Election Period | Alight Retiree Health Solutions

Medicare Eligibility and Enrollment

ELECTION PERIODS

Understand when you can join, change, or end plans

Knowing when you can enroll or change your plan is an important part of getting your Medicare coverage. There are certain times during the year when you can do this, each with specific rules that apply to that type of enrollment.

Find the situation that applies to you below.

I want to SIGN UP for plans:

Initial Enrollment Period

When can I first enroll in Medicare?

TURNING 65/Initial Enrollment Period You qualify for Medicare, also known as Original Medicare, when you turn age 65. There is a 7-month window to enroll in Part A (hospital insurance) and/or Part B (medical insurance) which begins 3 months before the month you turn 65, the month you turn 65, and up to 3 months after the month you turn 65. If your birthday is on the first of the month, your 7-month window begins 4 months before you turn 65 and ends 2 months after your birth month.

Part A is free for most since you’ve paid into Medicare through taxes, but there is a cost to Part B. Under certain situations, you will be automatically enrolled in Part A and receive a Medicare ID card in the mail when you turn 65, but most will need to contact Social Security and enroll during the Initial Enrollment Period. Here’s how to contact Social Security:

Are there situations where I can enroll before I turn 65?

Yes, you can receive Medicare benefits if you are younger than age 65 with certain disabilities and have received Social Security disability benefits for 24 months, or if you have End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig's Disease). There is a five-month waiting period after a disability determination is made before you can begin to collect Social Security disability benefits. Those with ESRD and ALS, in contrast to persons with other causes of disability, do not have to collect benefits for 24 months in order to be eligible for Medicare.

Do I need both Part A and Part B?

At age 65, most people choose to enroll in Part A (Hospital Insurance) since there is typically no cost, but some choose to delay enrolling into Part B (Medical Insurance) depending on their health coverage situation. Some of these situations include: Being covered by an employer plan because you are actively working; being covered by a spouse’s active employer coverage; or having COBRA coverage. With some employer coverage — whether current employer, former employer, or COBRA — Medicare may be the primary coverage source. If you choose not to enroll in Part B during your Initial Enrollment Period, you may have to pay a penalty when you enroll into Part B later and you could have a gap in your health coverage. The longer you delay, the higher the penalty will be.

Why would I need to buy additional health care insurance like Medicare Advantage (Part C), Prescription Drug Plans (Part D), and/or Medigap?
 

Original Medicare Parts A and B (assuming you’re enrolled in both) provide coverage for a variety of select health-related services. However, we recommend that you find additional coverage to complete your benefits, since Original Medicare alone does not limit your annual out-of-pocket expenses and has gaps in coverage that result in direct costs to you. Private insurance companies offer plans through Alight Retiree Health Solutions to help cover costs that Original Medicare does not pay for.

When can I enroll in a Medigap Plan?

The best time to enroll in a Medigap Plan is during Medigap Open Enrollment, the 6-month period which begins on the first day of the month in which you're 65 and enrolled in Part B. This is a one-time-only 6-month period where you can buy any policy sold in your state for the same price (without medical underwriting) even if you have health problems — this is referred to as guaranteed issue rights. You won't have a right, in most cases, to switch Medigap plans unless you are eligible under a specific circumstance or have guaranteed issue rights, or you are within your 6-month Medigap enrollment period. You do not have to wait a certain amount of time if you have a plan before you can switch to a different plan.

You can change to another Medicare Advantage Plan or go back to Medicare Parts A and B within the first 3 months you have Medicare.

Annual Enrollment Period

 
When can I make changes to my current Medicare plans?

ANNUAL ENROLLMENT PERIOD Anyone with Medicare Advantage and Prescription Drug Plans can join, switch, or drop a plan each year during Medicare's Annual Enrollment Period between October 15 and December 7. You can also return to Original Medicare Parts A and B, or join a Medicare Advantage or Prescription Drug Plan if you only have Original Medicare Parts A and B.

Medigap Plans have different rules for changing plans; there are certain situations that may give you guaranteed-issue rights to make these changes. In most cases you won’t be able to change your Medigap Plan unless you are eligible under a specific circumstance or are within your Medigap Open Enrollment Period.

Plan costs, coverage, and doctor networks can be different every year, so you have the opportunity during the Annual Enrollment Period to find coverage that better meets your needs.

You should always review the materials your plan sends to you to make sure coverage will still meet your needs for the next year. You will typically receive information on next year’s plans by the beginning of October each year.

Our Plan Recommendation Tool simplifies all your Medicare options by using information you enter about your current doctors and prescription drugs and matches you to health insurance plans in your area. We also compare your current coverage with the same plan types (Medigap plans with other Medigap plans).

No. If you are satisfied with your current plan and it’s still being offered, you do not need to do anything.

Special Enrollment

 
Are there times when I can enroll outside of the Annual Enrollment Period?

In certain situations, you may be able to join, switch, or drop your Medicare Advantage and Prescription Drug plans outside of the Annual Enrollment Period. Those special circumstances may include a move out of your plan’s service area or if you lose your current coverage. Rules about special enrollment are different regarding when you can make changes and the type of changes you can make.

My coverage with my employer is ending; what can I do?

You can join a Medicare Advantage Plan or Medigap Plan and a Prescription Drug Plan within the three months prior and two months after your coverage ends.

If I move, will I still have the same coverage? Who do I notify?

It is possible you may not have the same coverage available if you move. If you qualify for Special Enrollment, you will be able to select another plan. Contact Alight Retiree Health Solutions for assistance.

 

I want to CHANGE my plan:

Annual Enrollment Period

 
When can I make changes to my Medicare Advantage and Prescription Drug Plans?

ANNUAL ENROLLMENT PERIOD Anyone with Medicare Advantage and Prescription Drug Plans can join, switch, or drop a plan each year during Open Enrollment Period between October 15 and December 7. You can also return to Original Medicare Parts A and B or join a Medicare Advantage or Prescription Drug Plan if you only have Original Medicare Parts A and B.

What other changes can I make during the Annual Enrollment Period?

You can switch from one Medicare Advantage Plan to another Medicare Advantage Plan; switch from a Medicare Advantage Plan that doesn't offer drug coverage to one that does or vice versa; join a Prescription Drug Plan; and switch or drop Prescription Drug Plans. You can also return to Original Medicare Parts A and B, or join a Medicare Advantage or Prescription Drug plan if you only have Original Medicare Parts A and B.

When is the Medicare Advantage Open Enrollment Period?

If you are in a Medicare Advantage Plan (MA or MAPD), you can switch to another Medicare Advantage Plan, or return to Original Medicare Parts A and B (and add a Prescription Drug Plan), each year from January 1 to March 31. This includes Medicare Advantage Plans with or without drug coverage. You can only switch plans once during this period.

Special Enrollment

 

In certain situations, you may be able to join, switch, or drop your Medicare Advantage and Prescription Drug plans outside of the Annual Enrollment Period. Those special circumstances may include a move out of your plan’s service area or if you lose your current coverage. Rules about special enrollment are different regarding when you can make changes and the type of changes you can make.

If you tell your plan before moving, you can switch plans the month before the month you move and up to 2 months after you move. If you wait until you move to tell your plan, you have 2 full months from the month you tell them.

 

I want to CANCEL my plan:

Trial Period

 

If you dropped your Medigap Plan and enrolled in a Medicare Advantage Plan for the first time, there is a trial period — the 12 months after your Medicare Advantage coverage first started — where you can disenroll from the Medicare Advantage plan and go back to a Medigap plan with or without joining a stand-alone Prescription Drug Plan.

 

Special Enrollment and Medicare Advantage Prescription Drug Plans

 
What is the Medicare Advantage Open Enrollment period?

If you are in a Medicare Advantage Plan (MA or MAPD), you can switch to another Medicare Advantage Plan, or return to Original Medicare Parts A and B (and add a Prescription Drug Plan), each year from January 1 to March 31. This includes Medicare Advantage Plans with or without drug coverage. You can only switch plans once during this period.

You can drop your current plan whenever your employer allows you to make changes.

 

Medigap Plans

 

In specific situations, insurance companies must offer you certain Medigap Plans that cover pre-existing health conditions, and they cannot charge you more because of past or present health problems. You have guaranteed issue rights, meaning an insurance company cannot refuse to sell you a Medigap Plan, when you have other health care coverage that changes in some way (like when you lose coverage). You have guaranteed issue rights if:

  • You are in a MA Plan, and your plan is leaving Medicare or stops offering care in your area, or you move out of the plan's service area.
  • You have Original Medicare and an employer group health plan (including COBRA) is ending.
  • You dropped your Medigap Plan to join a Medicare Advantage Plan for the first time, and it has been less than a year, and you want to switch back to a Medigap Plan (trial right).
  • Your Medigap insurance company goes bankrupt and you lose your coverage, or your Medigap plan otherwise ends through no fault of your own.
  • You leave a MA Plan or drop a Medigap Plan because the company hasn't followed the rules or misled you in some way.

 

General FAQs

 

I didn’t sign up for Original Medicare when I was first eligible. What can I do?

If you missed your Initial Enrollment Period, you can sign up for Part A at any time and Part B during the General Enrollment Period between January 1 and March 31 each year. In most cases, you will be required to pay a penalty and coverage will start the first of the month after you sign up..

You do not need to sign up each year for Parts A and B, but you will have the opportunity to review your health care coverage and change your supplemental plans if necessary.

Medicare will automatically send you your Medicare ID card when you first enroll or if they make changes to the cards, and your new health care insurer will also send you your new cards within 2-3 weeks of applying for coverage. Your insurance carrier may have a self-service area on their website where you can download and print a copy of your card.

If everything is staying the same with your health care coverage, you do not need new cards -- this includes the Medicare ID card. However, if you change your healthcare plan, you will receive a new ID card for the new plan, usually within 2-3 weeks of applying for the new coverage. Your insurer has self-service areas on their websites to download a copy of your current card.

How will I get information about my new plan?

Most insurance carriers have their own websites where you can create a login/password and see your account 24/7. They will also start sending you communications either by US Mail or email once you let them know your communication preferences.

Can anyone buy health insurance through Alight Retiree Health Solutions?

Yes — if you are eligible for Medicare, you can buy health insurance through Alight.

Does it cost extra for services provided through Alight Retiree Health Solutions?

No — Alight's services are provided at no additional cost to you: you only pay for the plans you enroll in.

You can receive Medicare benefits if you are younger than age 65 with certain disabilities and have received Social Security disability benefits for 24 months, or if you have End-Stage Renal Disease (ESRD). There is a five-month waiting period after a disability determination is made before you can begin to collect Social Security disability benefits. Those with ESRD, in contrast to persons with other causes of disability, do not have to collect benefits for 24 months in order to be eligible for Medicare.

You can join during the 7-month period that begins 3 months before your 25th month of disability and ends 3 months after your 25th month of disability.

 

Our Enrollment Checklist details everything you need to enroll.

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