Each year, there are certain times when you can enroll in a Medicare Advantage (MA) plan. In order to join an MA plan, you must be enrolled in Medicare Parts A and B. From there, you can enroll in an MA plan during the following time periods:
1. Initial Coverage Election Period (ICEP)
The ICEP is the one-time event where people who are newly eligible for Medicare can enroll in an MA plan (with or without Part D coverage). Don’t confuse the ICEP with the Initial Enrollment Period (IEP). They are similar, but not exactly the same. The IEP lasts a total of seven months surrounding your month of entitlement to Medicare. (For example, your 65th birthday.) This means the three months before, the month of, and three months after. During this time, you enroll in Medicare Parts A, B and D.
It gets a little more complicated if you decide to delay Medicare Part B enrollment (such as if you have primary coverage through an employer, spouse or veterans’ benefits). If this is the case, then the time period for your ICEP changes a little. If you decide to delay Medicare Part B enrollment, your ICEP ends either the last day of the month before you are enrolled in both Parts A and B or the last day of the IEP – whichever is later. It’s very important to understand the ICEP so you do not miss the window to enroll in an MA plan.
2. Medicare’s Annual Election Period (AEP)
Medicare AEP occurs every fall from October 15 through December 7. During this time, you can change your Medicare coverage. You can choose a new MA plan, switch between Original Medicare (Parts A and B only) and MA, or change your Part D coverage. Of course, if you are enrolled in an MA plan, and you are satisfied with your coverage, you can elect to stay with this current plan for the next plan year.
3. Special Enrollment Periods (SEPs)
Special Enrollment Periods (SEPs) refer to periods of time outside your IEP/ICEP and AEP when you can enroll in Medicare. According to the Centers for Medicare and Medicaid Services (CMS), there are a number of special circumstances. The following special circumstances allow you to enroll in an MA plan (like Aspire Health Plan):
- Leaving employer group or union coverage (including COBRA coverage)
If this is you, your chance to join an MA plan lasts for two full months from the month after your coverage ends.
- Moving into Monterey County, California
If your moving to a new address not covered in your current plan’s service area (or if you address is still in your MA plan’s service area but there are new plan options), then you have one month after you tell your plan you’re moving plus two more full months to switch your coverage.
- Currently has, qualifies for, or loses Low Income Subsidy (LIS), “Extra Help for Part D”
If this is you, you can join, switch or drop your Medicare Part D coverage and join a MAPD plan one time during each of these time periods: January through March, April through June, July through September. Note, your coverage change takes effect on the first day of the following month, and you cannot use this SEP during Medicare AEP.
- Currently has, qualifies for, or loses Medi-Cal
If you are no longer eligible for Medicaid, known as Medi-Cal in California, you have three full months from the date you’re no longer eligible or notified to join an MA plan.
- Moves into, out of, or resides in a skilled nursing facility (SNF) or long-term care (LTC) hospital
If this is you, your opportunity to join an MA plan lasts for two full months after the month you leave the institution.
Of course, at Aspire Health Plan, we understand that you still might have questions about enrollment in Medicare Advantage plans. If you have any questions, we are here to help. Give us a call at (831) 657-0700.