Medicare Learning Center

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Medicare Enrollment Periods

Annual Election Period

  • Join, switch, or drop a plan
  • October 15 – December 7
  • Coverage begins January 1

Special Enrollment Period

  • Change Medicare coverage when certain events happen, like moving, turning 65, or losing other insurance coverage
  • Coverage begins the first of the month after the plan gets your request

Initial Enrollment Period

  • Enroll in Medicare when you turn 65 and/or you have a qualifying disability
  • hen turning 65, you have 7 months to enroll—your 65th birthday month, the 3 months before and the 3 months after
  • Coverage begins the first of the month after the plan gets your request
Enrollment Periods
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Original Medicare vs. Medicare Advantage

Original Medicare is the standard hospital (Part A) and medical (Part B) individual coverage offered by the federal government. Original Medicare does not cover some routine services, such as vision and dental.

Medicare Advantage (Part C) plans are offered through private insurance companies, such as Optima Health. The plans offer a full range of benefits beyond the Part A and Part B coverage you get from Original Medicare.

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Turning Age 65?

If you are turning age 65, you have a seven-month initial election period to enroll. This includes the three months before your birth month, the month you turn 65, and the three months after your birth month.

Enrollment Periods
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Receive Help with Prescription Drug Costs

People with limited resources and income may qualify for Extra Help to pay for their prescription drug costs. Extra Help is referred to as a low income subsidy (LIS) and helps pay for a part of your Part D monthly premium, annual deductible, and copayments.

Learn About Extra Help
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Frequently Asked Questions

Get answers to common questions about Medicare Advantage and understand your Optima Medicare plan options.

Questions and Answers

Understanding Medicare Coverage for Caregivers

We help caregivers make the most out of Medicare coverage when selecting the right plan for a spouse, parent, friend, or relative. A caregiver may assist a Medicare recipient with the enrollment process. Enrolling and making medical decisions on behalf of someone requires a Power of Attorney.

Caregivers can receive guidance on what to arrange by contacting Medicare at 1-800-MEDICARE (1-800-633-4227) or Optima Health at 757-552-7174 or 1-800-648-8420.

Medicare Eligibility Requirements

To be entitled to Medicare, you must be a U.S. citizen or a permanent legal resident, and answer yes to at least one (1) of the following questions:

  • Are you age 65 or older and eligible to receive Social Security benefits?
  • Are you under age 65, permanently disabled, and have been receiving Social Security Disability Insurance (SSDI) payments for at least two (2) years?
  • Do you receive continuing dialysis for permanent kidney failure or need a kidney transplant?
  • Do you have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease?

You can join a Medicare Advantage plan if:

  • You have Medicare Part A and Part B
  • You live in the service area of the plan

Important Note: federal government rules require that if you join a Medicare Advantage plan like Optima Medicare, and you want Medicare prescription drug coverage, you must get that drug coverage from your Medicare Advantage plan.
In addition, Medicare has special rules that dictate when you can join, change, or leave a Medicare Advantage plan.

Am I eligible for Optima Community Complete (HMO D-SNP)?

If you are eligible for Medicare (either by age or by disability) and get help from Medicaid and live in our service area, you should be eligible for Optima Community Complete.

  • You must be enrolled in Medicare Part A and Part B
  • You receive help from state Medicaid assistance
  • And you live in the service area