Part D Enrollment Periods
Medicare Advantage HMO-POS Plans
To get Medicare drug coverage (Part D), you must join a Medicare-approved plan that offers drug coverage. There are various types of plans as well as plan providers, and each plan can vary in cost and specific drugs covered. Medicare Part D has three enrollment periods that beneficiaries should be familiar with. Understanding these enrollment periods will help individuals avoid late enrollment penalties and obtain the best coverage.
The three Part D enrollment periods are:
- Initial Enrollment Period
- Special Enrollment Period
- Annual Enrollment Period
Part D Enrollment Penalty
The Part D late enrollment penalty is, in other words, an amount that’s permanently added to your Medicare drug coverage monthly premium. You may have to pay a late enrollment penalty if at any time after your Initial Enrollment Period is over, there is a period of 63 or more days in a row during which you don’t have Medicare drug coverage or other creditable prescription drug coverage. You will generally have to pay the penalty for as long as you have Medicare drug coverage.
The cost of the late enrollment penalty depends on how long you went without Part D or creditable prescription drug coverage.
Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” which amounts to $32.74 in 2023, with the number of full, uncovered months you didn’t have Part D or creditable coverage.
Part D Initial Enrollment Period
The Initial Enrollment Period (IEP) is unique to each individual. The IEP begins three months prior to an individual’s 65th birthday and ends three months after their birthday. This is the first opportunity for a Medicare beneficiary to purchase a Part D plan.
Part D Special Enrollment Period
Special Enrollment Periods are for individuals who have a qualifying event that allows them to either submit their first enrollment or change a current enrollment.
An event that would allow an individual to qualify for a SEP and change their Part D plan could be one of the following:
- Losing current health insurance coverage
- Moving to a new plan area or state
- Getting married or divorced
- Having a child
- Adopting a child
The SEP usually lasts for either 60 days before the qualifying event or 60 days after the qualifying event.
Of course, an individual must first meet all the requirements to enroll in a Part D plan initially. Speak with one of our knowledgeable agents if you think you may qualify for a SEP and wish to change your current coverage.
Part D Annual Enrollment Period
The Annual Enrollment Period happens each fall from October 15 through December 7. During this time, Medicare beneficiaries enrolled in a Part D plan can choose to enroll in a different plan for the upcoming year. This is a crucial time of year for Part c and Part D enrollment.
The Annual Notice of Change (ANOC) is sent out to all Part D members every year at the end of September. The ANOC will notify the member of any upcoming changes to their Part D plan. Changes may include changes to the premium, deductible, and overall coverage. Changes to the plan will go into effect on January 1 of the upcoming year. Unless the member chooses a new plan, their coverage will continue under the same plan with the new changes.
Any changes that are made will go into effect on January 1 of the new year.