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Health Care Reform:

Health Insurance & Affordable Care Act

Medicare Eligibility and Enrollment

Medicare Enrollment Periods continued...

Other enrollment periods. If you did not enroll in Parts A and B during the initial enrollment period, you may do so between Jan. 1 and March 31, with coverage beginning in July of that year. You may have to pay a higher monthly premium for coverage. There are some exceptions. If you are covered under a group health insurance plan through your job or your spouse's job, or if your employment ends after the initial enrollment period, you may enroll in Medicare during a Special Enrollment Period without having to pay a late-enrollment penalty.

Medicare Advantage Plan (Part C). You may join an advantage plan during the 7-month period when you first become eligible for Medicare. These plans may have more benefits and more coverage. You may join, switch, or drop a Part C plan between Oct. 15 and Dec. 7. You may switch to Original Medicare (Parts A and B) and sign up for a Medicare Prescription Drug Plan between Jan. 1 and Feb. 14. 

Medicare Prescription Drug Plans (Part D). You may join, switch, or drop a drug plan  between Oct. 15 and Dec. 7. You will  pay a penalty -- in higher premiums. There is an exception: You may join a 5-star Medicare Prescription Drug Plan, as rated by Medicare, any time. Go to www.medicare.gov/find-a-plan to see ratings. 

What to know about Medicare penalties.  If you don't sign up during your initial enrollment period for some programs -- like Medicare Parts A and B and Medicare Prescription Drug Coverage (Part D) -- you might pay a higher monthly fee when you sign up later. 

There are some exceptions. If you or your spouse have drug coverage now through an employer-based health plan that is as good as Medicare's or better, you shouldn't be charged a late penalty as long as you sign up within the deadlines. After insurance from an employer ends, you must sign up for Part B within 8 months and for Part D within 63 days. Keep in mind that an insurance policy from an employer with fewer than 20 employees is not as good as Medicare. If you work for a company of that size, you need to sign up for Medicare when you are first eligible to avoid penalties. 

Sign up for Medigap early. Medigap is private insurance you buy to help pay for additional Medicare costs.  If you need a Medigap plan, you should buy it within 6 months of getting Medicare Part B. During that period, you're protected. You're guaranteed to get any Medigap plan you want. But if you try to buy it after those 6 months, the insurance company can charge you a higher price or turn you down altogether.

 

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