Medicare Enrollment & Plan Options

Medicare Overview

Medicare Enrollment Overview

Medicare is a federal health insurance program primarily for individuals aged 65 or older, certain younger people with disabilities, and those with End-Stage Renal Disease (ESRD). Enrollment in Medicare involves choosing from four parts, each covering specific healthcare needs.

Part A (Hospital Insurance)

Covers inpatient hospital stays, skilled nursing facility care, hospice, and some home healthcare. Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes while working.

Part B (Medical Insurance)

Covers doctor visits, outpatient care, preventive services, and medical supplies. It requires a monthly premium, which varies based on income.

Part C (Medicare Advantage)

Offered by private insurers approved by Medicare, these plans include Parts A and B coverage and often additional benefits like dental, vision, or prescription drug coverage. Costs and coverage vary by plan.

Part D (Prescription Drug Coverage)

Offered by private insurers approved by Medicare to provide prescription drug coverage. Plans differ in premiums, drug costs, and covered medications.

Medicare Supplements (Medigap)

While not a Medicare “Part,” Medicare Supplements are useful ways to provide additional coverage to fill the gaps of original Medicare.

Medicare Initial Enrollment Period

The Initial Enrollment Period (IEP) is a seven-month window when individuals first become eligible to enroll in Medicare. This is the most common time for Medicare-eligible people to enroll. It begins three months before the month you turn 65, includes your birth month, and extends three months afterward. During this period, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance).

For most people, Part A is premium-free if they’ve paid Medicare taxes while working. Part B requires a monthly premium. If you don’t enroll in Part B during the IEP and don’t have qualifying coverage (like employer-sponsored insurance), you may face a late enrollment penalty that increases your Part B premium permanently.

The IEP also allows you to enroll in a Medicare Advantage Plan (Part C) or a standalone Prescription Drug Plan (Part D). These options may offer additional benefits, like drug coverage, vision, or dental care. Missing this window without other creditable coverage may also lead to late enrollment penalties for Part D.

To avoid penalties and ensure continuous coverage, it’s crucial to evaluate your healthcare needs and sign up during the IEP. We specialize in helping newly-eligible Medicare beneficiaries navigate their IEP. Special Enrollment Periods (SEPs) may apply later if you have certain circumstances, like delayed retirement or employer-provided insurance.

All Enrollment Periods

Initial Enrollment Period (IEP)

A 7-month window around your 65th birthday (3 months before, the month of, and 3 months after).

General Enrollment Period (GEP)

January 1 to March 31 for those who missed their IEP, with coverage starting July 1. Late enrollment may result in penalties.

Special Enrollment Period (SEP)

For qualifying circumstances like losing employer coverage or moving to a different state.

Annual Enrollment Period (AEP)

October 15 to December 7, for changing plans or adding coverage.

Timely enrollment is crucial to avoid late penalties and gaps in coverage. Let us review plans with you to ensure they meet your healthcare needs and budget.