Individual health insurance helps cover health care costs.

This is the main enrollment period each year. For plans through the Marketplace (like Get Covered Illinois), Open Enrollment typically runs November through mid-January. Coverage usually begins January 1 (or February 1 if you enroll later in the window).

Special Enrollment Period (SEP)

You may qualify to enroll any time of year if you experience a life event such as:

• Loss of employer coverage

• Marriage or divorce

• Birth or adoption of a child

• Moving to a new coverage area

• Turning 26 and aging off a parent’s plan

Most Special Enrollment Periods last 60 days from the qualifying event.

When you go to your Get Covered Illinois (state health insurance marketplace) appointment or start the enrollment process, it helps to have the right information and documents ready so they can complete your application and check your eligibility for financial help.

Personal & Identity Info

Bring copies or details for you and anyone you’re enrolling.

• Social Security number (if you have one)

• Birth Date(s)

• Address and contact info

• Photo ID or government-issued ID

• Immigration documents if they apply to you

Income & Household Info

• Recent pay stubs or proof of income (last 4 weeks)

• Last year’s tax returns (1040, W-2s, 1099s)

• Other income documentation (self-employment, unemployment, etc.)

Household & Coverage Details

• Names, birthdates, and relationship of everyone in your household

• Info about current or previous health coverage (if any)

• Documents showing any recent qualifying life event (if enrolling outside open enrollment)

Extra Documents (if requested)

If Get Covered Illinois asks you to verify your application, you may need to upload or bring specific proofs for items like income, citizenship, or life events. Responding to document requests promptly helps avoid delays in coverage.

If you continue working past 65, you may not have to enroll in Medicare right away-it depends on your coverage.

Here’s how it typically works:

If You Have Employer Health Insurance

• If you (or your spouse) are actively working and covered under a group health plan from an employer with 20 + employees, you can usually delay Medicare Part B without penalty.

• Many people also delay Part A, but some choose to take Part A since it’s often premium-free.

If The Employer Has Fewer Than 20 Employees

• Medicare generally becomes primary at 65, meaning you would need Part A and Part B to avoid gaps in coverage.

Important Things to Know

• If you delay Part B because you have qualifying employer coverage, you’ll get a Special Enrollment Period when you retire-so no late penalty.

• If you don’t have creditable coverage and delay, you could face a lifetime penalty.

Because every situation is a little different-employer size, HSA contributions, spouse coverage, etc. – it’s worth reviewing your specific details before making a decision.

Yes-there is a very important window each fall to review your coverage.

Medicare Annual Enrollment Period (AEP)

October 15-December 7 each year

During this time, you can:

• Switch from one Medicare Advantage (MAPD) plan to another

• Change your Medicare Part D prescription drug plan

• Move from Original Medicare to a Medicare Advantage plan (or vice versa)

Why Should You Review Your Plan?

Even if you’re happy with your current coverage, plans can change every year. Reviewing ensures:

• Your medications are still covered

• Your doctors and pharmacies remain in-network

• Your premiums, deductibles, and copays still make sense

• You’re not overpaying for coverage you don’t need

Insurance companies update formularies, networks, and costs annually. What worked well this year may not be your best option next year.

The best time to start gathering information for Medicare is about 3-6 months before you turn 65.

Here’s why that window works well:

• 6 Months before 65

Start learning the basics-Original Medicare (Part A & B), Medicare Advantage, Supplements (Medigap), and Part D Prescription plans. This gives you time to understand your options without pressure.

• 3 months before 65

Your Initial Enrollment Period begins. This is when you can officially enroll and compare plan pricing, provider networks, and drug coverage.

• Before your birthday month

Enrolling early helps avoid delays in coverage and prevents late enrollment penalties.

If you’re still working and covered under employer insurance, the timing may look a little different- but it’s still smart to start reviewing your options several months in advance so there are no surprises.

Planning ahead makes Medicare much less overwhelming and gives you time to make confident decisions.

Great question-and this is where timing really matters.

Will Social Security contact you?

Sometimes.

• If you’re already receiving Social Security benefits before age 65, you’re typically automatically enrolled in Medicare Parts A and B. Your card usually arrives about 3 months before your 65th birthday.

• If you are not receiving Social Security yet, you will not be automatically enrolled. You’ll need to sign up yourself.

When should you reach out?

If you are not drawing Social Security, plan to contact them about 3 months before you turn 65. That’s when your Initial Enrollment Period begins (it runs 3 months before, your birthday month, and 3 months after).

You can enroll:

• Online at SSA.gov

• By phone

• Or at your local Social Security office

If you’re still working and have employer coverage, the timing can be different-especially for Part B-so it’s smart to review your situation a few months ahead of time.

Starting early helps avoid gaps in coverage or late enrollment penalties.