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May 27, 2013

Medicare Part D Enrollment Period

Although Medicare enrollment is automatic for most U.S. citizens over the age of 65, Medicare Part D enrollment is not. Medicare beneficiaries can choose to sign up for Medicare Part D during a specific Part D Enrollment Period. Failing to enroll during a certain enrollment period can result in a Part D Enrollment penalty and a delay in receiving certain benefits until the Medicare Part D Annual Enrollment period occurs. Hence, it is important to know the different Part D Enrollment Period types.

Part D Initial Enrollment Period

Age and/or the qualifying condition for Medicare Part D eligibility affect your Part D Initial Enrollment. There are five categories you can fall into when you become eligible for enrollment into Medicare Part D:

  1. Newly eligible due to turning age 65 - Initial Part D Enrollment Period occurs three months before your 65th birthday and lasts for a total of seven months.

  2. Newly eligible due to disability - Enrollment period occurs 21 months after you receive disability benefits and lasts for seven months.

  3. Already eligible due to disability, but just turned age 65 - Initial Part D Enrollment Period occurs three months before your 65th birthday and lasts for a total of seven months.

  4. Do not have Medicare Part A and enrolled in Medicare Part B during the Part B General Enrollment Period (January 1st to March 31st) - Medicare Part D Initial Enrollment Period lasts from April 1st to June 30th.

  5. Already enrolled in Medicare Part A and enrolled in Medicare Part B during the Part B General Enrollment Period - Initial Enrollment Period lasts from April 1st to June 30th.

Annual Part D Enrollment Period

There are two separate annual enrollment period types that allow changes to your Medicare Part D coverage for next year.

  1. Open Enrollment Period (October 15th to December 7th) - If you have already enrolled in Medicare Part D and/or Medicare Advantage, you may switch plans, pick up a new plan, or drop coverage and return to Original Medicare. If you were not previously enrolled, you can join a new Part D plan during this enrollment period.

  2. Annual Disenrollment Period (January 1st to February 14th) - If you are enrolled in an Advantage plan, you can disenroll and return to Original Medicare. After switching back, you then have until February 14th to join a Part D Plan. You can also drop Part D coverage. You may not switch to another Medicare Advantage or Part D plan during this enrollment period.

Texas Medicare Part D Special Enrollment Period

You can also qualify for a Texas Medicare Part D Special Enrollment Period. Here are some special circumstances in which you can be eligible for a Special Enrollment Period:

  • Moved to a new address not in your current plan's service area

  • Lost employer or union health coverage (including COBRA coverage)

  • No longer eligible or just became eligible for Texas Medicaid

  • Involuntarily lost credible drug coverage

  • Entered a long term care facility

There are also other conditions that allow individuals to receive a Special Enrollment Period. Each has a different specified period of time in which you must sign, join, switch, or drop your Part D coverage. However, if you fail to do so during your Special Enrollment Period, you will have to wait until the next Annual Enrollment Period. For many, you may incur a Part D Enrollment Penalty if you fail to join a Medicare Part D plan on time.

Medicare has neither approved nor endorsed this information.