Understanding Other Medicare Enrollment Periods It is important to understand when to enroll in a Medicare Advantage plan outside of IEP and AEP
Medicare Advantage Open Enrollment Period (OEP)
Medicare Advantage participants can make a one-time plan change from January 1 through March 31. The Medicare Advantage OEP offers a one-time opportunity to:
- Switch to a different Medicare Advantage plan
- Drop Medicare Advantage and return to Original Medicare (Parts A and B)
- Sign up for a stand-alone Medicare Part D Prescription Drug plan, if you elect to return to an Original Medicare plan
The Medicare Advantage OEP is only accessible for current Medicare Advantage policyholders. During this time, Original Medicare policyholders cannot:
- Switch from Original Medicare to a Medicare Advantage plan
- Join a Medicare Prescription Drug plan (Part D)
- Switch Medicare Prescription Drug plans
Special Enrollment Period (SEP)
Certain events and life changes, such as moving or losing employer coverage, may allow you to enroll in Medicare or make changes to your existing Medicare Advantage coverage. These changes are called Medicare Special Enrollment Periods (SEP). There are special rules about the changes that someone may be able to make during this time.
SEP events for Medicare Advantage include:
- Moving to a new address that isn't in your current plan's service area
- Moving to a new location where new plan options are available, even though your current plan also includes coverage for your new address
- Returning to the U.S. after living outside the country
- Moving in or out of a skilled nursing facility or long-term care hospital
- Being released from jail
There is also one SEP for Original Medicare:
- Delaying enrollment in Medicare Parts A and B because you or your spouse worked past 65 and you are losing your group coverage, or you (or your spouse) stopped working.
In addition, there is a Medicare Advantage SEP that is provided for individuals who are Dual-Eligible or receive "Extra Help" (also known as Low Income Subsidy). Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. If you receive Extra Help in 2019, there is a SEP to enroll in a Medicare Advantage plan with or without drug coverage, or a Part D plan or switch between plans. This SEP is available once per quarter for the first three quarters of the year (January-March, April-June and July-September). Coverage changes become effective the first day of the month following the change.
Pete M., 8/9/2018