Medicare special enrollment period is for 2022; if you’re nearing your 65th birthday or already a Medicare enrollee, you may wonder how they can benefit you. In this blog post, we’ll provide an overview of the Medicare enrollment periods and tips on making the most of them. We’ll also discuss when it’s the right time to enroll in Medicare and your options.
What is the Medicare special enrollment period?
If you meet the requirements for a special enrollment period, you might still be able to enroll in private coverage or make changes to it after open enrollment for 2022 has concluded. A special enrollment period, or SEP, is a window of time during which you can enroll in or modify your Medicare coverage in response to specific life events, such as losing your job or moving beyond the coverage area of your plan. Depending on your eligibility, there may be restrictions on how long a SEP lasts or what you are permitted to do while it is in effect.
Who qualifies for a special enrollment period for Medicare?
You might believe there is nothing whether you have insurance through the Marketplace or not. Until November, correct? No, not always. Uninsured? It may be possible for you to sign up for health insurance through the market with a limited time to enroll. What types of “Life Events” may qualify you for a special enrollment period? Think Big.
- Getting married
- Having a child
- Placing a child for adoption, foster care, or adoption,
- Releasing from prison
- Gaining citizenship
- Gaining or losing a dependent
- Moving out of the area served by your current Marketplace health plan.
Losing your job is another circumstance that could make you eligible for a special enrollment period.
- You lost job-based coverage.
- You lost health coverage because you outgrew your parents’ plan,
- You lost “student” insurance after graduating
- Being divorced
- You lost your Medicaid eligibility because your income grew
It’s crucial to understand that quitting your insurance coverage willingly does not make you eligible for a unique period for enrolment. Once you contact the Marketplace’s support center online or by phone and inform them that upon the occurrence of your Life Event, you’ll be sent an eligibility notice informing you of your eligibility for a special enrollment period.
Typically, you have 60 days after the triggering life event to enroll if you are eligible for a special enrollment period. In most circumstances, you have 60 days from the triggering life event to enroll if you qualify for a special enrollment period; thus, it is crucial to report the life event immediately.
If you presently have Marketplace health insurance and encounter certain Life. You should notify the Marketplace of any changes since you might be able to switch to a different plan that works better or qualify for some financial savings with you. Additionally, you can lower your tax credit amount to avoid paying too much in taxes when submitting your taxes and credits.
Further, if your circumstances change, you might be qualified for Medicaid or CHIP coverage. Health Insurance for Children Program.
What exactly do we mean by “Life Changes” then? Being pregnant, gaining a new job, experiencing another shift in income, changing your name, Social Security number, citizenship, or immigration; getting insurance through your employment or a program like Medicare or Medicaid; or paying taxes for Alaskan indigenous and American Indians, your Tribal Status.
Please let the Marketplace know if any of those changes relate to you by contacting them online at HealthCare.gov. Please visit if you have any questions regarding the Special Enrollment Period, Life Changes, and Life Events or how they may affect you.
How long is the special enrollment period for Medicare?
There is an 8-month Special Enrollment Period for those who qualify to defer Medicare with creditable employment coverage and work over the age of 65. During this time, you can enroll in Part A (if you haven’t already)
- Part B
- Part C
- Part D without incurring late fees
However, this Special Enrollment Period is challenging. Why? Because you only have the first two months to enroll in Part C / Part D without paying the penalty, whereas you have the whole 8 months to purchase Parts A and B. You will be subject to late enrollment fees for Part D if you enroll after the two-month deadline. Regardless of whether you end up with a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage.
It would help if you currently were employed with a respectable employer or union health coverage in order to be eligible for the Part B Special Enrollment Period. Eight months after your employer coverage expires or eight months after your last day of employment, whichever comes first, your Special Enrollment Period will begin.
How to apply for Medicare part B special enrollment period?
Enroll in Medicare Part B during the special enrollment period. The government will impose a few restrictions during the special enrolment period stipulations.
- The first requirement is that you or your spouse must work for an employer with at least 20 employees.
- You must be registered in group health insurance through your employer or spouse if you meet these two requirements at any time while you are covered by the group health insurance plan, excellent news!
You can sign up for the program during the special enrollment period. Medicare part B without penalties what will you then need to do? You can take several paths to sign up for Medicare Part B during the special enrollment period.
- Track you can go down is download CMS form 40b
- Complete it and then have your employer complete CMS form l564;
- You complete those forms and then mail those to the social security administration to enroll.
If everything’s completed correctly, you’ll be able to be enrolled in Medicare part b. That is the classic track, and there are undoubtedly many excellent videos on YouTube that will match it.
When is the special enrollment period for Medicare part B?
While enrolled in a group health plan or for the first full month after leaving the plan, you can enroll. Additionally, you can enroll after the insured employee leaves their job (whichever happens first). Your coverage will start if so at either of the following times:
- On the first day of any of the following three months of your choosing;
- On the first day of the month in which you enroll.
Your coverage will start on the first day of the following month if you enroll during any of the SEP’s final seven enrollment periods.
Note: Six months before the date you apply for Medicare (or Social Security or RRB benefits), Part A coverage is provided without cost. It can’t start before the month you became eligible for Medicare. Once your Medicare coverage starts, you can no longer make HSA contributions. It would help if you stopped making contributions to your HSA at least six months before you applied for Medicare to avoid a tax penalty.
Do you really need Medicare part B? | Medicare if you’re still working
Even if you are employed, you can still be required to enroll in Medicare Part B.
|When you turn 65, you must obtain Part B in one of two circumstances.|
|If the number of employees at your employer is under 20.|
|If your spouse’s work covers you and the employer mandates that all insured dependents sign up for Medicare when they age 65.|
|If your domestic partner’s company offers health insurance and you are not married but cohabiting.|
You won’t be eligible for a Special Enrollment Period in any of the scenarios above, and you cannot put off enrolling without paying late enrollment fees.
Additionally, when you become eligible for Medicare, some employment plans will immediately lose priority.
In this scenario, Medicare would take over as your leading insurance and pay first. In this situation, Medicare takes the place of your primary insurance and pays first.
You would have virtually no coverage from your employer’s plan if you don’t have Medicare and need medical attention.
When is the special enrollment period for Medicare part D?
A Medicare Advantage plan, which includes medical and drug coverage, or a stand-alone Medicare Part D prescription drug plan are your two options for coverage. Both types of plans are provided by private insurance providers that Medicare oversees.
Remember that you can only enroll during specific times: The seven-month initial enrollment period starts on the first of the month, 3 months just before the month you turn 65, and ends 3 months after the birthday month.
Annually, from October 15 to December 7 is open enrollment, with coverage starting on January 1. During this time, you can also change to a different Part D or Medicare Advantage plan.
Open enrollment for Medicare Advantage is available annually from January 1 to March 31. If you currently have a Medicare Advantage plan, you can change to a different one that includes prescription coverage during this time.
Switch to a affordable Medicare Advantage plan or health management organization (HMO) or preferred provider organization (PPO) without pharmaceutical coverage.
You won’t be able to purchase a separate Part D plan, so make sure you have coverage through a retiree plan, Tricare, or another option.
Alternatively, you can revert to original Medicare and purchase a stand-alone Part D plan after leaving Medicare Advantage. The modifications become effective on the first day of the subsequent month.
You may enroll in Part D during a special enrollment time, which is separate from your initial registration period. To be eligible, you must fulfill a number of requirements, including the ones listed below:
|You typically have up to two months to enroll in a Part D or Medicare Advantage plan if you lose your employer- or union-provided health insurance.|
|You typically have up to two months to enroll in Part D or a Medicare Advantage plan with drug coverage if you lose prescription coverage deemed to be at least as good as a basic Part D plan, often known as “creditable coverage.” This creditable insurance may be provided by a company, a retirement plan, Tricare, or another organization. Every September, you’ll often receive a note informing you of the creditability of your insurance.|
|You typically have up to two months to change to a new Part D or Medicare Advantage plan if you relocate to a new address outside of the coverage region of your current plan.|
|During the first three quarters of the year, you may switch Part D plans up to once per calendar quarter if you get financial assistance from the Part D Extra Help program.|
|You can enroll in a Medicare Advantage or Part D plan that the Centers for Medicare & Medicaid Services (CMS) awarded five stars in your area during the five-star special enrollment period, which runs from December 8 through November 30 of the following year. One once a year is allowed for use. After receiving the enrollment request by the plan, enrollment becomes effective on the first of the following month.|
In some circumstances, such as if you sign up for Medicare from January 1 to March 31 in order to make up for missing your original and special enrollment periods, you might be eligible to enroll in Part D.
You can purchase a Part D policy from April 1 to June 30 if you do not currently have premium-free Part A and enroll in Part B during this time. Your Medicare and Part D coverage will both begin on July 1.
Do you automatically get Medicare with Social Security?
Once you have received Social Security disability benefits (or certain Railroad Retirement Board disability benefits) for two years, you will generally be automatically enrolled in Original Medicare, Parts A and B.
Beginning 24 months after the month you were eligible for disability benefits, you will be covered by Medicare. In certain situations, this may have happened before the month in which you got your first check.
Medicare eligibility requires that you have been a citizen of the United States for at least five consecutive years or a legal permanent resident.
What is a qualifying event for special enrollment?
A significant, sometimes planned, sometimes unplanned event in your life that has the potential to affect both you and your health insurance is referred to as a qualifying life event. You might be able to alter your health plan outside of the annual enrollment period if you go through a substantial life change (also called open enrollment).
Among the qualifying life, events include but are not restricted to:
- Having a child or adopting one
- Tying the knot
- Going somewhere new
- Seeing a change in one’s employment situation
- Becoming 26
- Having a divorce
- Death of a person covered by your health plan
- Gaining citizenship in the US
- Becoming 65
Special Enrollment Periods (SEPs) may occasionally be made available for extra eligible causes, such as a pandemic or natural disaster relief.