How Medicare Enrollment Works
- Cassidy Clark
- 4 days ago
- 2 min read
Let's review the basics of Medicare Enrollment Rules to help you avoid penalties and ensure your coverage begins when you need it. When preparing to enroll, contact your SGIA Benefit Consultant and they will help you walk through the entire enrollment process, all at no cost to you.
Who Is Eligible to Enroll?
Adults turning 65
Individuals under 65 with qualifying disabilities
People with ESRD or ALS
U.S. citizens or permanent residents (5+ years)
Part A & Part B Enrollment
Most people qualify for premium-free Part A based on work history or a spouse's work history.
Part B always requires a premium unless you qualify for assistance programs.
Late Enrollment Fees
Part A: Only applies if you are not eligible for premium-free Part A.
Penalty: 10% added to the monthly premium for twice the number of years you delayed.
Part B: Permanent penalty.
Penalty: 10% added for each full 12-month period you were eligible but didn’t enroll.
Part D: Permanent penalty.
Penalty: 1% of national base premium multiplied by the number of months without creditable coverage.
What Is Each Period For?
IEP → First chance to enroll
GEP → Enroll if you missed your IEP
SEP → Enroll after a qualifying life event
AEP → Change Advantage or drug plans
MA OEP → Adjust an existing Advantage plan
See image for an overview of all enrollment periods, eligibility, and more for Medicare.
Medigap enrollment follows different rules than Medicare enrollment periods. Ask your SGIA Benefit Consultant how and when Medigap fits into your Medicare decisions.
Where Medicare Supplement (Medigap) Fits In
Medicare Supplement Insurance (also called Medigap) helps pay for out-of-pocket costs that Original Medicare (Parts A and B) doesn’t fully cover, such as deductibles, copayments, and coinsurance.
You must be enrolled in both Part A and Part B to purchase a Medigap plan
Medigap only works with Original Medicare, not Medicare Advantage
Medigap plans are standardized and offered by private insurance companies
Medigap Open Enrollment Period
Begins when you are 65 or older AND enrolled in Part B
Lasts 6 months
During this time:
You cannot be denied coverage
You cannot be charged more due to health conditions
After this window:
Medical underwriting may apply
Acceptance is not guaranteed
Costs may be higher or coverage may be denied
Because Medigap timing is closely tied to when you enroll in Part B, working with an SGIA Benefit Consultant before enrolling is essential to avoid missed opportunities or unexpected costs.
Contact the Benefit Consultants at SGIA Medicare to help you through every step of enrollment. Subscribe to our weekly Blog for more information!
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