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