Coastal Georgia and the South Carolina Lowcountry, plus 9 further states by phone or video.
Enrolment
Medicare runs on dates. Miss the right one and the cost follows you for the rest of your life, which is why this page spells out the arithmetic rather than telling you to hurry.
The windows
Most people only ever use two of these. Knowing which two is the whole trick.
Seven months around your 65th birthday
Three months before the month you turn 65, the birthday month itself, and three months after. Sign up in the first three months and cover starts on the first of your birthday month; wait until after and it starts the month after you enrol.
1 January – 31 March
The catch-up window for anyone who missed their Initial Enrolment Period and has no Special Enrolment Period. Cover starts the first of the month after you enrol, and the Part B late-enrolment penalty usually follows you for life.
Eight months after employer cover ends
Triggered by losing qualifying employer cover, moving out of a plan's service area, a plan leaving your county, or gaining or losing Medicaid or Extra Help. No penalty if you use it in time. COBRA and retiree cover do not count as employer cover for this purpose.
15 October – 7 December
The autumn window everyone means by 'open enrolment'. Change Advantage plans, change Part D plans, or move between Advantage and Original Medicare. Whatever you choose starts on 1 January.
1 January – 31 March
For people already in an Advantage plan on 1 January. One change: switch to a different Advantage plan, or drop back to Original Medicare and pick up a Part D plan. It does not let you join an Advantage plan from Original Medicare.
Initial Enrolment Period
The seven-month window is not seven equal months. Sign up early and cover starts on the first of your birthday month; sign up late and every month of delay is a month of delay.
| You enrol | Cover starts | Effect |
|---|---|---|
| Three months before your birthday month | The first day of your birthday month | The clean option. No gap. |
| Your birthday month | The first day of the following month | One month later than you probably expected. |
| One month after | The first day of the following month | A month of exposure. |
| Two or three months after | The first day of the following month | Two or three months of exposure. |
The penalties
Both penalties are formulas, not fines. Once you can do the arithmetic, the decision to enrol or delay stops feeling like a gamble.
10% of the standard premium for each full 12-month period you could have had Part B and did not. It is added to your premium and, in almost every case, you pay it for as long as you have Part B.
1% of the national base beneficiary premium for every full month you went without creditable drug cover, rounded to the nearest 10 cents and added to your Part D premium. The base moves each year, so the penalty moves with it.
| Situation | Formula | Roughly |
|---|---|---|
| Part B, 26 months late | Two full 12-month periods = 20% | 20% of $185.00 ≈ $40.58 a month on top, for life |
| Part B, 11 months late | No full 12-month period = 0% | No penalty. The rule counts complete years only. |
| Part D, 14 months uncovered | 14% of $36.78 | ≈ $5.50 a month on top, recalculated each year |
| Part D, 40 months uncovered | 40% of $36.78 | ≈ $15.60 a month on top, recalculated each year |
Special Enrolment Periods
A Special Enrolment Period is the difference between changing plans freely and waiting until autumn. They are also the most commonly missed right in Medicare.
Eight months from the month employment or the group plan ends, whichever comes first. For a Part D plan you get two months. COBRA and retiree cover do not start this clock.
Moving out of your plan's service area, or into an area with new options, opens a window — usually two months after the move, or two months after you tell the plan.
If a plan is not renewed in your county, or loses its contract, you get a window to choose something else and a guaranteed right to certain Medigap policies.
Gaining, losing or changing status for Medicaid or the Extra Help subsidy opens a window, often quarterly while it lasts.
Moving out of a skilled nursing facility or long-term care hospital gives you a window to change plans.
A federal or state emergency declaration in your area can extend a window you missed while it was in force.
Windows and penalties
The autumn Annual Enrolment Period, 15 October to 7 December, is open to everyone with Medicare and lets you make any Part C or Part D change, effective 1 January. The Medicare Advantage Open Enrolment Period, 1 January to 31 March, is only for people already in an Advantage plan, and allows one change: a different Advantage plan, or back to Original Medicare with a Part D plan.
Not usually. A Special Enrolment Period gets you into Part B, Part C or Part D without penalty. Medigap has its own separate protections — the six-month open enrolment when Part B starts, and a handful of guaranteed issue rights, such as when a plan leaves your county or you try Advantage for the first time and leave within twelve months.
The General Enrolment Period runs 1 January to 31 March, and cover starts the first of the month after you enrol. Expect the Part B penalty unless you qualify for a Special Enrolment Period you did not know about — which is worth checking, because employer situations, Medicaid and moves all create them.
Yes, Part A and Part B are handled by the Social Security Administration online, by phone or at a local office. Choosing a Part C, Part D or Medigap plan is separate, and that is the part we do with you.
Two facts are usually enough for us to tell you which window you are in, whether delaying is safe, and what the deadline actually is.
A licensed, local advisor — usually the same day.
(912) 555-0148Mon – Thu 8:30 am – 6:00 pm
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