Medicare Enrollment Periods

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There are several enrollment periods, Initial, General, and Special. In addition, there are open enrollment periods for Medicare Part D (prescription drug coverage), Medicare Supplement (Medigap), and Medicare Part C (Medicare Advantage). Finally, there is a period disenrollment period from which you can disenroll from your Medicare Advantage Plan and return to Original Medicare.

Each of these enrollment periods are covered in topics within this article.

There can be additional scenarios for special enrollment cases, such as: if you have a disability, OR you are signing up for prescription drug plan (Part D) or Medicare Advantage (Part C) when you signed up for and obtained Medicare part B during the General (not Initial) Enrollment Period.

Disclaimer: for specific details for signing up for Medicare, contact Medicare direct (Medicare.gov or 1-800-633-4227 (1-800-MEDICARE)) or contact the Social Security Administration (https://www.ssa.gov/benefits/medicare/ or 1-800-772-1213). You can also visit your local Social Security office. (Call first to make an appointment.) You can find the local Social Security office here. Most, if not all, Social Security offices are now open to the public. You should be aware that the offices are very busy and appointments should be made before visiting an office. Even with an appointment there could be long wait times.

Jump to Initial Enrollment Period for Medicare Part A, Part B, Part C (Advantage), Part D (Drugs)
Jump to General Enrollment Period for Medicare Part A and Part B
Jump to Special Enrollment Period for Medicare Part B, Part C (Advantage), Part D (Drugs)
Jump to Open Enrollment Period for Medicare Part D (Drugs)
Jump to Open Enrollment Period for Medicare Supplement Coverage (Medigap)
Jump to Open Enrollment Period for Medicare Part C (Medicare Advantage)
Jump to Disenrollment Period for Medicare Part C (Medicare Advantage)

Initial Enrollment Period –
for Medicare Part A, Part B, Part C (Advantage), Part D (Drugs)
The Medicare Supplement (Medigap) coverage enrollment period is slightly different. Refer to the separate topic later in this page for Medicare Supplement (Medigap) enrollment.
(In the linked article, the Initial Enrollment Period is in the first section)

It is very important to sign up for Medicare during the Initial Enrollment Period, especially Part A (hospitalization) and maybe Part B (Medical) and Part D (Drug) unless covered by a qualified employer group health insurance. Avoid having to use the General Enrollment Period or you will probably have to pay penalties for the entire time you have Medicare.

Generally, the Initial Enrollment Period lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

If you are already receiving Social Security at least 4 months before you turn 65, in most cases, you’ll automatically get Medicare Part A and Part B starting the first day of the month you turn 65.

However, there are instances where you may have to manually enroll in Medicare Part A and Part B during your Initial Enrollment Period.

You will sign up for Medicare Part A (hospitalization) and Part B (medical) through the Social Security Administration (https://www.ssa.gov/benefits/medicare/ or 1-800-772-1213). You can also visit your local Social Security office. (Call first to make an appointment.) You can find the local Social Security office here. Most, if not all, Social Security offices are open to the public. You should be aware that the offices are very busy and appointments should be made before visiting an office. Even with an appointment there could be long wait times.

You will also want to sign up for Medicare Part D (prescription drug coverage) during the Initial Enrollment Period, if applicable, to avoid late enrollment penalties. You will need to first sign up for Medicare Part A and Part B before signing up for Medicare Part D, drug coverage. If you elect to sign up for a Medicare Advantage Plan (Part C), and if you want/need prescription drug coverage you must sign up for it through your Medicare Advantage Plan. In most cases you will not be able to obtain a separate Medicare Part D Prescription Drug plan without changing back to Original Medicare.

You will sign up for Medicare Part D (prescription drug coverage) using the Medicare Plan Finder or directly with the plan or contact Medicare at 1-800-633-4227 (1-800-MEDICARE), if you are not electing to use Medicare Part C (Medicare Advantage).

You may also want to sign up for Medicare Supplement (Medigap) coverage. If so, refer to the separate topic below on Medicare Supplement (Medigap) enrollment, if you are not electing to use Medicare Part C (Medicare Advantage).

If you choose a Medicare Part C (Medicare Advantage) plan, you will want to sign up for it during the Initial Enrollment Period, to avoid late enrollment penalties. The Medicare Advantage plan should include prescription drug coverage if you want prescription drug coverage. You will not be able to obtain a Medicare Supplement Plan (Medigap) if you opt for Medicare Part C (Medicare Advantage). You will need to first sign up for Medicare Part A and Part B.

You can sign up for Medicare Part C (Medicare Advantage) using the Medicare Plan Finder or directly with the plan or contact Medicare at 1-800-633-4227 (1-800-MEDICARE).

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.
** 3 months before you turn 65, the month you turn 65, and 3 months after you turn 65 **

For example, three (3) months prior to the month of your birthday, e.g. your birthday month is October, you should sign up in July, August, or September.

However, you it is best to sign up in the 3 months prior to your 65th birthday month and not wait, e.g. your birthday month is October, your Initial Enrollment Period should be in July, August, or September. But, if your birth date is the 1st day of the month, then your Initial Enrollment Period should be in June, July, or August.

Because,
“If you wait until the month you turn 65 (or the 3 months after you turn 65) to enroll, your Part B coverage will be delayed. This could cause a gap in your coverage.”
And, “In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll have to pay this penalty for as long as you have Part B and could have a gap in your health coverage..

If you sign up for Medicare Part A (and Part B) in the three months prior to the month you turn 65, coverage starts on the 1st day of your birthday month.

For example, If your 65th birthday is July 20, 2023. If you sign up for Medicare in April, May, or June, your coverage will start on July 1, 2023. If your birthday is on the first day of the month, your coverage starts the first day of the prior month. If your birth date is the 1st day of the month, then your Initial Enrollment Period should be in March, April, or May.

If you sign up for Medicare Part A (and Part B) the month you turn 65, coverage starts 1 month after you sign up.
If you sign up for Medicare Part A (and Part B) 1 month after you turn 65, coverage starts 2 months after you sign up.
If you sign up for Medicare Part A (and Part B) 2 month after you turn 65, coverage starts 3 months after you sign up.
If you sign up for Medicare Part A (and Part B) 3 month after you turn 65, coverage starts 3 months after you sign up.

If you do not sign up for Medicare during the Initial Enrollment Period, there is a General Enrollment Period (best to avoid if at all possible) and a Special Circumstances (Special Enrollment Period).

If your employer has 20 or more employees.
And, if your employer provides creditable health insurance coverage, You should sign up for Part A when you’re first eligible. Since most people don’t pay a premium for Part A, you should sign up for Part A when first eligible. You can delay getting Part B until you quit the job or are no longer covered by the employer’s creditable health insurance coverage. You will have an 8-month Special Enrollment Period to sign up for Part B when you stop working, even if you choose COBRA or other coverage that’s not Medicare. If you miss this 8-month Special Enrollment Period, you’ll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up.

In regards to Medicare Part D Drug coverage, you can get Medicare drug coverage once you sign up for either Part A or Part B. You can join a Medicare drug plan or Medicare Advantage Plan with drug coverage anytime while you have job-based health insurance, and up to 2 months after you lose that insurance.
Even if you have a Special Enrollment Period to join a plan after you first get Medicare, you might have to pay the Part D late enrollment penalty. To avoid the Part D late enrollment penalty, don’t go 63 days or more in a row without Medicare drug coverage or other creditable drug coverage.
If you have other drug coverage: Ask your drug plan if it’s “creditable drug coverage.”
Each year, your plan must tell you if your non-Medicare drug coverage is creditable coverage. Keep this information — you may need it when you’re ready to join a Medicare drug plan.

General Enrollment Period
for Medicare Part A and Part B
(In the linked article, Scroll down to see the “Between January 1–March 31 each year” topic for the General Enrollment Period.)

Each year Medicare runs a General Enrollment Period (GEP) from Jan. 1 through March 31.

The General Enrollment Period is an opportunity for those who missed their initial Medicare enrollment window to enroll in Medicare Parts A and/or B. Someone joining Medicare for the first time during the General Enrollment Period will have coverage starting the month after enrollment—and may have to pay a late enrollment penalty.

It is best, if at all possible, to avoid signing up for Medicare during a General Enrollment Period. You should, at a minimum, sign up for Medicare Part A during the Initial Enrollment Period to avoid a premium on Part A. You should also sign up for Medicare Part B during the Initial Enrollment Period unless you are confident you will be able to sign up during the Special Enrollment Period, see the next topic.

If you do not sign up for Medicare in the Initial Enrollment Period, you may have to pay a premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B. You could pay an extra 10% for your monthly premium. You could pay the higher premium amount each month for twice the number of years you could have signed up for Part A, but didn’t.

The General Enrollment Period is between January 1-March 31 each year. (Scroll down through the linked article to see the “Between January 1–March 31 each year” topic for the General Enrollment Period.)

Coverage starts July 1 of the years you sign up for Medicare under the General Enrollment Period.

You can sign up for Part A and/or Part B during the General Enrollment Period between January 1-March 31 each year if both of these apply:

You didn’t sign up when you were first eligible.
You aren’t eligible for a Special Enrollment Period (see below).

Check out the “Part A Late Enrollment Penalty, Part B Late Enrollment Penalty, and Part D Late Enrollment Penalty” links at this “Avoid Late Enrollment Penalties” site for information on higher premiums if you sign up during a General Enrollment Period instead of the Initial Enrollment Period.

You may have to pay premiums for Part A and Part B, if applicable. Your coverage will start July 1. You may have to pay a premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.

If you don’t sign up for Part A when you’re first eligible for Medicare, usually when you turn 65, you may have to pay an extra 10% for your monthly premium. You’ll pay the higher premium amount each month for twice the number of years you could have signed up for Part A, but didn’t.

Special Enrollment Period
for Medicare Part B, Part C (Advantage), Part D (Drugs)
(In the linked article, Scroll down to see the “Special Situations (Special Enrollment Periods)” topic for the Special Enrollment Period.)

Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period (SEP).

The Special Enrollment Period is used primarily by people who have “creditable” employer group health insurance coverage and/or “creditable” prescription drug coverage and your employment ends. You should already have signed up for Medicare Part A. You can possibly use the Special Enrollment Period to sign up for Medicare Part B (medical), Medicare Part D (prescription drug coverage), or Medicare Part C (Medicare Advantage (for when you elect to use private HMO/PPO insurance coverage and not use Original Medicare).

Creditable prescription drug coverage is coverage (for example, from an employer or union) that’s expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.

If you have or had health insurance through your job, your spouse’s job (or a family member’s job if you’re disabled*) there is an 8-month Special Enrollment Period to sign up for Part A and/or Part B that starts at one of these times (whichever happens first) (In the linked article, Scroll down to see the “Special Situations (Special Enrollment Periods)” topic for the Special Enrollment Period.):

The month after the employment ends
The month after group health plan insurance based on current employment ends

Usually, you don’t pay a late enrollment penalty if you sign up during a Special Enrollment Period when employment ends.

The Special Enrollment Period may also include those people who:
Are a volunteer, serving in a foreign country. You must contact Social Security for more details.
Or, in certain situations for people with TRICARE. You must contact TRICARE for more details.
The Special Enrollment Period ends at different times for different situations, other than employment, and could be 6 months or could be twelve months.

There are also Special Enrollment Periods if you move and are changing Medicare Part C (Medicare Advantage) or Part D (Prescription drug coverage).

Here is a document from Medicare for “Understanding Medicare Part C & Part D Enrollment Periods”. It has a lot of good information including how to change your Medicare Part C (Medicare Advantage), if applicable, & Part D (prescription drugs) Coverage when there are changes in where you live.

If your employer has fewer than 20 employees.
You should sign up for Part A and Part B when you’re first eligible. In this case, Medicare pays before your other coverage. Learn more about how to get Parts A and B. If you don’t sign up for Part A and Part B, your job-based insurance might not cover the costs for services you get.

If your employer has 20 or more employees.
And, if your employer provides creditable health insurance coverage, You should sign up for Part A when you’re first eligible. Since most people don’t pay a premium for Part A, you should sign up for Part A when first eligible. You can delay getting Part B until you quit the job or are no longer covered by the employer’s creditable health insurance coverage. You will have an 8-month Special Enrollment Period to sign up for Part B when you stop working. COBRA isn’t considered group health plan coverage. Getting COBRA doesn’t change when this Special Enrollment Period ends. If you miss this 8-month Special Enrollment Period, you’ll have to wait to sign up and go months without coverage. You might also pay a monthly penalty for as long as you have Part B. The penalty goes up the longer you wait to sign up.

Open Enrollment Period for Medicare Part D (Prescription Drug Coverage)
(In the linked article, Scroll down to the topic titled “When to Join a Medicare health or drug plan”, “Open enrollment period” topic.)

Each year, you can make changes to your Medicare prescription drug coverage for the following year. You can also elect to join a Medicare prescription drug plan. At the Medicare “Joining a health or drug plan” web page, scroll down to the headline/link “When to Join a Medicare health or drug plan”, “Open enrollment period” topic.”

When is the Open Enrollment Period?
October 15 – December 7

What can I do during the Open Enrollment Period for a Medicare Prescription Drug Plan?

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

IMPORTANT: if you do not sign up for Medicare Part D (prescription drug coverage) during the Initial Enrollment Period you will likely encounter a Late Enrollment Penalty when you want to sign up later. The Late Enrollment Penalty could also apply if you drop prescription drug coverage for any continuous period of 63 days or more after your Initial Enrollment Period is over.

Open Enrollment Period for Medicare Supplement Coverage (Medigap)

There is a 6-month Medigap Open Enrollment Period. However, some states allow you to enroll earlier, up to 3-months prior to your 65th birthday, similar to Medicare Part A and Part B. Contact your state insurance department and/or your insurance company to determine if you can sign up early. After clicking on the state insurance department link, select the SHIP locator to access links to the different states’ health insurance assistance programs.

The best time to buy Medicare Supplement Coverage (Medigap) is during your 6-month Medigap open enrollment period or earlier if possible. During that time you can buy any Medigap policy sold in your state, even if you have health problems.

You should research the Medigap options and contact your chosen provider (insurance company) in advance of the open enrollment period. It can take 10-15 business days, or longer, to have Medigap approved, date of application, card in hand. It is advisable to do it at least three weeks in advance.

After this enrollment period, you may not be able to buy a Medigap policy. If you’re able to buy one, it may cost more.

The Medicare website has a “Find a Medigap policy that works for you” section that will step you through selecting the insurance company you will use to provide Medigap insurance (Supplement Coverage). You will have already reviewed the Medigap Plan types A, B, D. G, K, L,M, N. Medigap Plan types C and F aren’t available if you turned 65 on or after January 1, 2020, and to some people under age 65. Check out the Medigap Supplement Coverage (Medigap) topic on this site for additional information.

Some states have additional Open Enrollment Periods including those for people under 65. As of 2023, the states with additional Open Enrollment for Medigap (Medicare Supplement plans) include California, Connecticut, Idaho, Illinois, Maine, Massachusetts, Missouri, Nevada, New York, and Oregon. However, you should contact your state insurance department for more information before you do anything.

Here is a good publication from Medicare covering Medicare Supplement plans (Medigap).
2024 Choosing a Medigap Policy – A Guide to Health Insurance for People with Medicare.
You can also go to the Medicare “How to compare Medigap policies” website for information.

When is the Medicare Supplement (Medigap) Open Enrollment period?
Starts the month you turn 65 and are enrolled in Medicare Part B (medical).

During your Medigap Open Enrollment Period, you have a “guaranteed issue right” to buy any Medigap plan sold in your state. Guaranteed issue rights (also called “Medigap protections”), (scroll down to the guaranteed issue rights link), are rights you have in certain situations when insurance companies must offer you certain Medigap policies. Thus allowing you to return to Original Medicare and drop the Medicare Advantage Plan.

Switching Medigap policies

In most cases, you won’t have a right under Federal law to switch Medigap policies, unless one of these applies:
You’re eligible under a specific circumstance or guaranteed issue rights
You’re within your 6-month Medigap open enrollment period

However, there are several situations you can review to see if switching Medigap policies would work for you. If you are eligible to switch Medigap policies, you have 30 days (“free look period”) to decide if you want to keep the new Medigap policy. The 30-day free look period starts when you get your new Medigap policy. You’ll need to pay both premiums for one month. Don’t cancel your first Medigap policy until you’ve decided to keep the second Medigap policy.

Open Enrollment for Medicare Part C (Medicare Advantage)
(In the linked article, Scroll down to the headline/link “Open Enrollment Period” OR “Medicare Advantage Open Enrollment Period”.)

Each year, you can make changes to your Medicare Advantage plan for the following year. You can also elect to join a Medicare Advantage plan. At the Medicare “Joining a health or drug plan” web page, scroll down to the headline/link”Open Enrollment Period” OR “Medicare Advantage Open Enrollment Period”.

Primary Open Enrollment Period:
(Scroll down to the headline/link “Open Enrollment Period”.)
October 15 – December 7

What can I do during the Open Enrollment Period for a Medicare Part C (Advantage) Plan?

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.

Secondary Open Enrollment Period:
(Scroll down to the headline/link “Medicare Advantage Open Enrollment Period”.)
January 1 – March 31 or within the first 3 months you get Medicare.

What can I do during this secondary Open Enrollment Period for a Medicare Part C (Advantage) Plan?

Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
You can disenroll from your Medicare Advantage Plan and return to Original Medicare. If you choose to do so, you’ll be able to join a Medicare Prescription Drug Plan.
If you enrolled in a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without drug coverage) within the first 3 months you have Medicare.
Join a Medicare Prescription Drug Plan if you’re in Original Medicare.

What can’t I do during the secondary Open Enrollment Period for a Medicare Part C (Advantage) Plan?

Switch from Original Medicare to a Medicare Advantage Plan.

It is important to note that if you want to change from a Medicare Advantage back to Original Medicare and obtain Medicare Supplement (Medigap) coverage, your acceptance into a Medicare Supplement (Medigap) plan ISN’T ALWAYS GUARANTEED. For example, if you have health problems, the insurance company can base its decision on your health history in a process known as medical underwriting. The company can decide not to sell you a plan, or to charge you more because of your health condition. In some cases you may be able to change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed issue rights (scroll down to the guaranteed issue rights link), meaning that the insurance company must accept you as a member and cannot charge you more due to your health condition. However, in some cases the company may be allowed to impose a waiting period on coverage relating to your health condition.
It is also important to note that if you want to change from a Medicare Advantage Plan to Original Medicare, you should obtain Medicare Part D (prescription drug coverage).

Disenrollment for Medicare Part C (Medicare Advantage)
(In the linked article, Scroll down to the headline/link “Open Enrollment Period” OR “Medicare Advantage Open Enrollment Period”.)

Each year, you can leave your Medicare Advantage plan and switch to Original Medicare. At the Medicare “Joining a health or drug plan” web page, scroll down to the headline/links “Open Enrollment Period” OR “Medicare Advantage Open Enrollment Period.”

When is the Disenrollment Period for Medicare Part C (Medicare Advantage)?
Open Enrollment Period
October 15-December 7.

Medicare Advantage Open Enrollment Period
(only if you’re already in a Medicare Advantage Plan)
January 1-March 31.
Within the first 3 months you get Medicare.

What can I do during the Disenrollment Period for a Medicare Part C (Advantage) Plan?

If you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare.
If you switch to Original Medicare during this period, you can also add Medicare drug coverage. You’ll have the same time periods to join a Medicare Prescription Drug Plan. Your coverage will begin the first day of the month after the plan gets your enrollment form.

It is important to note that if you want to change from a Medicare Advantage back to Original Medicare and obtain Medicare Supplement (Medigap) coverage, your acceptance into a Medicare Supplement (Medigap) plan isn’t always guaranteed. For example, if you have health problems, the insurance company can base its decision on your health history in a process known as medical underwriting. The company can decide not to sell you a plan, or to charge you more because of your health condition.In some cases you may be able to change from a Medicare Advantage plan to a Medicare Supplement plan with guaranteed issue rights (scroll down to the guaranteed issue rights link), meaning that the insurance company must accept you as a member and cannot charge you more due to your health condition. However, in some cases the company may be allowed to impose a waiting period on coverage relating to your health condition.
It is also important to note that if you want to change from a Medicare Advantage Plan to Original Medicare, you should obtain Medicare Part D (prescription drug coverage).

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