The Medicare dates that matter.
I'm Erick Vallarino, an insurance agent here in the Valley. Medicare has a few deadlines: miss one, and you may wait months for coverage, or pay a late penalty every month. Here they are, in plain words, and my help costs you nothing.
Which window is yours?
| When | What it's called | Who it's for |
|---|---|---|
| The 7 months around your 65th birthday | Initial Enrollment Period | People new to Medicare |
| October 15 to December 7, every year | Open Enrollment (also called the Annual Enrollment Period) | Everyone with Medicare |
| January 1 to March 31, every year | Medicare Advantage Open Enrollment | People already in a Medicare Advantage plan |
| January 1 to March 31, every year | General Enrollment Period | People who missed their first chance to sign up for Part B |
| When your life changes | Special Enrollment Periods | People who move, lose job coverage, or get or lose Medicaid or Extra Help, and more |
| 6 months, once, starting when you have Part B and are 65 or older | Medigap Open Enrollment | People with Original Medicare who want a Medicare Supplement |
Turning 65: your 7-month window.
Your first chance to sign up for Medicare lasts 7 months: usually the 3 months before your birthday month, your birthday month, and the 3 months after. If your birthday is on the 1st of the month, it all moves one month earlier.
When does your coverage start?
It depends on when you sign up. In the 3 months before your birthday month: your coverage starts on the 1st of your birthday month. In your birthday month, or in the 3 months after: your coverage starts on the 1st of the month after you sign up. If you get Part A without a premium, like most people, it starts the month you turn 65. These dates matter most for Part B.
Is your birthday on the 1st?
Then everything moves one month earlier. Example: your birthday is June 1. Your window is February to August. Sign up in February, March or April, and your coverage starts May 1.
Already getting Social Security?
If your Social Security or Railroad Retirement Board benefits started at least 4 months before you turn 65, you get Part A and Part B automatically. If not, you have to sign up yourself, usually through Social Security (or the Railroad Retirement Board if you worked for a railroad).
Still working, with insurance from your job or your spouse's job?
You may be able to wait on Part B. When the job or that insurance ends, whichever comes first, you have 8 months to sign up for Part B without a late penalty. COBRA and retiree coverage don't count as job coverage, and they don't give you more time. If you want Medicare to start when your job insurance ends, sign up for Part B the month before you (or your spouse) retire. Every case is different, so let's check before you decide anything.
What if you miss your window?
Without insurance from a current job, you may have to wait for the General Enrollment Period and pay a Part B late penalty for as long as you have Part B.
Open Enrollment, October 15 to December 7.
Also called the Annual Enrollment Period, or AEP. This is the one time each year when everyone with Medicare can change their health and drug plans for next year. During these weeks, you can:
- Switch from Original Medicare to a Medicare Advantage plan, or from a Medicare Advantage plan back to Original Medicare.
- Switch from one Medicare Advantage plan to another, or add or drop drug coverage.
- Join, switch or drop a Medicare drug plan (Part D), if you have Original Medicare.
Your changes start January 1. The plan has to get your request by December 7. This year: Open Enrollment runs from October 15 to December 7, 2026. Changes start January 1, 2027. Thinking about Medicare Advantage? Bring your list of doctors and medicines, and I'll look them up in the plans I offer. Have a Medicare Supplement now? Call me before you drop it. You may not be able to get it back later. If it's your first time in a Medicare Advantage plan, you may be able to get it back within the first 12 months.
Each fall, your plan sends you a letter.
If you keep your plan, you don't have to do anything. Your coverage continues on its own. But plans can change their costs, their doctors and their drug list every year.
Don't put it in a drawer.
The letter tells you what changes on January 1. Text me a picture of it, and we'll go over it together.
Is your plan leaving Medicare?
You get a different letter in October. Then you do need to choose new coverage, so call me right away.
Medicare Advantage Open Enrollment.
Only for people already in a Medicare Advantage plan. If you're in a Medicare Advantage plan and it isn't working for you, you get one more chance.
What can you change?
From January 1 to March 31, you can make one change: switch to a different Medicare Advantage plan (with or without drug coverage), or leave your Medicare Advantage plan and go back to Original Medicare. If you go back, you can also join a separate drug plan. The change starts on the 1st of the month after the plan gets your request.
New to Medicare?
If you joined a Medicare Advantage plan when you first got Medicare, you get this same chance during your first 3 months with Part A and Part B.
What can't you do in this window?
You can't switch from Original Medicare to Medicare Advantage, or join or change a drug plan if you have Original Medicare. That waits for Open Enrollment in the fall, unless a special window applies to you.
Thinking of going back to Original Medicare?
After your Medigap Open Enrollment is over, an insurance company can turn you down for a Medigap policy because of your health, unless you have a special right. Call me before you switch.
General Enrollment Period.
If you didn't sign up for Part B when you were first able to, and you don't qualify for a special window, you can sign up from January 1 to March 31 of any year.
- Your coverage starts on the 1st of the month after you sign up.
- You may have to pay a Part B late penalty (see below).
- This window is also for Part A if you have to pay a premium for it. Most people get Part A without a premium, and they can sign up for it any time after 65.
- If you also want a Medicare Advantage plan, there is a short window to join after you sign up. I'll check your dates with you.
Special Enrollment Periods.
Some changes in your life open a special window to change your Medicare Advantage or drug plan outside the usual dates. Here are a few common ones. Other situations may qualify too.
You move.
If you move out of your plan's area, or to a place with new plan choices, you can change plans. Your window starts when you move and lasts 2 full months after. If you tell your plan before you move, it starts the month before you move.
You lose job or union coverage.
When insurance from a job or union ends (including COBRA), you have 2 full months after the month it ends to join a Medicare Advantage or drug plan. Part B is different: its 8 months count from when the job or the job insurance ended, whichever came first. COBRA ending does not start a new 8 months (see "Still working" above).
You have Medicaid or Extra Help.
If you have Medicare and Medicaid, or you get Extra Help paying for your medicines, you may be able to make certain changes once a month: switch to a different drug plan, or leave a Medicare Advantage plan and go back to Original Medicare with a separate drug plan. If you get full Medicaid benefits, you may also be able to join a plan made to coordinate your Medicare and Medicaid, if one is offered where you live. The change starts on the 1st of the next month. This doesn't apply to everyone (for example, some people in a plan's drug safety program), so call me to check first.
You lose Medicaid or Extra Help.
You have 3 full months to change plans, counted from the date you lose it or the date you're told, whichever is later.
You move into or out of a nursing home.
You can change plans while you live there, and for 2 full months after the month you move out.
6 months, one time only.
For people with Original Medicare who want a Medicare Supplement (Medigap). Your Medigap Open Enrollment lasts 6 months. It starts the first month you have Part B and are 65 or older. During those 6 months:
- You can buy any Medigap policy sold in your state.
- The insurance company can't turn you down or charge you more because of health problems. Some policies may delay coverage of a pre-existing condition for as long as 6 months. Qualifying prior health coverage can shorten or eliminate that wait, and some special protections prevent it. We'll check which rules apply to you.
It happens only once. It does not come back every year like Open Enrollment does. After it ends, a company can turn you down or charge you more because of your health, unless you have a special right. Careful: the 6 months start when your Part B starts, even if you still have insurance from a job.
Late penalties: Part B and Part D.
A late penalty is not a one-time fee. It is added to your monthly premium, and you usually pay it for as long as you have that coverage.
Part B
10% more for each full 12 months you could have had Part B but didn't sign up. You generally pay it for as long as you have Part B. Example: if you waited 2 full years, you pay 20% more. Usually there is no penalty if you signed up during a Special Enrollment Period, like the 8 months after your job or your job insurance ends.
Part D (drug coverage)
After your first window, if you go 63 days or more in a row without Medicare drug coverage, or other drug coverage that's as good as Medicare's (called "creditable coverage"), you may pay a penalty when you join later. It's 1% of a national base amount for each full month you went without. That base amount can change every year, so the penalty can too. It's added to your drug premium for as long as you have Medicare drug coverage, even if you switch plans. People who get Extra Help don't pay it. Example: 14 months without drug coverage means a penalty of 14% of that base amount, added every month.
Dates that matter
- October 15 to December 7: Anyone with Medicare can change their health and drug plans for next year. Your changes start January 1.
- January 1 to March 31: People in a Medicare Advantage plan can make one change. Switch to another Advantage plan, or go back to Original Medicare.
- 7 months: Your first chance to sign up for Medicare, around the month you turn 65. Usually the 3 months before your birthday month, that month, and the 3 months after. If your birthday is on the 1st of the month, it all moves one month earlier.
- 6 months: Your protected time to buy a Medicare Supplement, once you’re 65 and have Part B. In those 6 months, a company can’t turn you down or charge you more because of your health.
Still have questions? That's what I'm here for.
No question is too small. I'll explain it as many times as you need, in English or Spanish. My help costs you nothing.