Enrollment
Almost every problem starts as a date.
The rules are not complicated. Knowing which window you are standing in is most of the work, and missing one usually means waiting a year — sometimes with a penalty attached.
Current plan-year dates: Medicare Open Enrollment 15 October – 7 December · Medicare Advantage Open Enrollment 1 January – 31 March · Marketplace Open Enrollment 1 November – 15 January
The five windows
Which one applies depends on your age, your situation, and whether something just changed.
- Initial Enrollment Period · Turning 65
- Seven months around your 65th birthday: the three months before, the birthday month, and the three months after. Enrolling in the front half generally starts coverage sooner than the back half — the window is seven months but the useful part is the beginning.
- General Enrollment Period · Missed your Initial window
- A first-quarter fallback for people with no other qualifying coverage. Coverage starts later than it would have, and a late-enrollment penalty may attach — one that for Part B can stay permanently.
- Open Enrollment Period · Already on Medicare
- The autumn window, for changing something rather than joining. Switch between Original Medicare and Advantage, change Advantage plans, or join, drop or switch a drug plan.
- Special Enrollment Period · A life event happened
- Triggered by an event rather than a date: losing employer coverage, moving out of a service area, your plan leaving, or becoming eligible for another programme. The clock usually runs from the event, not from when you noticed.
- Marketplace Open Enrollment · Under 65, buying your own
- The annual window for ACA coverage. Outside it you generally need a qualifying life event, and the documentation for one is easier to obtain at the time than months later.
What triggers a Special Enrollment Period
The list is longer than this and several entries carry conditions that are easy to read past. If something significant changed, ask rather than assuming it does not count.
- Losing employer coverage — yours or a spouse’s, through retirement or job loss
- A permanent move that changes the plans available to you
- Marriage, divorce, a birth, an adoption, or a death in the household
- Becoming eligible for, or losing, Medicaid or a related programme
- Your plan leaving your area or ending its contract
- Certain changes in immigration status
Before a window opens
1
Find the date
The event date, or your birthday month. Not the date you started looking — the clock rarely runs from there.
2
Get the paperwork now
A termination letter or a certificate of coverage is easy to obtain in the week you leave and difficult six months later.
3
List doctors and prescriptions
Names, locations, doses. This is the input everything else is checked against.
4
Act in the first half
There is no advantage to the second half of any window, and plenty of risk in it.
You may not need an agent at all
These services are free, independent, and will show you every plan in your area — including plans we cannot sell. If your situation is simple, they may be all you need.
- Medicare.gov Plan Finder — every Medicare Advantage and Part D plan where you live. Call1-800-MEDICARE, 24 hours a day, TTY 1-877-486-2048.
- Your State Health Insurance Assistance Program (SHIP) — free one-to-one Medicare counselling from people who sell nothing.
- HealthCare.gov — Marketplace plans and subsidy eligibility, plusfree local Navigators.
We list these because the alternative is you finding out later. If you call us and a free route fits better, that is what we will tell you.
Not sure which window you are in?
It takes about two minutes on the telephone to find out, and there is no cost.
No obligation. We'll tell you if a free option through Medicare.gov or HealthCare.gov suits you better. Monday to Friday, 9:00am – 5:00pm ET.