Medicare Elections

Initial Enrollment Period

Your Initial Enrollment Period runs for seven months around your 65th birthday: the three months before, your birthday month, and the three months after. This is when you enrol in Part A and Part B and decide how you want the rest of your coverage structured.

It also starts the clock on your Medigap open enrollment: six months from your Part B effective date, during which no carrier can ask you a health question. Miss that and a future Medigap application is medically underwritten.

The Annual Election Period, October 15 to December 7

Every autumn you can join, switch or drop a Medicare Advantage plan or a Part D prescription drug plan. Changes made during this window take effect on January 1.

In September your carrier sends an Annual Notice of Change. Read it. Benefits, formulary, pharmacy network, provider network, premium, copayments and co-insurance can all change on January 1 — and the plan that was right for you last year may not be this year.

Still working past 65, or retiring later

If you or your spouse are still covered by an employer group plan, you may be able to delay Part B without penalty and take a Special Enrollment Period when that coverage ends. The rules depend on the size of the employer and how the group plan coordinates with Medicare.

Because we work both the senior market and the employer group market, we can look at the employer plan and the Medicare options in the same conversation — which is exactly where these decisions usually go wrong.

Locked in for the year — mostly

Medicare Advantage plans have lock-in periods. Once you enrol, you generally stay enrolled for the rest of the calendar year and can only dis-enrol during specific windows. If you leave an Advantage plan to return to Original Medicare, you must notify the Advantage carrier.

Medicare Supplements work differently: there is no annual election period, and you can change at any time if you can qualify medically.