Medicare Advantage Plans

Medicare Enrollment Periods
Medicare Advantage Plans
General Enrollment Period
Medicare Advantage Disenrollment Period (MADP)
Summary of Enrollment Periods

Medicare Enrollment Periods
There are certain periods when you can join, change or drop the different parts of Medicare (A, B, C, and D). In other words, you are not allowed to enroll or disenroll whenever you want. This fact sheet discusses 5 different enrollment periods in relation to the different parts of Medicare:

• Initial Enrollment Period (IEP)
• Annual Election Period (AEP)
• Special Enrollment Periods (SEPs)
• Low Income (LIS): Medicaid (Medi-Cal)
• Medicare Advantage Disenrollment Period (MADP)

Note: Enrollment periods are also mentioned in other fact sheets that focus on a particular part of Medicare. For information on enrollment periods relating to Medigap or Medicare supplement insurance policies in particular, see our fact sheet "Supplementing Medicare: Your Rights to Purchase a Medigap Policy" at cahealthadvocates.org.

The different parts of Medicare are:

Part A – Hospital insurance;
Part B – Outpatient medical services;
Part C – Medicare Advantage plans; and
Part D – Medicare prescription drug plans.

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Medicare Advantage Plans:
Initial Enrollment Period for Part D If you are newly eligible for Medicare, the IEP for Part D is the same as the IEP for Parts A and B. To enroll in a Medicare Part D plan, you must be eligible for either Part A or Part B. People who have Medicare due to a disability have another IEP for Part D when they turn 65 years old.

If you don't enroll in a Medicare drug plan during this initial enrollment period you can only enroll at the end of each year during the Annual Election Period (October 15 – December 7) or a Special Enrollment Period explained below.

Also, if you do not join a Part D plan during your IEP AND do not have creditable coverage for your drugs (prescription drug coverage that is at least as good as Medicare's Part D benefit), you may incur a penalty of 1% of the average national premium for every month you were eligible and did not sign up. This amount is added on to your drug plan premium. (The average national premium is about $31.08 in 2012and changes each year.)

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General Enrollment Period
People who did not enroll in Part A or B during their IEP, or terminated their Part A or Part B benefits and want to re-enroll, may enroll in either or both Parts during the General Enrollment Period (GEP), which is January 1 to March 31 of each year. If you enroll during the GEP, your benefits will begin the following July 1. If you enroll in Part B during the GEP, you may have to pay the late enrollment penalty mentioned above.

Annual Election Period
Annual Election Period (AEP), which is October 15 to December 7 of every year, allows people to join, change or drop an MA plan or Part D plan. For example:

• If you did not enroll in an MA plan during your ICEP or a Part D plan during your IEP, you may enroll in an MA plan or Part D plan during the AEP.
• If you are already in an MA plan or Part D plan, you may change plans or disenroll from your plan during the AEP.
• If you had an MA plan and went back to Original Medicare and now want to be in an MA plan again, you may enroll during the AEP.

You may make more than one election during the AEP. Your final election during that period is the one that counts. The last election (or only election) made during the AEP will be effective January 1 of the following year.

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Medicare Advantage Disenrollment Period (MADP)
In addition to the Annual Election Period (AEP), Medicare Advantage plans also have a yearly Medicare Advantage Disenrollment Period (MADP) from January 1 - February 14 each year. During this time period, beneficiaries can disenroll from their MA/MA-PD plan and return to Original Medicare. A consumer can also elect to enroll in a PDP plan during this period if they elect to disenroll from their MA/MA-PD plan.

Note: By enrolling in a Part D plan, you would automatically be disenrolled from your MA plan and enrolled in Original Medicare.

This fact sheet contains general information and should not be relied upon to make individual decisions. If you would like to discuss your specific situation, call the Health Insurance Counseling and Advocacy Program (HICAP). HICAP provides free and objective information and counseling on Medicare and can help you understand your specific rights and health care options. You can call 1-800-434-0222 to make an appointment at the HICAP office nearest you.

A beneficiary who has end-stage renal disease (ESRD) — permanent kidney failure — and needs dialysis on a regular basis or a kidney transplant, can get Medicare Parts A and B within 3 months of his or her first dialysis treatment. Please see the fact sheet “Medicare and People with End- Stage Renal Disease” at cahealthadvocates.org.


Summary of Enrollment Periods

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