Medicare Enrollment Updates

Today’s video is an update with respect to our Medicare Enrollment recommendations as well as a reminder that two Medicare Enrollment Periods end on March 31st.

General Enrollment Period (GEP)

First, we do not recommend using the General Enrollment Period to get on Medicare Part B but if you didn’t enroll through either an Initial Enrollment Period or a Special Enrollment Period, then the General Enrollment Period is your default option. If so, you do not want to miss the March 31st deadline or you will have to wait another year to enroll.

You must have a Medicare number to enroll which one obtains by applying for Medicare Part A. You do not need to worry about enrollment periods with Medicare Part A as long as you have earned premium-free Part A or were married long enough to someone who has earned it. Once you have your Medicare ID via enrolling in Part A, download and complete a CMS 40B and submit the form either via fax to your local Social Security office or mail the form with tracking. Your Part B effective date will be July 1.

Medicare Advantage Open Enrollment Period

This Enrollment Period is also the first quarter of every year. It is only relevant for those who want to return to original Medicare from an Advantage Plan or those who want to change from one Advantage Plan to another. If you choose to enroll in a different Advantage Plan, you simply enroll in the new Plan and your enrollment in your current Plan will be terminated. If you want to return to original Medicare, we suggest enrolling in a freestanding Part D Plan, enrolling in a Medicare supplement, and terminating your current Advantage Plan. Your new coverage should be effective the first of the month after filing an application.

Special Enrollment Period (SEP)

Unlike the two Enrollment Periods mentioned above which occur the first quarter of every year, the Special Enrollment Period is for those who continue to have active group coverage through their active work or a spouse’s active work after one’s Initial Enrollment Period ends which is three months after one’s 65th birthday. A Special Enrollment Period is tied to your retirement or loss of active group coverage. If you need to learn more about this Enrollment Period, watch the video or review the blog copy published on October 14, 2021.

Our update is that we now favor faxing or sending the forms typically associated with an SEP, directly to your local Social Security office rather than using the portal that was made available early on in the pandemic. The most common forms used are a CMS-L564 and CMS-40B but a 1095-C as well as other methods of proving group coverage can be used. Anyway, we may change this recommendation again at some point but our anecdotal experience is that local office staff often assume more ownership of the process for the population they exist to serve.

Initial Enrollment Period (IEP)

If you are going onto Medicare at age 65, start as early as possible. The IEP begins three months before the month of your 65th birthday. We have seen clients’ applications for benefits require longer processing time so plan on starting early.

In all, Social Security provides a high level of service but work is more difficult with a remote and/or hybrid workforce. As a result, it is extremely important to know what you have to do, when you have to do it and to stay on top of the process.