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Why the Initial Enrollment Period is so Important

There are certain times of the year, or enrollment periods, when eligible people can enroll in Medicare coverage. Seniors are encouraged to sign up for Medicare during their Initial Enrollment Period (IEP) for several reasons, including:

  • Taking advantage of Medicare coverage as soon as you are eligible

  • Avoiding late enrollment penalties

  • Avoiding underwriting for Medicare Supplement (Medigap) plans

What is the Medicare Initial Enrollment Period (IEP)?

The Initial Enrollment Period (IEP) is a seven-month window around a senior’s 65th birthday (or 25th disability check) where they can sign up for Medicare Part A and Part B (Original Medicare) as well as Part D prescription drug coverage and supplemental insurance. Enrolling in a Medicare Advantage (Part C) is another option during IEP. Part C plans always include Part A and Part B and often include Part D and other additional coverage as well.

The Initial Enrollment Period is relevant any time a person is newly eligible for Medicare for any reason. Some people get a second IEP because they qualify for Medicare for a second reason. For example, people who qualify for Medicare because of a disability before they turn 65 will have an IEP at that time and then have another one when they turn 65. Another reason would be if a person has one IEP when they turn 65 and then later develops End Stage Renal Disease (ESRD). If you owe a Medicare Part B or Part D late-enrollment penalty because you didn’t sign up within your first IEP window, it gets erased when you re-qualify for Medicare and sign up within your second IEP window.

Breaking down the IEP window:

The IEP begins three months before your birthday month, includes the birthday month, and extends three months after the birthday month. For example: if you turn 65 on May 10, your IEP is February 1 – August 31.

The only exception is if your birthday falls on the first of the month. If that is the case, your IEP is determined as though you were born the month before (so a person born on May 1 would have an IEP between January 1 and July 31).

When does Medicare coverage start?

Premium-free Part A:

Premium-free Part A coverage always starts on the first of the month, the month you turn 65 (except if your birthday is on the first of the month, then coverage starts the month before you turn 65).

Part B and premium Part A:

Part B and premium Part A coverage starts depending on which month you sign up during your Initial Enrollment Period:

What happens if I miss my IEP?

After your Initial Enrollment Period ends, you can only sign up for Medicare during one of the other enrollment periods:

  • The General Enrollment Period (GEP) is available to seniors who didn’t sign up for Medicare during their IEP AND who aren’t eligible for a Special Enrollment Period. It runs between January 1–March 31 each year and coverage begins the following July 1. You may have to pay a monthly late enrollment penalty if you don’t qualify for a Special Enrollment Period.

  • Seniors can use a Special Enrollment Period (SEP) to enroll in Medicare without paying a late enrollment penalty if they missed their IEP because they were still covered by a group health plan. The SEP is an eight-month time frame that starts the month after the job ends or the month after the group health plan through the job ends. Coverage generally starts the month after enrolling.

  • The Annual Enrollment Period (AEP) is open every year between October 15 and December 7. During this period, seniors can enroll in, drop, or switch their Medicare coverage. If you missed your IEP and are enrolling in Medicare for the first time during AEP, you may be assessed a late enrollment penalty. Plans go into effect the following January 1.

If you need help enrolling in Medicare, a local Medicare agent can help!

Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. We are the only insurance agency in Hawaii contracted with EVERY Medicare Advantage plan, which means we are able to offer unbiased advice; all at no cost to our clients.

At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.

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