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 within 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.

Annual Enrollment Period (AEP): October 15 - December 7

During this time, Medicare beneficiaries may change and/or enroll in a Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD), or Prescription Drug Plan (PDP), or return to Original Medicare. Changes you make during this period will take effect on January 1.

Open Enrollment Period (OEP): January 1 - March 31

If you enrolled in a Medicare Advantage plan, this is when you can switch plans or return to Original Medicare. You can change plans only one time during this enrollment period.

"Lock-In" Period: April 1 - October 14

During this time you cannot change your Medicare Advantage (MA) or Prescription Drug Plan (PDP) unless a special situation comes up which may allow you to qualify for a Special Enrollment Period (SEP).

Special Enrollment Period (SEP)

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 Enrollment Period (SEP).

Some examples of special enrollment situations are:

  • Your current plan stops serving your location of residence.
  • 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 the Centers for Medicare & Medicaid (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 health care 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 voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.