Medicare Advantage Plans

When to Enroll in a Medicare Advantage Plan

Important Dates and Information about When You Can Enroll

Choosing a Medicare Advantage plan can be tricky, especially when you have so many options. Depending on the type of plan in which you want to enroll, the time of year, and when you became eligible for Medicare Part A and Part B, your options may be limited. Keep reading to find out about the rules for Medicare enrollment periods.

Medicare Advantage Plans: Enrollment Periods

New to Medicare?

If you recently became eligible for Medicare, through age or disability, you generally have the option to apply for coverage in a Medicare Advantage plan close to the date when your Medicare Part A and Part B coverage starts.

Your Medicare Advantage plan can't start before both your Part A and Part B coverage begins. However, you generally have a period of seven months to apply for coverage in a Medicare Advantage plan.

This means you can apply for coverage in a Medicare Advantage plan three months before, the month of, or three months after your Medicare Part A and Part B coverage starts. You must be enrolled in Medicare Part A and in Medicare Part B. This period is known as the Initial Coverage Election Period (ICEP).

Already enrolled in Medicare?

If you didn't recently become eligible for Medicare, your enrollment options are different and may be limited to certain times during the year.

October 15 - December 7 – Annual Election Period (AEP)

The Medicare Annual Election Period (AEP) runs from October 15 through December 7 of each year. During this time, Medicare beneficiaries may change and/or enroll in a stand-alone prescription drug plan (PDP) and/or a Medicare Advantage plan, or return to Original Medicare. Changes you make during this period will take effect on January 1.

April 1 - December 31 – "Lock-in" Period

Medicare beneficiaries usually cannot switch coverage between April 1 and December 31. This time is referred to as the "lock-in" period. During this “lock-in” period, you generally must stay with your current plan until December 31. On January 1, the coverage you choose between October 15 and December 7 goes into effect.

Special Election Period

In certain situations, beneficiaries may be able to join, switch, or leave a Medicare Advantage plan or a prescription drug plan (PDP) during a Special Election Period (SEP).

An SEP is a period outside of the ICEP or AEP when an individual may elect a plan or change his or her current plan election. Some examples of special election situations are:

  • The organization does not renew its contract with CMS.
  • You recently moved to the plan coverage area.
  • You have Medicare and Medicaid.
  • You are disenrolling from an Employer’s or Union’s health coverage.
  • You want to enroll in a plan that received a 5-star rating from Medicare for that plan year.
  • You enter, reside in, or leave a long-term care facility.
  • You qualify for “Extra Help.”
  • You involuntarily lost creditable prescription drug coverage.
  • Other exceptional conditions may exist, as determined by CMS.

Beneficiary and Plan Rights and Responsibilities Upon Disenrollment

Within ten (10) calendar days of receiving a member’s request to disenroll, CarePlus will acknowledge the request in writing and include the effective date of disenrollment with the plan. Beginning on the effective date of the member’s disenrollment, CarePlus will not cover any healthcare the individual receives. In addition, beginning on the effective date of the member’s disenrollment, the individual can see a healthcare provider through the Original Medicare Plan, unless the individual has enrolled in another Medicare Advantage plan. If the member’s doctor(s) needs to send claims to Medicare, the member may want to let the doctor(s) know that he/she just disenrolled from CarePlus and that it may take a few weeks for Medicare to update their records.

For additional information, please call CarePlus Member Services at 1-800-794-5907; TTY: 711. From October 1 - March 31, we are open 7 days a week; 8 a.m. to 8 p.m.. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voice mail message after-hours, Saturdays, Sundays, and holidays and we will return your call within 1 business day.