Medicare-related enrollment dates and guidelines

 

Medicare Supplement Open Enrollment

 

  • The best time to buy a Medigap policy is during your Medigap Open Enrollment Period, which is the six-month period that begins on the first day of the month in which you turn 65 or older and have enrolled in Part B. (Some state have additional Open Enrollment Periods.) After this enrollment period, you may not be able to buy a Medigap policy. If you are able to buy one, it may cost more.
  • If you delay in Part B because you have group health coverage based on you (or your spouse's) current employment, you Medigap Open Enrollment Period won't start until you sign up for Part B

September & October—Review and Compare Medicare Advantage Plans

 

  • Review any notices from your plan about changes for next year. To learn more about your options download Medicare and You
  • This is the one time of year when ALL people with Medicare can make changes to their health and prescription drug plans for the next year.

 

Medicare Annual Enrollment For Medicare Advantage and Part D Plans

Between: October 15- December 7

 

  • 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 Prescription Drug Plan.
  • Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
  • Drop your Medicare prescription drug coverage completely.

January 1—Coverage Begins

 

  • Your new coverage begins if you switched to a new plan. If you stay with the same plan, any changes to coverage, benefits, or costs for the new year will begin on January 1.

 

Medicare Open Enrollment For Medicare Advantage

Between January 1–March 31st

 

  • If you’re in a Medicare Advantage Plan (like an HMO or PPO), You can change to a different Medicare Advantage Plan
  • If you’re in a Medicare Advantage Plan (like an HMO or PPO), you can leave your plan and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until March 31st, to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

 

Special Enrollment Period

A Medicare Special Enrollment Period is an opportunity for people in special circumstances to enroll in Medicare. During a Special Enrollment Period (SEP), you can join, switch or drop a Medicare Advantage or prescription drug plan outside the basic enrollment periods. In order to qualify for an SEP, certain events must occur that require you to change your coverage.

 

You may qualify for a Medicare Special Enrollment Period in the following situations:

 

  • You move out of your plan’s service area.
  • Your plan closes, stops serving the area where you live, significantly reduces its provider network or your plan consistently receives low Medicare star ratings.
  • You want to enroll in a 5-star plan at any time or drop your first Medicare Advantage plan within 12 months of enrolling.
  • You move into or out of a qualified institutional facility, like a nursing home.
  • You are enrolled in or lose eligibility for a qualified State Pharmaceutical Assistance Program.
  • You have Medicare financial assistance such as Medicaid, a Medicare Savings Program or Extra Help, or you gain or lose eligibility for any of these.
  • You enroll in or leave the Program of All-Inclusive Care for Elderly (PACE).
  • You gain or lose eligibility for a Special Needs Plan.

 

Some situations not listed here may qualify for a Special Enrollment Period as well. If you have questions about your personal situation, call us at 1(800) 459-6087

Or email at vic@vcritelliinsurance.com

 

 

The 5-Star Enrollment Period 

The 5-star enrollment period for Medicare Advantage. This SEP lasts for nearly a year as it runs from December 8 to November 30 of the following year.

If a Medicare Advantage plan with a 5-star rating is available in your area, you can use the 5-star Special Enrollment Period (SEP) to switch from their current Medicare plan to a Medicare plan with a “5-star” quality rating.
 

Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans. A plan can get a rating between 1 and 5 stars. A 5-star rating is considered excellent.

CMS rates Medicare Advantage and Part D plans annually, using a scale from one to five, with more stars equating to better performance and quality. A five-star rating is the highest a Medicare Advantage or Part D plan can receive, and half-ratings also exist (1.5, 2.5, 3.5, 4.5).

 

Here’s what the star ratings mean:

 

  • 5-star rating: excellent performance
  • 4-star rating: above-average performance 
  • 3-star rating: average performance
  • 2-star rating: below-average performance
  • 1-star rating: poor performance

 

Medicare Advantage Trial Right Period

If you enroll in a Medicare Advantage plan during your Initial Coverage Election Period when you were first eligible for Medicare, Or you have dropped a Medicare Supplement policy to enroll in a Medicare Advantage Plan for the first time, you are entitled to a 12-month trial period. During this 12-month window, you have a Special Enrollment Period you can use at any time to cancel your Medicare Advantage plan and return to Original Medicare.

 

 

 

By contacting the phone number on this website you will be directed to a licensed agent.

 

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