Now that we are in a new plan year for Medicare health and drug coverage, some Medicare beneficiaries may find that that their current coverage does not meet their needs. Others who did not sign up for Medicare Part B when they were first eligible may be looking to enroll now. There are two enrollment periods available currently that have a March 31st deadline:
General Enrollment Period for Medicare Part B
Each year, individuals who did not sign up for Medicare Part B when they were first eligible can enroll in Part B during the General Enrollment Period, which runs from January 1st through March 31st. Coverage for those who enroll during the General Enrollment Period starts July 1st.
Social Security Administration (SSA) offices are still closed to the public due to the COVID pandemic. People can apply for Medicare in the following ways: 1) online at www.ssa.gov, 2) mail Medicare enrollment forms to a local SSA office (we recommend keeping a copy of the completed forms and sending them certified), or 3) fax application to 1-833-914-2016. Further information about how to apply for Medicare can be found on SSA’s website.
Medicare Advantage Open Enrollment Period
The Medicare Advantage Open Enrollment period runs from January 1st through March 31st. This enrollment period allows people who are enrolled in a Medicare Advantage plan on January 1st to switch to another Medicare Advantage plan (with or without drug coverage) or disenroll from their Medicare Advantage plan and return to Original Medicare. Anyone choosing to return to Original Medicare during this period will be able to join a stand-alone prescription drug plan for Part D coverage.
Only one change may be made during this period, but people may have other opportunities to change their plan outside of this enrollment period. See the next section (below) describing other opportunities to change Medicare. Any change made during this period will become effective the first day of the next month. For example, if someone disenrolls from their Medicare Advantage plan and enrolls in a prescription drug plan on March 5th, they will have Original Medicare and their chosen prescription drug plan coverage starting on April 1st.
There are other opportunities to change Medicare health and drug plans during the year. They include:
Special Enrollment Period for Dual Eligibles and People with Extra Help
Dual eligibles (people with both Medicare and Medicaid coverage) and other individuals who are eligible for Extra Help with their Part D costs can change their Medicare health or drug plan once per quarter during each of the first three quarters in a calendar year. Changes made during the first three quarters of the year will start the first of the next month. After September 30th, duals and those eligible for Extra Help can use the yearly Open Enrollment Period (October 15th – December 7th) to make changes and with the new plan starting January 1st.
Other Special Enrollment Periods (SEPs)
There are several other SEPs that exist for various circumstances that people can use to make coverage changes during the year. Common ones include when people move, when people lose Medicaid coverage, or when people lose other prescription coverage and need to enroll in Part D.
A Special Enrollment Period may be available for other special circumstances, for example when someone experienced a marketing violation or was given misleading information by someone like an agent or broker or from the Plan Finder and enrolled in a plan that does not meet their needs. If you, or a consumer you work with, believe you received misinformation and ended up with Medicare coverage that does not work for you, call 1-800-MEDICARE to explain your circumstances and discuss the availability of a Special Enrollment Period. For more information about Medicare enrollment periods and other SEPs that may be available, see Medicare’s publication on this topic here.
We encourage people who have questions about Medicare plan choices or who need help enrolling or changing plans to call PA MEDI (formerly APPRISE) at 1-800-783-7067.