Planning for Medicare

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Find a Medicare Plan That is Right for You

When can you enroll in a Medicare plan?

Once you’ve decided which EmblemHealth Medicare Advantage plan is right for you, you’re ready to enroll.

There are specific enrollment periods and rules for when you can enroll, how often you can change the way you get Medicare, and what choices you have when you make the change.

Enrollment Period Dates

If you are eligible, you may only enroll in an EmblemHealth Medicare Advantage plan during specific times of the year. Below you’ll find some important enrollment dates.

Initial Coverage
Election Period

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Annual Election Period for 2025 Coverage: Oct. 15, 2024 – Dec. 7, 2024

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Special Enrollment Periods for All Medicare Advantage Plans

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You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, such as a move or a loss of other insurance coverage. These chances to make changes are called Special Election Periods(SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.

When does Special Election Period (SEP) coverage become effective?

If you enroll in Medicare Part B while covered by a group health plan or during the first full month after coverage ends, your Medicare Part B coverage starts on the first day of the month you enroll. You also can delay the start date for Medicare Part B coverage until the first day of any of the following three months.
If you enroll during any of the seven remaining months of the SEP, your Medicare Part B coverage begins the month after you enroll.

Who can qualify for a Special Election Period (SEP)?

For a variety of reasons, you may qualify to enroll in Medicare coverage at any time of the year. Below are situations that might qualify you for an SEP:

You recently moved outside of the service area for your current plan.
You recently had a change in your Medicaid (newly got Medicaid, had a change in level of Medicaid assistance, or lost Medicaid).
You recently had a change in your Extra Help paying for Medicare prescription drug coverage (newly got Extra Help, had a change in the level of Extra Help, or lost Extra Help).
You are moving into, live in, or recently moved out of a Long-Term Care Facility (for example, a nursing home).
You recently left a PACE (Programs of All-Inclusive Care for the Elderly) program.
You recently involuntarily lost your creditable prescription drug coverage (coverage as good as Medicare’s).
You are leaving employer or union coverage.
You belong to a pharmacy assistance program provided by the state.
You recently returned to the United States after living permanently outside of the U.S.
Your plan is ending its contract with Medicare, or Medicare is ending its contract with your plan.
You were enrolled in a plan by Medicare (or your state) and you want to choose a different plan.
You were enrolled in a Special Needs Plan (SNP), but you have lost the special needs qualification required to be in that plan.

Visit the SEP section on medicare.gov to learn more about the circumstances that qualify you for an SEP.

How can I disenroll?

We are sure that you will be happy with all the benefits EmblemHealth has to offer. But should you wish to leave your plan, you may do so in one of two ways:

If you wish to leave the plan during the Medicare Advantage Disenrollment or Special Election Periods, please send your request in writing, signed and dated to us, or
You can call 800-MEDICARE (800-633-4227). If you use a TTY, please call 877-486-2048.

After you submit the request, the plan will make a decision on whether to approve or deny the disenrollment request within 10 calendar days of receipt of the request to disenroll. If you leave our plan, it may take time before your membership ends and your new Medicare coverage goes into effect. During this time, you must continue to get your medical care and prescription drugs through us.

You can continue to use your network pharmacies to get your prescriptions filled until your membership in your current plan ends. If you are hospitalized on the day your membership ends, your hospital stay will usually be covered by the plan until you’re discharged (even if you’re discharged after your new health coverage begins).

Am I eligible for Medicare at 65?

If you are almost age 65 and are retired or ready to retire, you are likely signing up for Medicare for the first time. Read our tips below to help you plan for Medicare enrollment.

You have a limited time to enroll once you reach the Medicare eligibility age, called the Initial Coverage Election Period (ICEP). This period covers three months before the month of your 65th birthday to three months after. During these seven months, you may enroll in any Medicare health insurance plan you’re eligible for.

4-6 months before you turn 65

Four to six months before turning 65, you can learn the Medicare basics: What are the parts of Medicare? What do they cover? How much will I pay? See Medicare Basics

1-3 months before you turn 65

One to three months before turning 65, you can enroll in Medicare Parts A and B so that you don’t have a lapse in coverage.
Contact your local Social Security Administration office to check whether you’re automatically enrolled based on your Social Security benefits.
Look at affordable options that give you more coverage than Original Medicare alone, like Medicare Advantage plans.

Medicare Advantage plans give you all the benefits of Medicare Parts A and B, plus even more coverage such as eyewear, dental, hearing aids, and fitness. Medicare Advantage Prescription Drug plans also include Medicare Part D drug coverage in the same plan.

Check with your doctor(s) to see if they accept different types of Medicare coverage. Certain providers may not accept Medicare. Check your prescription drugs to see if they’re covered.

What should I do before my
Medicare initial enrollment period ends?

Let us help you find a Medicare Advantage plan that works for you.

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from Us

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Call our Medicare Specialists

If not currently enrolled,

call 800-859-4880 (TTY: 711).

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Friday from 8 a.m. to 8 p.m.

800-859-4880 (TTY:711)

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Last Updated 10/01/2024

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Popular Tasks

Neighborhood Care

Planning for Medicare

When can you enroll in a Medicare plan?

Enrollment Period Dates

How can I disenroll?

Am I eligible for Medicare at 65?

4-6 months before you turn 65

1-3 months before you turn 65

What should I do before my
Medicare initial enrollment period ends?

Popular Tasks

Neighborhood Care

Planning for Medicare

When can you enroll in a Medicare plan?

Enrollment Period Dates

How can I disenroll?

Am I eligible for Medicare at 65?

4-6 months before you turn 65

1-3 months before you turn 65

What should I do before my Medicare initial enrollment period ends?

What should I do before my
Medicare initial enrollment period ends?