Enrolling in Medicare Part C
To join a Medicare Advantage (MA) plan, you must have Medicare Parts A and B. Your Part B premium will continue to be taken out of your Social Security or Railroad Retirement benefits check, unless you are enrolled in a Medicare Savings Program or Medi-Cal.
You cannot be denied enrollment in an MA plan due to a pre-existing condition, unless you have end-stage renal disease (ESRD) — permanent kidney failure. If you develop end-stage renal disease while enrolled in an MA plan, the plan cannot disenroll you.
If you want to join an MA plan, you must reside in the plan's service area and the plan you choose must be accepting new members.
If you are newly eligible for Medicare, you have an Initial Coverage Election Period (ICEP) to join an MA plan that begins 3 months immediately before you first become eligible for both Medicare Part A and Part B and ends on the later of:
- The last day of your Part B initial enrollment period, or;
- The last day of the month preceding your eligibility for both Part A and Part B.
Example 1: A person’s month of eligibility is April. His IEP for Parts A and B is January 1 to July 31. If the effective date of his Part A and Part B benefits is April 1, his ICEP for MA plans is January 1 to July 31.
Example 2: A person’s month of eligibility is April and her IEP for Parts A and B is January 1 to July 31. She does not enroll in Part B because she continues to work and is covered by her employer’s group health plan. She retires and then enrolls in Part B which becomes effective December 1 of that same year. Her ICEP to enroll in a MA plan is September 1 to November 30.
Submit your application directly to the MA plan or its sales representative. Enrollment is usually effective on the first of the month following the month of your enrollment. You cannot receive coverage for medical care from MA plan providers until enrollment takes effect. In general, you should not drop your existing coverage until your coverage with your preferred MA plan is in effect.
If you are not new to Medicare, in general you can only join, switch or get out of an MA plan at certain times of the year. One of these times is the annual election period during mid November through December of each year. Plan changes are effective January 1 of the following year. Prior to this annual election period, MA plans are required to announce whether they are leaving or reducing their service area the following year. MA plans must also provide information on future changes in benefits, changes in co-payments, and increases in premiums. MA plans may decide to close enrollment to new members except for those who are first enrolling in Medicare or who are moving into the MA plan's service area.
The other time you can join, switch or get out of an MA plan is during their open enrollment period (OEP) from January 1 through March 31 of each year. During this 3-month period, you can make one change in your MA plan choice. You can switch MA plans, return to Original Medicare, or, if you are in Original Medicare, you can join an MA plan.
Note: During this OEP, you can not drop or add Part D coverage. If you are in an MA plan with Part D coverage (MA-PD), you can either switch to another MA-PD or to Original Medicare and enroll into a stand-alone prescription drug plan (PDP). If you are in an MA only plan without Part D coverage, you can either join another MA only plan or switch to Original Medicare with no PDP. For more information, see Enrolling in a Medicare Advantage plan.
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Page updated July 23, 2008
