Medicare initial enrollment, general enrollment, open enrollment, special enrollment 2025
Initial enrollment, general enrollment, open enrollment, special enrollment – those Medicare terms are confusing to many consumers. In the following, we will explain the differences and your options to enroll in Medicare health plans.
When can I enroll in Medicare Part A and B 2025?
If you are already receiving benefits from Social Security or the Railroad Retirement Board, you will automatically be enrolled in Part A and Part B on the first day of the month of your 65th birthday, or the first day of the month before if you are born on the first of a month. If you are under 65 and disabled, you automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months. Slightly different rules apply if you have Amyotrophic Lateral Sclerosis (ALS)/Lou Gehrig’s disease or live in Puerto Rico. You will know that you are enrolled when you receive your Medicare card in the mail.
Keeping the card means you agree to Medicare and will have to start paying Medicare Part B premiums. If you don’t want Medicare, follow the instructions that come with the card to send it back.
If you are not receiving Social Security or Railroad Retirement Board benefits, e.g. because you are still working or have End-Stage Renal Disease (ESRD), you need to sign up yourself. You can either apply online at https://www.socialsecurity.gov, or visit or call your local Social Security Office at 1-800-772-1213 (TTY 1-800-325-0778).
If you were not automatically enrolled, you can still enroll in Medicare Part A and B
- When you’re first eligible (Initial Enrollment period) – When you are first eligible for Medicare, you have seven months (3 months before and after you become eligible) to enroll in additional Medicare health coverage.
- During the General Enrollment period between January 1 – March 31 each year – If you didn’t sign up for Medicare Part A and/or Part B during your Initial Enrollment Period, you can still sign up between January 1 and March 31 each year. Your coverage will begin the first day of the month after you sign up. You may have to pay a higher premium for late enrollment.
- Do you qualify for a Special Enrollment period? – If you’re covered under a group health plan based on current employment, you can sign up any time as long as you or your spouse is working, and have an 8-month Special Enrollment Period that starts the month after the employment ends or the group health plan insurance based on current employment ends.
When can I enroll in a Medicare supplement insurance (Medigap plan)?
You have a 6-month open enrollment period to buy a Medicare supplement (Medigap) policy starting the first month you are 65 and enrolled in Part B. During the Medigap Open Enrollment Period, you have a guaranteed right to buy any Medigap policy sold in your state regardless of your health status.
When can I enroll in a Medicare advantage plan or Part D (Prescription drug coverage) plan?
You must have Medicare Part A and B to enroll in an advantage plan. There are specific times when you can enroll in Medicare Advantage (Part C) or Medicare prescription drug coverage (Part D), or make changes to your existing coverage:
- When you first become eligible for Medicare or when you turn 65, during your Initial Enrollment period (see above)
- During the Open Enrollment period each year (see below)
- Under certain circumstances that qualify you for a Special Enrollment period (SEP)
such as moving, you become eligible for Medicaid, you qualify for extra help with Medicare prescription drug costs, you move into a skilled nursing facility or long-term care hospital.
Medicare Open enrollment period: October 15 through December 7, 2024
During this time, you may:
- Change from original Medicare to a Medicare advantage plan
- Change from a Medicare advantage plan back to original Medicare
- Switch from one Medicare advantage plan to another Medicare advantage plan
- Switch from a Medicare advantage plan that doesn’t offer drug coverage to a Medicare advantage plan that offers drug coverage, or vice versa
- Join a Medicare prescription drug plan
- Switch from one Medicare prescription drug plan to another Medicare prescription drug plan
- Drop your Medicare prescription drug coverage completely
The changes will take effect on January 1, 2025
Special Enrollment periods for Part C and Part D
You can make changes to your Medicare advantage and Medicare prescription drug coverage at specific times, such as if you move, or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Examples include, but are not limited to, the following situations:
- You move to a new area that is not included in your plan’s service area
- You move back to the United States
- You move into a skilled nursing facility or long-term care hospital
- You are no longer eligible for Medicaid
- You get or leave coverage from your employer or union
- You live in the service area of one or more Medicare advantage or Medicare prescription drug plans with an overall quality rating of 5 stars
- Your current plan is discontinued
You may switch to a 5-Star rated Medicare advantage plan all year
You can switch to a 5-star Medicare advantage plan at any time during the year. The overall plan star ratings are available at
medicare.gov/find-a-plan. You can only join a 5-star Medicare advantage plan that is available in your area. You can only switch to a 5-star plan one time each year.
Visit www.medicare.gov to get detailed information about your Medicare eligibility and enrollment options, or call 1-800-MEDICARE (1-800-633-4227) or TTY 1-877-486-2048.
