How and when to enroll in Medicare Part C or Part D

Part C Medicare Advantage

Part C Medicare Advantage managed care plans combine Medicare Part A and Part B coverage within a managed care framework. Medicare doesn't control the amount a plan charges for this coverage, but it does regulate who may enroll in such a plan and when.

• Within six months of enrolling in Medicare Part A and B. Once your friend or relative enrolls in Medicare Part A and B, she has a six-month period in which she may join any Medicare Advantage managed care plan that is operating in the county where she lives. In this period, a plan must accept her enrollment without any medical screening and on the same terms as for anyone else of her age, regardless of her medical history.
• During the plan's open enrollment period. Every Medicare Advantage managed care plan designates at least one month a year for open enrollment, if it's accepting any new enrollees at all. Some plans have open enrollment for more than one month. During the open enrollment period, she can join the plan regardless of her medical history. Most plans pick November for open enrollment, with coverage beginning the following January 1.
• If dropped by another managed care plan. Unfortunately, Medicare Advantage managed care plans regularly drop out of geographic areas that they don't feel are profitable enough for them. If her plan is dropping out of the area where she lives, it will notify her by October 1, effective the following January 1. She then has two options. She can rejoin traditional Medicare Part A and Medicare Part B; if she does, she is also guaranteed the right to buy a medigap supplemental insurance policy to fill gaps in Medicare coverage. Or she can enroll in any other Plan C Medicare Advantage managed care plan that's operating in the county where she lives and that isn't closed to all further enrollment. She can join one of these plans from October 15 through December 7.
• If moving out of the plan's service area. Managed care plans operate within geographic areas. They aren't required to continue covering someone enrolled in the plan who moves out of the area it serves. If she's in this situation, she's guaranteed the right to join any Medicare Advantage managed care plan operating in the new area where she lives, during that plan's yearly open enrollment period. If there's a gap between when she moves and the open enrollment period for the new plan she'd like to join, she'll have to use traditional Medicare Part A and Part B in the meantime.

Medicare Part D prescription drug plan

Anyone eligible for Medicare is guaranteed the right to enroll in any Medicare Plan D prescription drug plan sold in the state where she lives during an initial enrollment period. This period begins three months before the month she turns 65, and continues until three months after the month she turns 65. If she doesn't sign up for a Part D plan by the end of this period, she has to wait until the Plan D yearly general enrollment period of November 15 through December 31.

There's a financial penalty if she doesn't enroll in a plan during her initial enrollment period but later decides to join a plan. For each month she delays enrolling after the close of her initial enrollment period, she must pay a 1 percent penalty on the premium price of any plan she eventually joins.