Medicare’s General Enrollment Period vs. Open Enrollment Period

Medicare has many different enrollment periods, which can get confusing! There’s an initial enrollment period, the annual enrollment period, more than one open enrollment period, an initial election period, and a general enrollment period.

First thing’s first: be sure to download our guide to important Medicare dates. This guide simplifies all of the important deadlines throughout the year. And if you’re a client here at Sams/Hockaday, rest assured that your Medicare agent will take care of this for you.

However, a lot of individuals get confused between the General Enrollment Period (GEP) and the Open Enrollment Period (OEP) of Medicare. Let’s break each down, because they are very different, and there are penalties involved if you don’t understand the timing.

What is the General Enrollment Period?

If you missed signing up for Medicare for the first time, you can sign up for Medicare Part B from January 1-March 31. This window of time is called the General Enrollment Period.

The Medicare Part B premium penalty will apply, and coverage would begin July 1st.

What is the Open Enrollment Period?

There is so much confusion surrounding the term “Open Enrollment Period,” especially when it comes to Medicare.  

For starters, there are more than one “Open Enrollment” period:

1. Medigap Open Enrollment Period: During this 6-month window, you can buy any Medigap policy (also known as Medicare Supplement) sold in your state without having to answer any health questions.

2. Medicare Advantage Open Enrollment Period (MA OEP): If you have a Medicare Advantage plan, you’re allowed to switch to a different Medicare Advantage plan or go back to Original Medicare from January 1-March 31.

In addition, many people – including Medicare itself – refer to the Annual Enrollment Period as an “Open Enrollment Period,” even though that isn’t technically the correct term.

The Annual Enrollment Period is from October 15-December 7. You can make changes to your Medicare Part D drug plan or Medicare Advantage plan during this window of time in the fall. Outside of special circumstances and turning 65, this is the only time of year you’re allowed to switch or enroll in a drug plan or Medicare Advantage plan.

See what we mean about confusing?

Note: all of our clients benefit from having a licensed agent walk them through the Medicare maze. As long as you reach out to us before you turn 65, we will ensure you know your enrollment periods and don’t miss any critical deadlines.

Try to Avoid the General Enrollment Period (GEP)

The General Enrollment Period (GEP) is for individuals who didn’t sign up for Medicare Part B when they were first eligible. For most people, this is when you turn 65.

Many individuals still have group insurance through their employer or through their spouse’s employer at age 65. If that’s the case, you won’t be penalized for not signing up for Medicare when you’re first eligible.

However, if you don’t have any other credible coverage and don’t sign up for Part B of Medicare when you’re first eligible, you’ll have to wait until the GEP – and you’ll be penalized for life.

Try to avoid the GEP at all costs!

What is the GEP Penalty?

If you didn't get Part B when you're first eligible, your monthly premium may go up 10% for each 12-month period you could've had Part B but didn't sign up.  

In most cases, you'll have to pay this penalty each time you pay your premiums, for as long as you have Part B. What’s worse – that penalty increases the longer you go without Part B coverage.

The Part B premium is $170.10 in 2022. Imagine having to pay 10% more for the rest of your life, just because you forgot to sign up for Medicare Part B when you were first eligible!

And that’s on top of any other premium adjustments due to a high income.

Read more: How Income Affects Your Medicare Costs In 2022

Get a Medicare Agent to Help Avoid Penalties

There are several penalties related to missing Medicare enrollment deadlines. Have a Medicare agent on your side to ensure you’re on track and have the coverage you need when you need it.

Our licensed insurance agents at Sams/Hockaday have been helping individuals through the Medicare process for over 40 years. Call us to schedule your appointment at 217-423-8000!