Medicare Enrollment Periods – Initial, Special and General
Today we address the Enrollment Periods used to make the initial transition onto Medicare Part A and Medicare Part B. The transition onto Medicare is more complicated than what most people have experienced during their adult lives dealing with group or individual coverage primarily because Medicare has different parts. There are also decisions beyond enrolling in Medicare Part A and Medicare Part B such as whether to remain in Original Medicare and purchase a supplement and Part D Plan or whether to choose an Advantage Plan.
However, the process must begin with the initial transition onto Medicare which occurs during an Initial, Special or General Enrollment Period. Please note that the General Enrollment Period is designed to be punitive so one should Plan to avoid relying on the General Enrollment Period to transition onto Medicare Part B. The Annual Open Enrollment Period only applies to a change in a drug or Advantage Plan for people who are already on Medicare.
Those who are receiving Social Security Disability Benefits or who elect to take their Social Security payment before age 65 are automatically enrolled in Medicare Part A and Medicare Part B and sent their Medicare card. Virtually everyone else must actively enroll in Parts A and B through Social Security as well as make decisions about Advantage Plans and/or Medicare supplements and Part D Plans and make separate applications for those Plans. There are exceptions. Railroad retirees transition onto Medicare Part A and Part B through the U.S. Railroad Retirement Board. Federal government retirees are not required to enroll in Part B.
We have developed resource materials on our website on Medicare Enrollment Periods and welcome readers to review those materials. If you go to healthcarenavigation.com/education, you will find four separate documents pertaining to Medicare. The first is a simplified PowerPoint presentation, Medicare: Navigating Traps and Gaps with an accompanying Word document, A Guide to Medicare: Navigating Traps and Gaps. The next document, Resource Documents for Medicare: Navigating Traps and Gaps includes as its first attachment a lengthy, detailed document, Understanding Medicare Enrollment Periods. The final document is Medicare Initial, Special and General Enrollment Periods Explained which provides much more detail than this brief summary.
Remember, most Americans should transition to Medicare at age 65. Those who clearly have a choice to postpone Medicare enrollment are those who have active group coverage through an employer of 20 or more people through their ACTIVE employment or a spouse’s employment. Even those with active group coverage might consider enrolling in Medicare Part A unless they are on a high-deductible health plan with a health savings account and wish to continue contributions to the HSA. Those with active group coverage through an employer of fewer than 20 employees are often required to enroll in Medicare Parts A and B but that requirement can vary by state and by Plan.
We will do separate videos on the Initial, Special and General Enrollment Periods and follow them with problems we have encountered with each type of Enrollment Period.