When to Enroll
Original Medicare: Part A
Enrollment in Medicare Part A is usually automatic starting the first day of the month you turn 65. If you don’t receive an enrollment notice, call Social Security at 1-800-772-1213 (railroad retirees should call 1-800-808-0772).
If you are disabled, there is a 24-month waiting period for Medicare after you become disabled. After that, you are automatically enrolled in Medicare Part A and must decline Part B if it is not wanted. In the meantime, you may qualify for Medicaid/Medical Assistance, use COBRA coverage or services from state-specific programs.
Original Medicare: Part B
There are three opportunities to sign up for Part B: the Initial Enrollment Period, the Special Enrollment Period and the General Enrollment Period.
Part B Initial Enrollment Period
During the Part B Initial Enrollment Period, you can enroll three (3) months prior to, the month of, or three (3) months after your 65th birthday. Or, if you are disabled, after your 24th month of receiving disability benefits. If you want to decline Part B enrollment during the Initial Enrollment Period, you must return your Part B notice to Social Security.
If you do not sign up, a 10 percent penalty is typically added to the Part B premium for each 12-month period you could have had Part B but didn’t sign up for it when first eligible, unless you qualify for the Part B Special Enrollment Period. The penalty continues for as long as you have Part B.
Part B Special Enrollment Period
If you or your spouse has medical coverage through a union or an employer with more than 20 employees, or you did not have Part B coverage because you went back to work and had group medical coverage, you can use the Part B Special Enrollment Period to enroll. The Special Enrollment Period lasts for eight months and begins when your employer or union coverage ends, or when employment ends, whichever is first.
To use the Part B Special Enrollment Period, contact Social Security four months before you retire or when your employer or union coverage ends, and request a form that your employer will need to complete to activate your Special Enrollment Period. Then send the employer paperwork along with your Part B enrollment form to Social Security.
If you are 65 and continue your employer coverage through COBRA, you should enroll in Part B — you will not get a Special Enrollment Period when COBRA ends. You must sign up for Part B during the first eight months you have COBRA coverage to avoid the late enrollment penalty in the General Enrollment Period.
Part B General Enrollment Period
If you do not enroll in Part B during the Initial or Special Enrollment Periods, you can enroll during the General Enrollment Period from January 1 through March 31 of each year, with coverage not starting until July 1 of the year you enroll. For each year you are late in enrolling, you are charged a 10 percent Part B penalty. This charge increases annually as Medicare premiums increase and will continue for your lifetime or as long as you are on Part B.
Medicare Supplement (Medigap) Plans
If you are newly eligible for Medicare and want to enroll in a Medigap plan, the Medigap Open Enrollment Period lasts for six months starting on the first day of the month in which your Medicare Part B coverage becomes effective. If you enroll during this time, you won’t need to provide a health history to your insurance company. If you delay buying Medigap coverage during this timeframe, you may need to complete a health history application and could be denied coverage.
Note: If you want to enroll in a Medigap plan and in a Prescription Drug Plan, be sure to do so within the different enrollment periods outlined here.
Prescription Drug Plans, Medicare Advantage Plans, and Medicare Advantage Plans with Prescription Drug Coverage
Initial Enrollment Period
If you are newly eligible for Medicare, you most likely qualify for an Initial Enrollment Period. During the Initial Enrollment Period you can enroll in a Prescription Drug Plan, a Medicare Advantage Plan or a Medicare Advantage Plan with Prescription Drug coverage, three (3) months prior to, the month of, or three (3) months after your 65th birthday, or after your 24th month of receiving disability benefits.
Annual Enrollment Period
If you are currently a Medicare beneficiary, you can make one “election” during the Annual Enrollment Period between November 15 and December 31 of each year. This includes enrolling
in or changing to a Prescription Drug Plan, a Medicare Advantage Plan or a Medicare Advantage Plan with Prescription Drugs or other Medicare health plan for an effective date of January 1 of the following year.
Open Enrollment Period
The Open Enrollment Period from January 1 through March 31 of each year can be used only for these situations:
- Medicare Advantage members who can enroll in 1) a different Medicare Advantage Plan or 2) Original Medicare* only
- Members in a Medicare Advantage Plan with a Prescription Drug Plan who can enroll in 1) a different Medicare Advantage Plan with Prescription Drugs or 2) Original Medicare* and a Prescription Drug Plan
- Beneficiaries with Original Medicare* and a Prescription Drug Plan who can enroll in a Medicare Advantage Plan with Prescription Drugs
- Beneficiaries with Original Medicare* and no other coverage who can enroll in a Medicare Advantage Plan
* Beneficiaries with Original Medicare may also be enrolled in a Medigap Plan.
Special Election Period
A Special Election Period allows you to enroll in a Prescription Drug Plan or Medicare Advantage Plan after an Initial or Annual Enrollment Period has ended. Some reasons you might qualify for a Special Election Period are:
- You are eligible for additional financial help from Social Security
- You permanently move outside your plan’s service area
- Your plan’s contract is terminated, or the plan goes out of business
- You lose your prescription coverage from an employer or union, OR your coverage changes so that it is no longer as good as (“creditable”) the standard Medicare benefit
- You qualify because of other circumstances
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2008 MedicareBlue PPO Enrollment Form