Medicare in Montana consists of several specific enrollment periods.
Enrollment periods allow Medicare beneficiaries the opportunity to enroll, change or drop their Medicare insurance plans at certain times of the year. Missing one of these important enrollment periods could result in life-time premium penalties and/or you may need to wait before you will be able to enroll into Original Medicare or a Medicare Insurance plan. Understanding your enrollment opportunities can help you avoid such situations.
Enrollment periods for Original Medicare
(Part A and Part B)
Initial Enrollment Period (IEP)
The Initial Enrollment Period allows individuals to enroll into Original Medicare any time during a seven-month period that begins three months prior, the month of and three months following your 65th birthday.
If you want your Original Medicare Part A and B benefits to start the month you turn 65, you should enroll during the first three months of your Initial Enrollment Period. Otherwise, Original Medicare benefits will start the first of the month following enrollment.
You may qualify for Original Medicare before you turn 65 if you receive Social Security or Railroad disability benefits. On the 25th month of disability benefits, you will be automatically enrolled in both Original Medicare Part A and B. If you have end-stage renal disease (ESRD) or Lou Gehrig’s disease (ALS), you may be eligible for Medicare immediately at any age.
Part B Special Enrollment Period
Some individuals will chose to delay enrollment into Original Medicare Part B past age 65 due to having health insurance coverage through a current employer or a spouse’s current employer.
If you have chosen to delay Original Medicare benefits and have not enrolled, you will have an eight-month period from the date you or your spouse’s coverage or employment ends (whichever happens first) to enroll into Original Medicare Part B. Your Medicare Part B coverage will become effective the first of the month following your enrollment.
General Enrollment Period
If you missed enrollment during your Initial Enrollment Period (IEP) or you do not qualify for a Part B Special Enrollment, you will most likely need to enroll during the General Enrollment Period for Original Medicare.
This enrollment period takes place January 1 and extends to March 31 of each year. If you are using the General Enrollment Period to activate your Medicare Part B, your coverage will not begin until July 1 of the current year.
Using the General Enrollment Period to enroll in Original Medicare Part B will most likely result in a Late Enrollment Penalty. This penalty will be applied to your Medicare Part B premium.
During the Original Medicare enrollment periods, you will generally have an option to enroll into a Medicare Advantage, Medicare Supplement (MEDIGAP) or a Medicare Part D prescription drug plan. There are multiple insurance carriers that offer an array of plan options in Montana. Not all of these options are available in every county in Montana. Enlisting the help of a local resource like a Medicare Specialist at Roger L. Daniel Insurance can help you navigate through your options more efficiently. The Medicare Team at Roger L. Daniel Insurance has experience and familiarity with the various plan options available in Montana and can provide unbiased assistance when selecting a plan option that fits your needs and budget.
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Enrollment Periods for Medicare Advantage and Part D prescription drug plans.
Annual Enrollment Period (AEP)
The Annual Enrollment Period occurs October 15 through December 7 of each year. During this enrollment period you can join or switch your Medicare Advantage or Medicare Part D Prescription Drug plan options.
New enrollment or plan changes made during the Annual Enrollment Period become effective January 1 of the following year. You can make as many enrollment changes as you like during AEP; the last change being the plan option you will begin the following year with.
Open Enrollment Period (OEP)
Open Enrollment for Medicare Advantage plans begins January 1 and extends through March 31 each year.
If you have a Medicare Advantage plan, you may use this period to make a change to your Medicare Advantage plan selection. You may also drop your Medicare Advantage plan and return to Original Medicare with or without a Part D prescription drug plan. Unlike the Annual Enrollment Period, you can only make one enrollment change during this time. Your new coverage will become effective the 1st of the month following enrollment.
Special Enrollment Period (SEP)
There are approximately 30 Special Enrollment Periods recognized by the Centers for Medicare and Medicaid Services (CMS) These SEPs provide opportunities to make changes to your Medicare health and drug coverage options based on certain circumstances, such as moving to a new area or if your plan leaves the Medicare program.
Special Enrollment Periods may happen anytime you experience a qualifying event.
Plan options can change annually, as well as your health care needs. It is important to evaluate your plan choices during the Annual Enrollment Period to ensure that your Medicare coverage options works well for your individual needs and budget. Meeting with a local and trusted Medicare Insurance Specialist can be beneficial during the Annual Enrollment Period. You Medicare Insurance agent will help explore and share information about new plan options available during AEP for your Medicare Advantage or Prescription Drug (Part D) plan needs.
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Medicare Supplement (MEDIGAP) plan enrollment.
MEDIGAP Open Enrollment Period
The best time to purchase a MEDIGAP (Medicare Supplement) plan is during the MEDIGAP Open Enrollment Period. This period begins the first of the month that you are enrolled in both Original Medicare Part A and Part B, and lasts for six months.
During the period, you will receive a guaranteed issue of the Medicare Supplement plan you choose. This means that the Supplement Insurance Carrier (company) cannot deny your enrollment base on any pre-existing conditions.
There are otherwise, no enrollment periods associated with Medicare Supplement (MEDIGAP) plans. You can apply for coverage on a MEDIGAP plan at anytime during a year. If you are outside of your Open Enrollment Period for a Medicare Supplement plan, you will most likely be subject to answering health questions and medical underwriting. A Medicare Supplement Insurance company may deny your requested enrollment or charge you a higher premium based on your health status.