There are certain times each year when you can enroll in a Medicare Advantage Medicare Advantage, also known as Part C, Medicare Private Health Plan, or Medicare Managed Care Plan, allows you to get Medicare coverage from a private health plan that contracts with the federal government. All Medicare Advantage Plans must offer at least the same benefits as Original Medicare (Part A and Part B), but can do so with different rules, costs, and coverage restrictions. Plans typically offer Part D drug coverage as part of Medicare Advantage benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medicare Medical Savings Accounts (MSAs). Plan. It is usually best to enroll in a plan by calling 1-800-Medicare, rather than by calling the new plan. To join an MA Plan, you must be enrolled in Medicare Parts A and B. If you enroll in an MA Plan before you are enrolled in Medicare, your Medicare Advantage coverage will begin the first of the month that you have both Part A Part A, also known as hospital insurance, is the part of Medicare that covers most medically necessary hospital inpatient care, skilled nursing facility (SNF) care, home health care, and hospice care. and Part B Part B, also known as medical insurance, is the part of Medicare that covers most medically necessary doctors’ services, preventive care, hospital outpatient care, durable medical equipment (DME), laboratory tests, x-rays, mental health services, and some home health care and ambulance services. .
You can typically enroll in Medicare Advantage during the following periods:
- Initial Enrollment Period (IEP): Seven-month period, including the three months before, the month of, and the three months after the month you first become eligible for Medicare (either your 65th birth month or the 25th month you have collected disability benefits).
- Initial Coverage Election Period (ICEP): You can enroll in a Medicare Advantage Plan for the first time during this period. The ICEP begins three months before you are enrolled in both Parts A and B and ends either the last day of the second month after the month in which you are first entitled to Part A and enrolled in Part B, or the last day of your Part B Initial Enrollment Period, whichever is later.
- Part B Special Enrollment Period (SEP) for losing job-based insurance: SEPs are periods of time outside normal enrollment periods to enroll in health insurance. This Part B SEP lets you delay enrollment in Part B without penalty if you are covered by job-based insurance when you first become eligible for Medicare. You can enroll in Medicare without penalty for up to eight months after you lose job-based coverage. Your ICEP begins three months before you have both Part A and Part B, and ends the last day of the second month after the month in which you are first entitled to Part A and enrolled in Part B. You may also have an SEP to enroll in an MA Plan that ends two months after the month in which your employer or union coverage ends.
- Part B SEPs for exceptional circumstances: There are SEPs for less common situations, such as if you live in an area impacted by a natural disaster or emergency situation. Your ICEP begins three months before you are enrolled in Part A and Part B and ends the last day of the second month after the month in which you are first entitled to Part A and enrolled in Part B. You also have an SEP to enroll in an MA Plan that ends two months after you are enrolled in Part A and Part B.
- General Enrollment Period (GEP): The January 1 through March 31 period each year when you can sign up for Medicare if you did not sign up for it when you originally became eligible. If you sign up for Medicare during the GEP, you use the ICEP to enroll in a Medicare Advantage Plan. Your ICEP begins three months before you are enrolled in Part A and Part B, and ends the last day of the second month after the month in which you are first entitled to Part A and enrolled in Part B. Your MA Plan coverage begins the first of the month after the month you enroll.
- Fall Open Enrollment Period: The October 15 through December 7 period each year when you can change your Medicare coverage. You can pick a new MA Plan, or switch between Original Medicare Original Medicare, also known as Traditional Medicare, is the fee-for-service health insurance program offered through the federal government, which pays providers directly for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare. and Medicare Advantage. You can also change your stand-alone prescription drug coverage ( Part D Part D, also known as the Medicare prescription drug benefit, is the part of Medicare that provides prescription drug coverage. Part D is offered through private companies either as a stand-alone plan, for those enrolled in Original Medicare, or as a set of benefits included with a Medicare Advantage Plan. ) during this time.
- Medicare Advantage Open Enrollment Period (MA OEP): The January 1 through March 31 period each year when you can switch from your Medicare Advantage Plan (excluding Medical Savings Accounts, cost plans, and PACE) to another Medicare Advantage Plan, or to Original Medicare with or without a Part D plan. You can only use this enrollment period if you have a Medicare Advantage Plan.
- Other SEPs may apply based on your specific circumstances. For a full list of SEPs and requirements, please see the Special Enrollment Period (SEP) Chart.