When am I eligible for a Medicare Advantage plan?  

Before shopping for a Medicare Advantage or Medicare Advantage Prescription Drug plan (MAPD), you should understand your eligibility. Part of knowing when you’re eligible is knowing when your enrollment window opens. The other part is knowing what qualifies you for a Medicare Advantage plan.  

You are first eligible for Medicare Advantage when you become eligible for Original Medicare. This is known as your Initial Enrollment Period (IEP) and is a seven-month window beginning three months before your 65th birthday, the month of your birthday, and three months after. If you were born on the first of the month, the enrollment period begins four months before your 65th birthday and ends two months after your birthday month. 

Who can enroll in Medicare Part C?   

Medicare Advantage is also known as Medicare Part C. Anyone who is already enrolled in, or is eligible for, Original Medicare Parts A and B can enroll in Medicare Part C.   

To qualify for Original Medicare, you must be a United States citizen or permanent legal resident for the last five years. You must also be one of the following:  

• You are age 65 or older 
• You have received Social Security Disability Insurance (SSDI) benefits for at least 24 months
• You have Amyotrophic Lateral Sclerosis (ALS, also called Lou Gehrig’s disease)
• You have End‑Stage Renal Disease (ESRD), meaning permanent kidney failure requiring dialysis or a transplant

 

When is the Annual Enrollment Period? 

The Annual Enrollment Period (AEP) for Medicare Advantage is October 15 to December 7 each year. This period is for enrolling in Medicare Advantage or Prescription Drug Plans with coverage that begins January 1 of the following year.

 

What is the Medicare Advantage Open Enrollment Period?

You can change your Medicare Advantage plan during the Medicare Advantage Open Enrollment period (OEP).  

The MA OEP runs from January 1 to March 31 each year and is only for people who are already enrolled in a Medicare Advantage plan. During this three-month window, you can make one change:

• Switch to a different Medicare Advantage plan, or   
• Return to Original Medicare (and add a Part D prescription drug plan if needed) 

Your new plan will typically begin on the first day of the following month after your plan receives your enrollment request.

 

What is a special enrollment period (SEP)?  

A special enrollment period (SEP) is a time of your life when you’ve experienced a major event that qualifies you to enroll in Medicare Advantage or change your coverage outside of the AEP and OEP windows.  

Some special enrollment periods may include:  

• You moved and your plan isn’t in your new area 
• You moved back to the United States after living abroad 
• You’re no longer eligible for Medicaid 
• You left coverage from your employer
• You recently left a Program of All-Inclusive Care for the Elderly (PACE) program
• Your plan changed its contract with Medicare 
• Medicare ended your plan’s contract 

For the full list of special enrollment period events and what they mean for you, please visit Medicare.gov.  

 

Who is not eligible for Medicare Advantage?  

To enroll in a Medicare Advantage plan, you must meet certain eligibility requirements. You must be enrolled in both Medicare Part A and Part B. If you delay enrolling in Part B. For example, some people enroll in Medicare Part A when they’re eligible, but delay enrolling in Part B. To enroll in a Medicare Advantage plan, you must be enrolled in both parts of Original Medicare. Someone who delayed their Part B enrollment is not eligible for a Medicare Advantage Plan. You would not be eligible to enroll in a Medicare Advantage plan until you have both parts. You must also live in the service area of the plan you want to join. 

In general, you must first be eligible for Medicare to enroll in a Medicare Advantage plan.