Your Members’ Guide to Understanding Medicare Enrollment Periods

Your Members’ Guide to Understanding Medicare Enrollment Periods

Are your members reaching Medicare eligibility? They may have some questions! If you have members approaching their eligibility date and you’re helping them navigate their health care coverage, understanding enrollment periods is key. Missing a deadline could mean delayed coverage or costly penalties.

We know you keep your members well informed, but we want to make it easier for you to provide them with information about Medicare enrollment windows and what they can do during each phase.

Initial Enrollment Period (IEP)

When: Starts three months before the month your member turns 65 — includes their birthday month — and ends three months after, for a total of seven months.

What they can do during the IEP:

• Enroll in Medicare Part A and/or Part B
• Join a Medicare Advantage Plan (Part C)
• Add a Part D prescription drug plan

Tip: Tell your members to enroll early to avoid delays in coverage and potential late penalties.

General Enrollment Period (GEP)

When: January 1 to March 31 of each year

What your member can do during the GEP:

• Sign up for Part A and/or Part B if they missed their IEP

Coverage begins on the first of the month after they enroll.

Note: Your member may face a late enrollment penalty if they didn’t qualify for a Special Enrollment Period.

Annual Enrollment Period (AEP)

When: October 15 to December 7 of each year

What your member can do during the AEP:

• Switch between Original Medicare and Medicare Advantage
• Change or drop their Part D plan
• Enroll in a new Medicare Advantage plan

Coverage begins January 1 of the following year.

Special Enrollment Periods (SEPs)

SEPs are triggered by specific life events, such as:

• Moving to a new area
• Losing employer or Medicaid coverage
• Being released from incarceration
• Returning to the U.S. after living abroad

What your member can do during an SEP:

• Make changes to their Medicare Advantage or Part D plans
• Avoid late penalties if they qualify

An SEP usually lasts two full months after the qualifying event.

Medicare Advantage Open Enrollment Period

When: January 1 to March 31

What your member can do during Medicare Advantage Open Enrollment:

• Switch to a different Medicare Advantage plan
• Drop Medicare Advantage and return to Original Medicare
• Join a Part D plan if returning to Original Medicare

Note: Your member can only make one change during this period.

Understanding these enrollment periods is important so that your members can avoid penalties, ensure continuous coverage and choose the best plan for their needs.

The AdventHealth Well 65+ Difference

At our AdventHealth Well 65+ senior primary care clinics, your members’ health and well-being are our highest priority. Your members will experience high-quality care and unmatched compassion at every appointment.

• Same- and Next-Day Appointments: We make it easy for patients to get care when they need it
• Longer Visits: Extended appointments ensure patients get more time with their provider to address concerns
• Board-Certified Physicians: Our dedicated physicians are experienced in caring for adults aged 65 and older
• Advanced Practice Providers: Our certified APPs provide comprehensive care in a collaborative setting

To learn more about AdventHealth Well 65+ and the way we care for the senior community, connect with us on LinkedIn.

Sources:

https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start

https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods