Who: People approaching 65 or who just turned 65.

When: This is a seven-month window around your 65th birthday. It begins three months before the month you turn 65, includes the month you turn 65, and ends three months after the month you turn 65.

What: There is a seven-month Initial Enrollment Period to sign up for Medicare parts A, B, C and D.

• In most cases, for those without qualifying employer coverage, if you don’t sign up for Medicare Part B when you are first eligible, you will have to pay a lifetime late enrollment penalty. See “Special Enrollment” below for more information.

Who: If at age 65 you (or your spouse) are still working for an employer with 20 or more employees, and you are covered by a group health plan as defined by the IRS based on that current employment, you can delay signing up for Medicare parts A and B until you retire and your qualified employer health coverage ends.

When: The Special Enrollment Period for Part B is an eight-month window that begins either the month after employment ends or the month after the group health plan insurance based on current employment ends, whichever happens first. People who qualify for a Special Enrollment Period usually avoid a late enrollment penalty.

What: Signing up for Medicare while still under a group health plan can prevent you from contributing to your employer’s Health Savings Account. In addition, this may cause you to pay Medicare Part B premiums unnecessarily.

• Although there are typically no monthly or quarterly costs to sign up for Medicare Part A without Part B, doing so means both you and your employer will no longer be able to contribute to an HSA. Discuss with your financial advisor if starting Medicare Part A makes sense for your individual situation.

Who: If you missed the Initial Enrollment Period and you do not qualify for a Special Enrollment Period, you can sign up for Medicare Part A and/or Part B during the General Enrollment Period.

When: Jan. 1-March 31

What: When you sign up during General Enrollment, coverage begins July 1.

Who: During the annual Open Enrollment Period, anyone already enrolled in a Medicare Advantage plan has a one-time election to switch to another Medicare Advantage plan or switch from a Medicare Advantage plan to Original Medicare and a standalone Part D plan.

When: Jan. 1-March 31

What: You cannot switch from Original Medicare to a Medicare Advantage plan during Medicare Advantage Open Enrollment. You can only change from Original Medicare to Medicare Advantage during Medicare Open Enrollment – see next option below.

Who: Existing Medicare recipients.

When: Oct. 15-Dec. 7

What: You can:

• Change from Original Medicare to a Medicare Advantage plan.
• Change from a Medicare Advantage plan back to Original Medicare.
• Switch from one Medicare Advantage plan to another Medicare Advantage plan.
• Switch from a Medicare Advantage plan that doesn’t offer drug coverage to a Medicare Advantage plan that offers drug coverage.
• Switch from a Medicare Advantage plan that offers drug coverage to a Medicare Advantage plan that doesn’t offer drug coverage.
• Join a Medicare drug plan.
• Switch from one Medicare drug plan to another Medicare drug plan.
• Drop your Medicare drug coverage completely.

Key date: Your new coverage begins Jan. 1.

When you are covered by Medicare, your Part B premium is based on your income. Once you are retired, you may have income options that could help you to stay under the Medicare surtax. Contact us to talk with an Edelman Financial Engines advisor to discuss strategies appropriate for your planning situation and mark your calendar with these important Medicare deadlines.