Part C Enrollment
Enrollment Requirements
In order to Join a Medicare Advantage Plan you must:
- Have both Medicare Parts A and B
- Live in the health plan’s service area
You can only join, switch, or drop a Medicare Advantage Plan (Part C) during certain times, called enrollment periods.
When to Enroll
There are specific times when you can join a Medicare Advantage Plan, or make changes to your existing Medicare Advantage Plan.
Enrollment Requirements
In order to Join a Medicare Advantage Plan you must:
- Have both Medicare Parts A and B
- Live in the health plan’s
service area
You can only join, switch, or drop a Medicare Advantage Plan (Part C) during certain times, called enrollment periods.
When to Enroll
There are specific times when you can join a Medicare Advantage Plan, or make changes to your existing Medicare Advantage Plan.
Initial Enrollment Period: If you are newly eligible for Medicare because you turned 65 you can enroll in Part C during the Initial Enrollment Period. There is a 7 month window that begins 3 months before your 65th birthday, the month of your 65th birthday and 3 months after your 65th birthday. If you enroll during the first 3 months, coverage becomes effective the first day of the month you turn 65. If you enroll during the month you turn 65, or during the 3 months after you turn 65, coverage becomes effective the first of the following month.
Annual Enrollment Period: This period runs from October 15 to December 7 of each year with coverage being effective January 1st of the following year. During this time, you can join a Medicare Advantage Plan, drop a Medicare Advantage Plan, return to original Medicare, or switch to a different Medicare Advantage Plan.
Open Enrollment Period: This period runs from January 1 to March 31 with coverage being effective the first of the following month. During this time you can switch to a different Medicare Advantage Plan with or without drug coverage, drop a Medicare Advantage Plan and return to original Medicare and enroll in a Medicare prescription drug plan (Part D) if you go back to Original Medicare.
Special Enrollment Period: Under certain circumstances, you can enroll or make changes to a Medicare Advantage Plan when certain events happen in your life. Examples consist of but are not limited to:
- Moving out of a service area
- Losing group or union coverage
- Moving back to the U.S. after living outside the count
- Living in or moving out of an institution such as a nursing home or rehabilitation hospital
- Were incarcerated and have been released
- Are no longer eligible for Medicaid
- Having a chance to enroll in other coverage offered by your employer or union
- Living in a service area that has a Medicare Advantage Plan with a 5 star rating
- Your Medicare Advantage Plan ends
- You’re in a plan that has a star rating of 3 stars or less for the last 3 years
- You’re eligible for both Medicare and Medicaid
- You receive Extra Help paying for Medicare drug coverage
- You’re in a state pharmaceutical program
- You’re in the trial period for the first time you took out a Medicare Advantage plan
- You have a severe disabling condition and there is a Chronic Special Needs Plan available that serves people with your condition.
The coverage effective date for a special enrollment period is the first of the month following the event.
The coverage effective date for a
special enrollment period is the
first of the month following the
event.