Discover the Right Time to Enroll or Change Your Medicare Advantage Plan

At P3 Health Partners, we understand that your healthcare needs evolve as your circumstances change. If you are not currently on Medicare yet or do not have a plan that is giving you the coverage you need, there are many opportunities throughout the year to make a positive change.

Medicare is a federal health insurance program offered by the Centers for Medicare and Medicaid Services, which offers doctor visits, hospital coverage and medical insurance. Medicare Advantage Plans include additional benefits such as prescription drug management, dental coverage, vision coverage, transportation assistance and meal deliveries.

Here are the four enrollment periods to keep in mind. It is important to make changes or sign up for a Medicare or Medicare Advantage plan during these specific windows to avoid paying any penalties.

Initial Enrollment – You Just Turned 65

Turning 65 is a huge milestone and it marks when you first become eligible for Medicare. When you sign up for Medicare, you have access to healthcare benefits you’ve contributed to during your working years.

Enrollment window begins during the seven-month period that:

  • Begins three months before the month you turn 65
  • During the month you turn 65
  • Ends three months after the month you turn 65

Special Enrollment Period – You Have A Qualifying Event

If you select a Medicare Advantage plan, you stay enrolled in the plan until Annual Enrollment Period (AEP) begins. However, there are some life changes that may qualify you for a Special Election Period (SEP) during other times of the year, allowing you to make a change to your Medicare Advantage coverage. The length of the special enrollment period is dependent on your current situation.

Enrollment window may begin:

  • If you have recently moved to a new address that isn’t in your plan’s service area
    • Eligible to change your plan one month before you move and two months after you move
  • Have been recently diagnosed with a chronic condition such as diabetes, end-stage renal disease (ESRD) or chronic obstructive pulmonary disease (COPD)
    • May qualify for a Special Needs Plan (SNP)

Annual Enrollment Period – You Want to Enroll or Switch Health Plans

Every year insurance companies make changes to their current plans that can impact the out-of-pocket costs for medications or co-payments, provider availability or pharmacy networks. It’s recommended to reassess your current medical needs and lifestyle changes and compare it to what your plan is currently offering. You have the availability to explore other options during AEP. If you select a new plan during this period, benefits will start January 1 of the new year.

Enrollment window:

  • October 15 through December 7

Open Enrollment – You Want to Make a One-Time Change

If you choose a health plan during AEP and realized it is not the proper fit, you have a one-time opportunity to switch to another Medicare Advantage plan or revert to Original Medicare during Medicare’s Open Enrollment Period (OEP). Be sure to select a plan that includes your preferred provider and specialist(s).

Enrollment window:

  • January 1 through March 31

Before you enroll in a Medicare Advantage plan, you must first be enrolled in traditional Medicare.

There Are Several Ways to Enroll:

  1. Online at socialsecurity.gov
  2. By calling the Social Security office at (800) 772-1213
  3. In person at your local Social Security office; or,
  4. Utilizing the services of a licensed Medicare agent

Be sure to reassess your life changes every year to make sure your current coverage still meets your needs so you can get the care you deserve, while keeping in mind the enrollment dates listed above. For more information, please visit P3HP.org/AEP.