The two dates everyone mixes up
Open Enrollment is not the only window, and it is not for everything.
October 15 through December 7 is Medicare Open Enrollment, when anyone with Medicare can join, drop or switch a Medicare Advantage plan or a drug plan. Changes take effect January 1, and the plan has to receive your request by December 7. It is the window most people know about. It is also not the window most people actually need.
- Open Enrollment, October 15 to December 7: change Advantage plans or drug plans, or move between Original Medicare and Advantage. Effective January 1.
- Medicare Advantage Open Enrollment, January 1 to March 31: only if you are already in an Advantage plan, and only one change. You can switch Advantage plans or drop back to Original Medicare and add a drug plan.
- During that January window you cannot move from Original Medicare into an Advantage plan, and you cannot switch drug plans if you are on Original Medicare.
- General Enrollment Period, January 1 to March 31: for people who missed their first window entirely. Coverage starts the first of the month after you sign up.
The most expensive trap on this page
Eight months for Part B. Two months for your drug plan.
When you or your spouse stops working and the group coverage ends, you get an eight-month Special Enrollment Period to take Part B. That part is widely known. What almost nobody is told is that the window to join a Medicare Advantage or Part D drug plan is only two full months. People use their eight months for Part B, feel like they handled it, and pick up a lifetime drug penalty on the way. And COBRA does not pause either clock.
- Part B after employer coverage ends: 8 months, beginning the month after the employment or the coverage ends, whichever happens first.
- Medicare Advantage or Part D after that same coverage ends: 2 full months. That is the one that catches people.
- COBRA does not extend either window. The clock runs whether or not you elect it.
- Going more than 63 days without creditable drug coverage is what triggers the Part D penalty.
Special Enrollment Periods
Life changes can open a window outside the calendar.
You do not always have to wait for the fall. A number of situations open a Special Enrollment Period, most of them running two full months after the month the change happens. If any of these describe you, call us before you assume you are stuck.
- You moved, and your plan is not available where you live now, or new plans are.
- You lost Medicaid eligibility. This one gives you 3 full months from the date you lost it or were notified, whichever is later.
- You moved into, live in, or moved out of a nursing home or long-term care facility.
- Your employer or union coverage ended, or you lost creditable drug coverage.
- Your plan left Medicare, or Medicare ended its contract with your plan.
- You are eligible for a 5-star plan in your area. Once a year, December 8 through November 30.
- You were released from incarceration, or you moved back to the United States.
- You qualify for Extra Help or Medicaid. That allows a change once per calendar month.
One time only, and it never comes back
Medicare Supplement open enrollment does not repeat.
If you want a Medicare Supplement, also called Medigap, you get one six-month window that starts the first month you have Part B and are 65 or older. Inside it, a company cannot refuse you, cannot use your health history to decide, and cannot charge you more for pre-existing conditions. After it closes there is no federal guarantee that anyone will sell you a policy, and if they do it may cost more. This is not the fall Open Enrollment period, and it does not come around again every year. Read that twice, because assuming otherwise is how people lose a protection they cannot get back.
- Guaranteed issue rights exist in certain situations after the window, including losing coverage through no fault of your own.
- You may have additional rights under Colorado law. Check with the Colorado Division of Insurance, or ask us and we will look with you.
- Supplements are standardized differently in Massachusetts, Minnesota and Wisconsin.
What arrives in the mail, and when
When to expect your card.
If you are already receiving Social Security when you turn 65, you are enrolled automatically and your welcome package with your red, white and blue Medicare card arrives about three months before your coverage starts. If you are not yet claiming Social Security, nothing arrives on its own. You have to apply, and the card comes after that. If you are enrolling because of disability, the package arrives about two weeks after you sign up.
- Enrolled automatically: welcome package roughly 3 months before coverage begins.
- Applying yourself: nothing comes automatically. You apply through Social Security, then the card follows.
- Enrolling due to disability: about 2 weeks after you sign up.
- If you join a Medicare Advantage plan, you will use that plan's card for care, not your red, white and blue card. Keep the Medicare card somewhere safe anyway.
Working past 65
The size of your employer changes the answer.
If your employer has 20 or more employees, you can usually delay Part B while you are still covered and not owe a penalty later. If your employer has fewer than 20 employees, your job-based coverage might not pay properly unless you have both Part A and Part B, which turns this from a penalty question into a coverage gap question. Ask us before you decide, because it is a different answer for different people.
- 20 or more employees: delaying Part B is usually safe while the coverage lasts.
- Fewer than 20 employees: the group plan may not pay correctly without Part A and Part B.
- Health Savings Accounts: enrolling in Medicare, including premium-free Part A, ends your ability to contribute. Because Part A can be granted retroactively up to six months when you apply late, the conservative move is to stop contributions six months before you apply.
