Eligibility and Enrollment
You’re turning 65—Congratulations!
Along with celebrating this milestone, it’s also time to think about health coverage. You may not be exactly sure what Medicare covers or how it works so let’s break it down simply:
What is Medicare?
Medicare is health insurance provided by the federal government for individuals 65 and older.
When do you sign up?
You have a 7-month window (also known as your IEP; initial enrollment period) to sign up for Medicare:
Starts 3 months before your 65th birthday
Includes your birthday month
Ends 3 months after your birthday month
When are the enrollment periods?
Initial Enrollment Period (IEP): Your IEP is a seven-month window that starts three months before your 65th birthday, includes your birth month, and ends three months thereafter. This is your first opportunity to enroll in Original Medicare, as well as Medicare Advantage (Part C), and Part D prescription drug plans.
Annual Enrollment Period (AEP): You can make changes to your existing Medicare coverage from October 15th to December 7th of each year. This includes switching between Original Medicare and Medicare Advantage, changing Medicare Advantage plans, and enrolling in or changing Part D plans.
Medicare Advantage Open Enrollment Period (MA OEP): If you’re already enrolled in a Medicare Advantage plan, you have another opportunity to make changes from January 1st to March 31st of each year. You can switch to a different Medicare Advantage plan or disenroll and return to Original Medicare (and join a Part D plan).
Special Enrollment Periods (SEPs): Certain life events such as relocating or losing employer coverage may trigger a Special Enrollment Period.
What should you do now?
- Review your current insurance situation
- Take the “Which Medicare Option is Right for Me?” quiz
- Compare Traditional Medicare and Medicare Advantage
Now is the time to consider a Medigap plan (supplemental plan). Medigap helps cover the costs that Medicare doesn’t fully cover—like copays, coinsurance, and deductibles—so you’ll get fewer surprise bills and is much easier to get when you choose Traditional Medicare when you are first eligible.
ACT EARLY!
Here’s why now is a great time to consider a Medigap plan:
- No medical questions during your enrollment window
- Lower premiums the earlier you enroll
- Freedom of choice
If you have questions, or need additional help understanding what is best for your situation, consider the following:
- Talk to your healthcare provider. Here is a list of questions to ask them.
- Contact your State Health Insurance Assistance Program (SHIP). In Tennessee, you can reach SHIP at 1.877.801.0044.
- Talk to someone at Medicare https://www.medicare.gov/talk-to-someone
- Ready to apply? Apply online at Medicare.gov
Health can change unexpectedly, and accidents or illnesses may lead to higher costs down the road. Keep this in mind if you are basing your health plan choice on your current health.
Half of lifetime healthcare spending occurs after the age of 65