When Should I Apply for Medicare Advantage?

Category: Medicare Originally Posted: February 22, 2016 by Quinn Korzeniecki Last modified: February 22, 2016

Medicare beneficiaries looking to apply for Medicare Advantage may do so at certain times of the year, including during their Initial Enrollment Period, the Annual Election Period or a Special Enrollment Period. Medicare Advantage plans are provided through private insurance companies and offer the same benefits as Original Medicare, with some also offering prescription drug coverage and vision, dental or hearing care.

Enrolling in a Medicare Advantage plan during your Initial Enrollment Period

When you first become eligible for Medicare, you have a 7-month Initial Enrollment Period (IEP) to sign up for a Medicare Advantage plan. If you are aging in to Medicare, then your IEP begins 3 months before the month that you turn 65 and ends 3 months after the month you turn 65. For example, if you age in to Medicare in May, then your Initial Enrollment Period begins February 1st and ends August 31st. People with End-Stage Renal Disease generally cannot enroll in a Medicare Advantage plan.

Enrolling in a Medicare Advantage plan during the Annual Election Period

The Medicare Annual Election Period (AEP) is an annual open enrollment period running from October 15 to December 7, during which Medicare beneficiaries can apply for Medicare Advantage plan coverage. Beneficiaries can make the following changes to their coverage during this two-month period:

  • Switch from Original Medicare to Medicare Advantage
  • Switch from a Medicare Advantage plan back to Original Medicare
  • Switch from a Medicare Advantage plan to different Medicare Advantage plan in their service area
  • Switch from a Medicare Advantage plan that doesn’t include drug coverage to one that does, and vice versa

Enrolling in a Medicare Advantage plan during a Special Enrollment Period

If you missed the other enrollment periods, you generally have to wait for the Annual Election Period to come around again to apply for a Medicare Advantage plan. However, there are certain special circumstances that could qualify you for a Special Enrollment Period, such as:

  • You moved out of your current plan’s service area.
  • You are eligible for Medicaid.
  • You qualify for the Extra Help program, which assists with the cost of your prescription medications.
  • You are receiving care in an institution, such as a long-term care hospital or skilled nursing facility.
  • You want to switch to a Medicare Advantage plan with a 5-star overall quality rating.

Can I enroll in a Medicare Advantage plan?

If you are enrolled in Medicare Part A and Part B and live in the Medicare Advantage plan’s service area, then you are eligible to join this plan during either your Initial Enrollment Period or the Annual Election Period, or during a Special Enrollment Period for which you qualify. Not all Medicare Advantage plans will work the same way, so it is recommended that you compare all plans in your area to find the right one for your needs.


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