Annual Election and Enrollment Periods
- Participating Physician Groups (PPG)
When a beneficiary first becomes eligible for Medicare, they may enroll during the seven-month enrollment period which begins three months before, includes the month of and ends three months after the member turns 65.
If the beneficiary qualifies for Medicare on the basis of disability, they can join during the seven-month period that begins three months before their 25th month of disability and ends three months after their 25th month of disability.
During the Annual Election Period (AEP) of October 15 through December 7, each year, beneficiaries may enroll, switch, or drop a Medicare Advantage plan or a Medicare Prescription Drug Plan. Coverage begins on January 1, as long as the plan gets the request by December 7.
Additionally, in certain situations, beneficiaries may be able to enroll, switch or disenroll from a Medicare Advantage plan or Medicare Prescription Drug Plan during a special election period (SEP). Examples of these situations include when a beneficiary:
- Moves out of their plan's service area.
- Has Medicaid.
- Qualifies for a low-income subsidy (LIS).
- Lives in an institution (for example, a nursing home).
Enrollment guidelines for Special Needs Plans (SNPs) are different. The SEP applies to an SNP, but lock-in to a particular plan for a specified time period does not apply to dual-eligible (Medicare and Medicaid) members.