The Medicare General Enrollment Period is an annual event, spanning from January 1st to March 31st, offering a unique chance for individuals who overlooked their initial enrollment in Medicare Part A and/or Part B to enroll. This designated period caters to those who, for various reasons, didn’t enroll in Medicare when initially eligible, providing them an opportunity to sign up without incurring late enrollment penalties. Unlike the Medicare Advantage Open Enrollment Period (MA OEP), where existing Medicare Advantage plan holders can switch to Original Medicare, the General Enrollment Period specifically targets those who missed their initial enrollment window and need to enroll in Medicare Parts A and/or B.

When is the Medicare General Enrollment Period?

The Medicare General Enrollment Period takes place annually, unfolding from January 1st to March 31st. During this window, individuals who missed their initial enrollment in Medicare Parts A and/or B can seize the opportunity to enroll in these essential Medicare components. It is crucial for individuals eligible for Medicare, but who missed their Initial Enrollment Period, to make use of the General Enrollment Period. This ensures they steer clear of potential late enrollment penalties and secure access to comprehensive Medicare coverage.

Medicare General Enrollment Period Eligibility Criteria

Eligibility for the Medicare General Enrollment Period (GEP) is contingent on specific criteria. To qualify for GEP enrollment, individuals must meet the following requirements:

Missed Initial Enrollment: Individuals should have missed their Initial Enrollment Period, a seven-month window surrounding their 65th birthday, starting three months before their 65th birthday month and concluding three months after.
Not Enrolled in Medicare: They must not have enrolled in Medicare Part A and/or Part B during their Initial Enrollment Period or any other Special Enrollment Period for which they may be eligible.
U.S. Citizen or Permanent Resident: Qualification for Medicare requires individuals to be either a U.S. citizen or a permanent resident with at least five consecutive years of residence in the United States.
Valid Social Security Number: Enrolling in Medicare mandates having a valid Social Security number.

It is imperative for individuals meeting these eligibility criteria, who missed their initial enrollment, to seize the opportunity provided by the Medicare General Enrollment Period. Enrolling during this period ensures access to Medicare coverage and guards against potential late enrollment penalties for Medicare Part A and/or Part B. The General Enrollment Period recurs annually from January 1st to March 31st.

Qualifying for Medicare Parts A and B

Medicare Part A

Medicare Part A extends coverage for inpatient hospital care, skilled nursing facility care, hospice care, and select home health services. Qualification for premium-free Medicare Part A is based on specific conditions:

Being 65 years or older and eligible for Social Security or Railroad Retirement Board benefits.
Working and paying Medicare taxes for a minimum of 10 years or being eligible for benefits due to a disability, even if under 65.
Having end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS).

Medicare Part B

Medicare Part B covers medical services such as doctor visits, outpatient care, preventive services, and durable medical equipment. Most individuals eligible for Part A also qualify for Part B. To be eligible for Part B, individuals must:

Be 65 years or older.
Be a U.S. citizen or a permanent resident with at least five consecutive years of U.S. residency.
Enroll during their Initial Enrollment Period to avoid late enrollment penalties.

Original Medicare and Medicare Fall Open Enrollment Period

Original Medicare, combining Medicare Part A and Part B, provides essential hospital and medical coverage for eligible individuals. Differing from the Medicare General Enrollment Period, the Fall Open Enrollment Period (Annual Election Period) occurs from October 15th to December 7th annually. During this period, individuals can make changes to their Medicare Advantage (Part C) plans and Medicare prescription drug coverage (Part D) plans.

Special Considerations for Late Enrollment Penalty

While the Medicare General Enrollment Period (GEP) itself doesn’t induce penalties, individuals may incur late enrollment penalties if they fail to sign up for Medicare Part D or Part B during their Initial Enrollment Period and endure a prolonged period without creditable coverage. Leveraging the GEP to enroll in Part B and/or Part D can mitigate or entirely avoid these penalties, ensuring uninterrupted access to vital healthcare services and prescription drugs.

How to Enroll During the Medicare GEP

Enrolling during the Medicare General Enrollment Period is a straightforward process. If you missed your Initial Enrollment Period and need to sign up for Medicare Part A and/or Part B, follow these step-by-step instructions:

Check Eligibility: Confirm eligibility for the Medicare GEP, occurring annually from January 1st to March 31st. Ensure that you missed your Initial Enrollment Period and are not already enrolled in Medicare Part A and/or Part B.
Gather Information: Collect necessary enrollment information, including your Social Security number, proof of U.S. citizenship or permanent residency status, and employment history if applicable.
Contact Social Security Administration: Enroll in Medicare Part A and/or Part B by contacting the Social Security Administration (SSA) through their website or phone. Apply online if within three months of turning 65 or older than 65 and not receiving Social Security benefits.
Complete the Application: Fill out the Medicare enrollment application provided by the SSA, indicating which parts of Medicare (Part A and/or Part B) you want to enroll in during the GEP.
Verify Effective Date: Confirm with the SSA the effective start date of your Medicare coverage. Generally, if you enroll during the GEP, coverage begins on July 1st of the same year.
Understand Premiums: Be aware of any premiums associated with Medicare Part A and/or Part B, considering your income and other factors.
Review Coverage Options: After enrolling in Medicare Part A and/or Part B during the GEP, explore additional coverage options during the Annual Election Period (AEP) in the fall, such as Medicare Advantage (Part C) plans or Medicare Part D (prescription drug coverage).

By following these step-by-step instructions, you can successfully enroll in Medicare during the General Enrollment Period and gain access to essential healthcare coverage provided by Medicare Part A and/or Part B.

Need help? Call Health Plans in Oregon: 503-928-6918. Our assistance is at no cost to you.

What Is the Medicare General Enrollment Period?