Understanding Medicare Enrollment Periods

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Understanding Medicare Enrollment Periods

When can you enroll in Medicare, and what are the different enrollment periods?

You can enroll in Original Medicare at certain times throughout the year, and these are known as enrollment periods. Typically, you can sign up for Medicare during your Initial Enrollment Period (IEP), General Enrollment Periods (GEP), and Special Enrollment Periods (SEP).

There is also An Annual Enrollment Period (AEP) that corresponds with health care enrollment periods for most adults (October 15 – December 7) where you may enroll in a Medicare Advantage plan or Medicare supplemental plan, should you choose to do so.

The Initial Enrollment Period

The Initial Enrollment Period (IEP) for Medicare is a seven-month period when people first become eligible for Medicare. The IEP starts three months before the month in which you turn 65, including the month of your 65th birthday, and ends three months after that month.
For example, if your 65th birthday is in June, your Initial Enrollment Period would start on March 1 and end on September 30.

If you have been receiving benefits from Social Security or the Railroad Retirement Board (RRB) at least four months before you turn 65, you will be automatically enrolled in Medicare Part A (hospital coverage) and Part B (medical coverage) starting the first day of the month that you turn 65.

It’s important to enroll in Medicare during your Initial Enrollment Period to avoid late enrollment penalties and to ensure that you have continuous health coverage.

The General Enrollment Period

The General Enrollment Period (GEP) for Medicare is a time when people who didn’t enroll in Medicare during their Initial Enrollment Period can sign up for Medicare Part A and/or Medicare Part B. The GEP runs from January 1 to March 31 each year.

If you didn’t sign up for Medicare Part A and/or Part B when you were first eligible, you may have to pay a late enrollment penalty for as long as you have Medicare. The penalty is an additional 10% of the Medicare Part B premium for each 12-month period that you could have had Part B, but didn’t sign up for it.

If you’re eligible for Medicare, it’s important to enroll during your Initial Enrollment Period if possible. However, if you miss your Initial Enrollment Period, the General Enrollment Period provides another opportunity to enroll, even if you have to incur a late enrollment penalty. Your coverage generally starts the month after you sign up.

Generally, you won’t have to pay a late enrollment penalty if you qualify for a Special Enrollment Period. To qualify, you (or your spouse) must still be working and you must have health coverage based on that job.

Special Enrollment Periods

A Special Enrollment Period (SEP) for Medicare is a limited time frame during which you can enroll in or make changes to your Medicare coverage outside of the standard enrollment periods, specifically Part B (and Premium-Part A) without paying a late enrollment penalty. There are several reasons that may qualify you for a Special Enrollment Period, such as:

  1. Losing other insurance coverage, such as employer-sponsored health insurance.
  2. Losing Medicaid coverage, or gaining eligibility for Medicaid.
  3. Moving out of the coverage area of your current Medicare Advantage Plan or leaving a Medicare Advantage Plan that is no longer offered in your area.
  4. Gaining or losing a dependent, such as through marriage, divorce, or birth.
  5. Being released from prison.

These are the most common, but certainly not all, of the situations in which a Special Enrollment Period is allowed. Generally, should you qualify, the Special Enrollment Period would begin the day after your unique event occurs (for example, the day you are released from prison) and lasts roughly six to eight months. However, before doing anything, you should speak to an experienced IPA agent to make sure you qualify, and have the tools you need to apply.

If you don’t sign up during your Special Enrollment Period, you’ll have to wait for the next General Enrollment Period and you might have to pay a monthly late enrollment penalty.

Insurance Professionals of Arizona are always available to answer your questions or concerns, so if you just missed an enrollment period, or currently are in an enrollment period but don’t know how to find the very best options for you, be sure to give one of our helpful agents a call or email.

We’re here to help! Call us today.

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