Enrolling in Medicare Part C

Print this page

back to Medicare basics

If you want to join a Medicare Advantage (MA) plan, you must have Medicare Parts A and B. Your Part B premium will continue to be taken out of your Social Security or Railroad Retirement benefits check, unless you are enrolled in a Medicare Savings Program (MSP) or have full Medi-Cal or Medi-Cal with a share of cost (SOC) under $500 (see our section on Low-Income Help).

You cannot be denied enrollment in an MA plan due to a pre-existing condition, unless you have end-stage renal disease (ESRD) — permanent kidney failure (see Medicare and People with ESRD (PDF) for more information). If you develop ESRD while enrolled in an MA plan, the plan cannot disenroll you.

If you want to join an MA plan, you must reside in the plan's service area and the plan you choose must be accepting new members.

You can only join MA plans during certain periods:

• Initial Coverage Election Period (ICEP): The 7-month period when you are first eligible for Medicare [link to subsection]
• Annual Election Period (AEP): November 15 – December 31 each year
• Open Enrollment Period (OEP): January 1 – March 31 each year

In addition, there are Special Election Periods (SEPs) during which you may be able to enroll in or disenroll from your MA plan, depending on your situation. See Special Election Periods (SEPs).

Initial Coverage Election Period (ICEP)

If you are newly eligible for Medicare, you have an Initial Coverage Election Period (ICEP) to join an MA plan that begins 3 months before you first become eligible for both Medicare Part A and Part B and ends on the later of:

• The last day of your Part B Initial Enrollment Period (IEP)
• The last day of the month preceding your eligibility for both Part A and Part B

Example 1: A person's month of eligibility is April. His IEP for Parts A and B is January 1 to July 31. If the effective date of his Part A and Part B benefits is April 1, his ICEP to enroll in an MA plan is January 1 to July 31.

Example 2: A person's month of eligibility is April and her IEP for Parts A and B is January 1 to July 31. She does not enroll in Part B because she continues to work and is covered by her employer's group health plan. She retires and then enrolls in Part B, which becomes effective December 1 of that same year. Her ICEP to enroll in a MA plan is September 1 to November 30.

Submit your application directly to the MA plan or its sales representative. Enrollment is usually effective on the first day of the month following the month you enroll. You cannot receive coverage for medical care from MA plan providers until enrollment takes effect.

Note: You should not drop your existing coverage until coverage with your new MA plan is in effect.

Annual Election Period (AEP)

If you are not new to Medicare, you can typically only join, switch or leave an MA plan at certain times of the year. One of these times is the Annual Election Period (AEP) from November 15 to December 31 each year. Plan changes are effective January 1 of the following year. Prior to this time, MA plans are required to:

• Inform you if they are leaving or reducing their service area the following year
• Provide information on future changes in benefits, copayments and premiums

In addition, MA plans may decide to close enrollment to new members except for those who are initially enrolling in Medicare or moving into the MA plan's service area.

Open Enrollment Period (OEP)

The other time you can join, switch or leave an MA plan is during the Open Enrollment Period (OEP) from January 1 through March 31 of each year. During this 3-month period, you can make one change in your MA plan choice (with the exception of Medicare Medical Savings Accounts, known as MSAs). You can switch MA plans, return to Original Medicare or — if you are in Original Medicare — join an MA plan.

Note: During this OEP, you can not drop or add Part D coverage. If you are in an MA plan without Part D coverage, you can either join another MA plan without Part D coverage or switch to Original Medicare with no stand-alone prescription drug plan (PDP). If you are in an MA plan with Part D coverage (MA-PD), you can either switch to another MA-PD plan or switch to Original Medicare and enroll in a PDP.

One exception exists: If you are in an MA-PD plan, you can change to an MA plan with no Part D coverage during the OEP if these 2 conditions are met:

• The new MA plan is a private fee-for-service (PFFS) plan, not a managed care plan (e.g., HMO or PPO)
• You also enroll in a stand-alone Part D plan

Note: Medigap plans also have an Open Enrollment Period, which should not be confused with the MA OEP. See Your Rights to Buy a Medigap Policy.

See also:

• Enrolling in Medicare Parts A and B
• Enrolling in Medicare Part D
• Special Election Periods (SEPs) for Parts C & D

back to Medicare Basics

Page updated Dec. 23, 2008