What is the Medicare Initial Enrollment Period?
The Initial Enrollment Period is a seven-month period when new beneficiaries can enroll in Medicare without a penalty. Most people enroll in Medicare at age 65.
Key Takeaways
- The IEP is a seven-month period, including the three months before, the month of, and the three months following a beneficiary’s 65th birthday.
- If a person qualifies for Medicare due to a disability or illness, their IEP is a 7-month period that starts three months before their 25th month of receiving SSDI payments.
- The date when a beneficiary’s Medicare coverage begins depends on when they sign up.
- Beneficiaries that missed their IEP may be able to enroll in Medicare during a different enrollment period.
- If a beneficiaryA person who has health care insurance through the Medicare or Medicaid programs. does not enroll during their IEP, penalties may apply.
When is the Initial Enrollment Period for Medicare?
The Initial Enrollment Period (IEP) is the first opportunity to enroll in Medicare and not risk late enrollment penalties. The IEP takes place during a seven-month period around a beneficiary’s 65th birthday. It starts three calendar months before their 65th birthday month and ends three months after their 65th birthday month.1Medicare.gov, “When does Medicare coverage start?“, Accessed September 25, 2021
During their IEP a beneficiary can enroll in Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. without penalty. Once enrolled in Part A and Part B, they can choose to join a Medicare Advantage planMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). or a Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... prescription drug plan. The effective date of benefits depends on the month of enrollment, as follows:1Medicare.gov, “When does Medicare coverage start?“, Accessed September 25, 2021
| If they sign up: | Coverage starts: |
|---|---|
| Before the month they turn 65 | The month they turn 65 |
| The month they turn 65 | The next month |
| 1 month after they turn 65 | 2 months after they sign up |
| 2 or 3 months after they turn 65 | 3 months after they sign up |
When is the Initial Enrollment Period for Social Security Beneficiaries?
Beneficiaries receiving Social Security Disability Insurance (SSDI) benefits will be automatically enrolled in Medicare Part A and Part B on the month of their 25th payment. Beneficiaries that want to enroll in a Medicare Advantage plan or add a Medicare Part D plan can make such plan elections during their IEP.2CMS.gov, “Top 5 things you need to know about Medicare Enrollment”, Accessed September 21, 2021
As with people turning age 65, SSDI beneficiaries will have a seven-month IEP to make their plan elections starting three months before their 25th month of SSDI benefits. Beneficiaries that enroll in a Medicare Advantage or Medicare Part D plan in the months before their 25th month of SSDI benefits, their plan benefits start on the 25th month. Beneficiaries that enroll on or after their 25th month, their plan benefits start the first of the month after the month they enroll.2CMS.gov, “Top 5 things you need to know about Medicare Enrollment”, Accessed September 21, 2021
What if I Missed My Initial Enrollment Period?
Beneficiaries that miss their IEP can still enroll in Medicare during the General Enrollment PeriodThe General Enrollment Period (GEP) allows beneficiaries to enroll in Medicare Part A and Part B from January 1 to March 31 if they missed their Initial Enrollment Period. Beneficiaries can also enroll in a... at the start of each year. However, enrolling late may incur penalties for their monthly premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. . These penalties only get bigger the longer beneficiaries wait to enroll.3Medicare.gov, “What does Medicare cost?“, Accessed September 6, 2021
Citations
- 1Medicare.gov, “When does Medicare coverage start?“, Accessed September 25, 2021
- 2CMS.gov, “Top 5 things you need to know about Medicare Enrollment”, Accessed September 21, 2021
- 3Medicare.gov, “What does Medicare cost?“, Accessed September 6, 2021