Once you are on Medicare, you can enroll onto a Medicare Advantage, Prescription Drug or Medicare Supplement. Your enrollment onto one of these plans must take place within the timelines described below.

New to Medicare Initial Enrollment Periods

Being new to Medicare is generally obtained by one of these 3 circumstances; Turning 65, Disabled for more than 2 years or have End Stage Renal disease. Once you receive your Medicare benefits, you can then choose to enroll in the plan of your choice; Medicare Advantage Plan, Prescription Drug plan or Medicare Supplement plan.

If you are new to Medicare and you are choosing a:

Medicare Advantage Plan (MA Plan):

  • Turning 65- you can enroll onto an MA plan during a 7-month window. 3 months before your 65th birthday, the month of your 65th birthday and 3 months after your 65th birthday.
  • Disabled-you can enroll onto an MA plan during a 7-month window. 3 months before your Medicare Part B begins, the month your Medicare Part B begins and up to 3 months after your Medicare Part B begins.
  • End Stage Renal Disease- In most cases, if you have End-Stage Renal Disease (ESRD), you can’t join a Medicare Advantage Plan.

Prescription Drug plan (Part D Plan):

  • Turning 65, Disabled or End Stage Renal Disease- You can enroll during a 7-month window. 3 months before your Medicare Part B begins, the month your Medicare Part B begins and up to 3 months after your Medicare Part B begins.

Medicare Supplements:

Medicare Supplement plans do not have an annual enrollment period; you can choose a Supplement plan anytime throughout the year. But, the best time to purchase a Medicare Supplement plan is during the 6-month Open Enrollment Period because you will not be subject to the underwriting requirements associated with Medicare Supplement policies.

If you apply for a Medicare Supplement policy outside of your initial open enrollment period or special election period, you may be subject to underwriting set forth by that policy. Generally, these eligibility questions are as follow:

1. Within the past two years, a licensed member of the medical profession provided medical advice or treatment for:

  • end stage renal (kidney) disease
  • kidney disease that may require dialysis
  • currently receiving dialysis
  • admitted to a hospital as an inpatient within the past 90 days

2. Within the past two years, has a licensed member of the medical profession recommended any of the following treatments for a medical condition, and that treatment has NOT been completed?

A YES answer to any of the above questions would automatically disqualify you from being able to apply, unless you have a Qualified Life Event or Special Enrollment Period that would otherwise grant guaranteed acceptance.

Guaranteed Acceptance on a Medicare Supplement Policy

You have a guaranteed issue right (which means an insurance company can’t refuse to sell you a Medigap policy) in these situations:

  • You’re in a Medicare Advantage Plan, and your plan is leaving Medicare or stops giving care in your area, or you move out of the plan’s service area.
  • You have Original Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare pays and that plan is ending.
  • You have Original Medicare and a Medicare SELECT policy. You move out of the Medicare SELECT policy’s service area.
  • You joined a Medicare Advantage Plan or Programs of All-inclusive Care for the Elderly (PACE) when you were first eligible for Medicare Part A at 65, and within the first year of joining, you decide you want to switch to Original Medicare. (Trial Right)
  • You dropped a Medigap policy to join a Medicare Advantage Plan (or to switch to a Medicare SELECT policy) for the first time, you’ve been in the plan less than a year, and you want to switch back. (Trial Right)
  • Your Medigap insurance company goes bankrupt and you lose your coverage, or your Medigap policy coverage otherwise ends through no fault of your own.
  • You leave a Medicare Advantage Plan or drop a Medigap policy because the company hasn’t followed the rules, or it misled you.