Medicare General Enrollment Period

What can I do during the Medicare General Enrollment Period?

The Medicare General Enrollment Period (also known as “GEP”) for Medicare beneficiaries who were not automatically enrolled original Medicare Part B can enroll during the Medicare General Enrollment Period.  If you are receiving Social Security benefits and turn 65 years of age enrollment in original Medicare Part A and Part B are automatic; however, you can opt out of Part B.  However, if you are not receiving Social Security benefits you need to enroll in original Medicare Part A and Part B during your Initial Enrollment Period (also known as “IEP”) which occurs three months before the month in which you turn 65 years of age, includes your birth month, and ends three months after your birth month.  It is recommended that you enroll during your Initial Enrollment Period for both original Medicare Part A and Part B; however, if you choose not to participate in original Medicare Part B, then it is highly recommended that you enroll in original Medicare Part A because it is typically provided at no cost and provides additional coverage you may not have, or it can assist with your employer group plan by being secondary coverage.  Regardless, if you do not enroll in original Medicare Part A or Part B, or you opt out of original Medicare Part B during your Initial Enrollment Period, you will have to wait until the Medicare General Enrollment Period to sign up for original Medicare Part A and/or  Part B. 

When is the Medicare General Enrollment Period?

The  Medicare General Enrollment Period starts January 1st and ends March 31st, with an effective date of coverage of original Medicare Part A and Part B of July 1st of the same year.  Important note:  although your original Medicare Part A and Part B will not go into effect until July 1st, you must enroll by March 31st, or you will have to wait until the next Medicare General Enrollment Period. 

What about late enrollment penalties?

If you enroll in original Medicare Part B during the Medicare General Enrollment Period because you missed your Initial Enrollment Period then you will be responsible for penalties for late enrollment for original Medicare Part B.  Since original Medicare Part A is usually provided at no charge or premium there will be no late enrollment penalty for late enrollment in original Medicare Part A; however, late enrollment in original Medicare Part B will result in penalties.  The late enrollment penalty for original Medicare Part B is 10 percent for each 12-month period you were eligible for original Medicare Part B, but did not enroll in original Medicare Part B.  Therefore, if you did not enroll in, or opted out of, original Medicare Part B during your Initial Enrollment Period then you will have to wait until the Medicare General Enrollment Period to enroll and be assessed the late enrollment penalty for original Medicare Part B. 

For example, the current monthly premium for original Medicare Part B is $104.90, and you delay enrollment in original Medicare Part B, then you will pay an additional $14.90 for your original Medicare Part B premium.  The penalty is calculated based on each 12-month period you were eligible for original Medicare Part B but did not have original Medicare Part B. 

Can I avoid late penalties by enrolling during the Medicare General Enrollment Period?

If you were working and had coverage through a group, or your spouse’s employer group insurance plan, or if you had retired but were still covered by your prior employer group retirement plan, or your spouse’s group coverage plan, then you can enroll in original Medicare Part A and/or Part B during other times during the year other than the Medicare General Enrollment Period.  If your coverage through an employer group plan terminates, if you voluntarily terminate your employer group coverage, or you are advised the group coverage is no longer creditable coverage, a Special Enrollment Period (also known as “SEP”) opens which allows you the opportunity to enroll in original Medicare within 63 days of the date of last coverage.  If you go beyond the 63 days after the date of last coverage then you will have to wait until the Medicare General Enrollment Period to enroll in original Medicare Part A and/or Part B.  Late enrollment penalties will not be assessed if you had creditable coverage and that is the basis for not enrolling in original Medicare Part B during your Initial Enrollment Period.  If you enroll in original Medicare Part A and Part B during this Special Enrollment Period, then coverage begins the 1st day of the following month.

Why would you not to enroll in original Medicare Part B during your Initial Enrollment Period?

Some situations that result in an individual having to wait and enroll in original Medicare during the Medicare General Enrollment Period include the following:

  • The Medicare beneficiary does not enroll in original Medicare Part B, or opts out of Part B coverage based upon the fact that it has a monthly premium and they do not want to pay the premium. 
  • Some Medicare beneficiaries may feel like they cannot afford the premium but do not realize they may qualify for assistance, or Medicaid, that can assist with the original Medicare Part B premium (and penalty). 

Regardless of the reason for not enrolling in, or opting out of, original Medicare Part B, typically the Medicare beneficiary does not realize there are penalties that will be assessed for not having original Medical Part B coverage when they could have, or they do not realize the significance of the amount of the penalty that they will have to pay for late enrollment.  Additionally, the Medicare beneficiary may not realize that by not enrolling in original Medicare Part B during their Initial Enrollment Period or a Special Enrollment Period, they cannot enroll until the next Medicare General Enrollment Period, which is always January 1st through March 31st of each year.

What else can I do during Medicare’s General Enrollment Period?

If you enroll in original Medicare Part B during the Medicare General Enrollment Period this opens a Special Enrollment Period which allows the Medicare beneficiary to purchase insurance through a private insurance carrier to assist with the out-of-pocket costs associated with original Medicare.  The Special Enrollment Period allows the new Medicare Part B enrollee to make one selection to join a Prescription Drug Plan (also known as “PDP” or “Part D”).  However, because beneficiaries who only have original Medicare Part A but not Part B are not eligible to enroll in a Medicare Advantage plan, this Special Enrollment Period enables Medicare beneficiaries who elect Part B during Medicare’s General Enrollment Period to enroll in a Medicare Advantage plan with drug coverage (also known as “MAPD”).  The Medicare Advantage plan will go into effect July 1st, the same date as original Medicare Part B if you enrolled during the Medicare General Enrollment Period.

The Medicare General Enrollment Period for enrollment in original Medicare Part A and/or Part B is underway and will end on March 31st.  As noted above, enrollment in original Medicare Part B opens a Special Enrollment Period which allows the Medicare beneficiary to purchase a Medicare Advantage plan.  The Special Enrollment Period for enrollment in a Medicare Advantage plan for a new Medicare Part B enrollee ends at the same time as the Medicare General Enrollment Period.  It is important if you do not have original Medicare Part A and/or Part B that you enroll in original Medicare during the Medicare General Election Period and contact a Medicare Pathways Benefit Specialist for assistance in enrollment in a Medicare Advantage plan.  A Medicare Pathways Benefit Specialist will assist in reviewing the plans that are available in your area and, by completing a needs analysis, can assist you in finding the most affordable and most appropriate Medicare Advantage plan to assist you with your out-of-pocket costs that original Medicare Part A and Part B leave the beneficiary responsible for paying.  Contact a Medicare Pathways Benefit Specialist today by calling 1-866-466-9118 to begin your needs analysis and enrollment in a Medicare Advantage plan or a Prescription Drug Plan.  You can also request a quote by clicking Get a Quote!

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