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New to Medicare? Here are enrollment periods you need to know

If you or a loved one is about to turn 65 and are new to Medicare, you’ve probably had questions about what you need to do and whether you need to sign up. There are some key time frames you should keep in mind to ensure you sign up in a timely manner so you do not lose access to primary health coverage or accrue any penalties for signing up late. 

Here, we discuss the most important sign-up periods  for those who are new to Medicare. In addition, we have also created a personalized guide here to help walk you through some of the best timelines for your unique needs. 

Before we discuss these, let’s start with two important notes:


- These sign-up windows are when you can sign up for Original Medicare, known as Part A and Part B. While signing up for Part A and Part B is a prerequisite to enroll in a Medicare Supplement plan, also known as a Medigap plan, or a Medicare Advantage plan, the process to sign up for those plans can be different. But they have the same starting point -- signing up for Part A and Part B. 

- Once you use one of these enrollment windows and are signed up for both Part A and Part B, you typically do not need to use a subsequent enrollment period. If you only sign up for Part A, however, you may use a subsequent enrollment period to sign up for Part B. 

As always, you can reach out to us directly at [email protected] or 605-205-8869 with any questions. 

Initial Enrollment Period

In most cases, Americans are first eligible for Medicare when they turn 65. There is a 7 month Initial Enrollment Period to sign up for Part A as well as Part B. It is important to note the dates this trial begins: 

- 3 months before the month you turn 65 is when people become eligible for Medicare

- This period also Includes the month you turn 65

- The Initial Enrollment Period Ends 3 months after the month you turn 65

We have put together an image to help you and your loved ones map out this Initial Enrollment Period.

In most circumstances, you should consider using the Initial Enrollment Period to sign up for Original Medicare if you or your spouse do not have employer-based coverage when you turn 65. If you do have employer-based coverage, you may want to use the Initial Enrollment Period to sign up for only Part A. 


Special Enrollment Period

If your Initial Enrollment Period has ended (or if you choose not to use it because you are employed at an organization with more than 20 people on its health plan), you may have a Special Enrollment Period to sign up for Original Medicare. 


This period is available to individuals or their spouses who are receiving health insurance from their employer (provided that employer has more than 20 employees on its health plan.) 


This period lasts for eight months after losing or ending employer-based coverage. Notably, employees can choose to transition to Medicare at any point to use this period -- they do not need to wait for a particular time during the calendar year. (If you are in this situation, you can use our Medicare Premiums Calculator to see if you might be able to get better benefits for less on Medicare relative to your employer coverage.)


If you are eligible and use the Special Enrollment Period to enroll in Original Medicare, you should be exempt from any penalties that might otherwise apply in situations where people wait to sign up for Part B past their Initial Enrollment Period. 


Notably, if you want to both sign up for Original Medicare and choose either a prescription drug plan or a Medicare Advantage plan, you will want to make your choice much sooner and ideally right when you retire. This will help to ensure you can sign up for these types of additional coverage. 


If you have any questions about the Special Enrollment Period, our team of advisors can help. We can help with any questions on costs, as well as on avoiding or minimizing gaps in coverage, Medigap waiting periods for pre-existing conditions, and potential penalties. 



General Enrollment Period 

If you missed your Initial Enrollment Period and are not able to use the Special Enrollment Period, you can consider signing up for Original Medicare during the General Enrollment period which starts on January 1 and runs to March 31 every year. If you choose to enroll during this time period, note your coverage will start on July 1. 


If you waited past your Initial Enrollment Period and an eligible Special Enrollment Period, you may be subject to penalties that Medicare assesses for late enrollments in Part B. 


You can learn more about the Original Medicare late enrollment penalties by clicking here and here.


If your situation falls into this bucket, our advisors can help you into the best course of action. You can give them a call at (605) 206-8869


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