Initial Election Period, ANNUAL ELECTION PERIOD, and Special Election Period
I think of the Initial Election Period as a time similar to when high school students begin visiting college campuses, checking out the scenery, getting a feel for the schools’ vibes, and deciding on which school they want to spend the next chapter of their lives in. It’s an exciting yet simultaneously scary time where you’re faced with an important decision with only a few months to make up your mind.
So, you’ve recently qualified for Medicare (or are close to qualifying); you’re turning 65 soon (happy birthday!), or maybe your 65th is a way to go but you’re just passing your 2-year mark of having a disability. In either case, it’s time to sign up for Medicare. [For this blog, I’ll be focusing on the process for people who age into Medicare, just to keep it a little less bulky - there’s a lot of information!]. Here’s where the Initial Election Period comes in. Every year, about 4 million people turn 65 in the U.S. For all the newcomers, Initial Election Period is the time to sign up for Medicare for the first time.
How much time do you have to sign up? You have a total of 7 months to sign up: the month of your birthday, 3 months before your birthday month, and 3 months after.
When does my coverage start? If you were born on the 1st of the month, your coverage begins on the 1st of the month before. If you were born on any other day, your coverage begins on the 1st of your birthday month. Example: Charlie and Ryan are both turning 65 this year; Charlie’s birthday is on July 1st and Ryan’s is on April 19th. In this case, Charlie’s coverage will begin on June 1st and Ryan’s will begin on April 1st.
What if you already have Medicare but want to make a change to your plan? In this case, the Annual Election Period (also known as the Open Enrollment Period) is particularly relevant to you. Every year, between October 15th and December 7th, people already signed up for Medicare (regardless of how recently they have signed up) are able to switch plans.
You've been through the Initial Election Period and every year you go through the Annual Election Period but now there are circumstances in your life that have changed your healthcare needs. In this case, you fall into the Special Election Period. Three of the most common reasons people require a Special Election Period are:
You’re retiring or have already retired and your employer-sponsored health insurance is ending soon.
You’re dual eligible for Medicare and Medicaid.
The amount of time you have to change your Medicare coverage during a Special Election Period depends on the circumstances that have qualified you for a Special Election Period. For example, someone retiring may have an 8-month window to sign up for Medicare Part B while a dual-eligible person may be able to change their Medicare plan during any month.
Why You Should Care
For the newcomers, it’s important to have proper health insurance coverage both to ensure that you’re financially able to care for your health and to avoid fees.
For those who already have Medicare, it’s important to keep in mind that the plan you have for this year may be changing or may not fit your health needs for the upcoming year. Whether for better or worse, Medicare plans change every year and you want to make sure that you’re well covered.