Medicare Enrollment Periods 2023
CMS regulates when beneficiaries can change Medicare Advantage and PDP plans. This article addresses Medicare enrollment, not MAPD/PDP enrollment.
General Enrollment Period
The General Enrollment Period (GEP) runs from January 1 through March 31. Coverage begins the first of the following month for beneficiaries enrolling in Medicare during the GEP. In previous years, coverage did not begin until July 1.
Initial Enrollment Period
The Initial Enrollment Period (IEP) is the seven-month period. Medicare beneficiaries can enroll 3 months prior and up to 3 months after their 65th birthday month. IEP includes three months before, the month of, and three months after someone’s 65th birthday month. Prior to 2023, people who enrolled in Medicare during the last three months of their IEP had to wait up to three months for coverage to begin. That is no longer the case. Coverage is effective the first of the month after the month of enrollment.
Special Medicare Enrollment Periods 2023
CMS established Special Enrollment Periods (SEPs) for Part B and premium Part A for those with an exceptional circumstance. SEP allows expand Medicare enrollment opportunities, reduce gaps in coverage, and prevent late enrollment penalties.
ISEP – New to Part B
This election period applies to beneficiaries new to Part B. Side note: a MAPD/PDD application must be submitted prior to the Part B effective date in order to use the ISEP.
SEP – Emergency or Disaster
This special election period offers beneficiaries that missed an enrollment opportunity due to a government declared an emergency. FEMA disasters are an example. Click here for additional disaster SEP information.
SEP for Loss of Coverage
An individual can use this SEP if their employer, employer plan, or someone acting on behalf of their employer gave them incorrect information that caused them to delay Medicare enrollment. In addition, this SEP applies when an individual loses group coverage. CMS allows a full 2 months for enrollment after the loss of creditable coverage.
SEP for Formerly Incarcerated Individuals
This SEP is for individuals who are released from incarceration on or after January 1, 2023. Formerly incarcerated people may be eligible for a Special Enrollment Period to enroll in Premium Part A and Part B. They won’t have to pay a late enrollment penalty if they enroll using the SEP.
Coverage start date is the first day of the month following the month of enrollment. Alternately, retroactive coverage can be requested up to 6 months in the past. Note: retroactive premiums apply.
SEP to Coordinate with Termination of Medicaid Coverage
This SEP, also called the Medicaid SEP, is for people who lose Medicaid eligibility. CMS allows a change for 3 months from either the day of ineligibility or notification, whichever is longer.
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