Medicare Eligibility
& Enrollment Periods

Eligibility Requirements

Original Medicare Eligibility Requirements

  • Age 65
  • Under 65 if you are disabled or have been diagnosed with End Stage Renal Disease (ESRD)

New Hanover Health Advantage Eligibility Requirements

  • You’re entitled to Medicare Part A and are enrolled in Medicare Part B
  • You live in New Hanover, Brunswick or Pender counties in North Carolina

WHEN CAN YOU ENROLL IN MEDICARE OR A MEDICARE ADVANTAGE PLAN?

There are four distinct enrollment periods during which you can enroll in Original Medicare or a Medicare Advantage plan.

Initial Enrollment Period (IEP)

If you’re eligible for Medicare when you turn 65, you can sign up for Medicare and a Medicare Advantage Plan during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

The Medicare Advantage plan will go into effect the first of the month that you turn 65.

Annual Enrollment Period

The Annual Enrollment Period runs from October 15 through December 7 each year.

During this time, you can move from any plan to another plan.

Any change made during AEP will be effective January 1 of the following year.

Open Enrollment Period (OEP)

The Open Enrollment Period runs from January 1 through March 31 each year.

If you are in a Medicare Advantage Plan (with or without drug coverage) during this time, you can switch to another Medicare Advantage Plan (with or without drug coverage).

If you are in a Medicare Advantage Plan during this time, you have the option to return to Original Medicare. You will also be able to join a Medicare Prescription Drug Plan.

Special Enrollment Period (SEP)

After your IEP is over, you have a chance to sign up for a Medicare Advantage Plan during a Special Enrollment Period, which may begin at any time when you experience the following life events:

  • You move outside your current plan’s service area
  • You move back to the United States after living outside the country
  • You move back into or out of an institution such as a skilled nursing facility or long-term care facility
  • You are released from incarceration
  • You recently obtained lawful presence status in the U.S.
  • You lose your current employer/union plan
  • You involuntarily lose credible drug coverage
  • You recently had a change in Medicaid status (new received Medicaid, had a change in Medicaid level of assistance, or lost Medicaid)
  • You receive federal or state assistance (SEP only valid once quarterly per individual and not during AEP quarter of October through December)
  • You qualify for Extra Help paying for Medicare prescription drug coverage (SEP only valid once quarterly per individual and not during AEP quarter of October through December)
  • You enrolled into a special needs plan (SNP) and no longer qualify as a special need that the plan covers
  • You enrolled in another MA plan or Private Fee for Service (PFFS) plan based on misleading or incorrect information provided by plan employees, agents, or brokers

Ready to Enroll?

If you are eligible, are within any of the above enrollment periods, and would like to enroll in a New Hanover Health FirstMedicare plan, or if you have any questions about enrolling in one of our plans, contact us to be connected with a licensed agent who can help.