Medicare enrollment periods
In order for agents to sell Medicare plans, one of the first things they need to understand are the Medicare enrollment periods. There are many different enrollment periods available to beneficiaries. Each one depends on their personal circumstances.
If a beneficiary already receives Social Security benefits, they will automatically be enrolled in Original Medicare. In other words, they do not need to sing themselves up for Medicare Part A or Part B. Beneficiaries who do not qualify for automatic enrollment should enroll during the Initial enrollment period.
There are three enrollment periods available for Original Medicare
- The first and most commonly used is the IEP or initial enrollment period.
- Second is the AEP or annual enrollment period which can be used for a number of different reasons.
- Third is the GEP or general election period that beneficiaries use to enroll in Original Medicare if they missed their IEP for some reason.
Medicare IEP (Initial Enrollment Period)
The Medicare IEP (Initial Enrollment Period) is a seven-month window available to beneficiaries to enroll in Medicare Part A & Part B. The IEP is based on either your 65th birthday or once a qualified beneficiary receives their 24th Social Security disability payment. This enrollment period starts 3 months before the qualifying event and continues through the month of the event. The IEP ends 3 months after the month of the qualifying event. If the beneficiary’s birthday falls on the first of the month, The IEP begins 4 months before the 65th birthday of the beneficiary and ends 2 months after the beneficiary’s birth month.
Coverage for beneficiaries who enroll in the months before their birthday begins the first day of their birth month. If they enroll either during or after their birth month, coverage begins the first day of the month after they enroll.
During the IEP, beneficiaries can choose to either enroll in both parts of Original Medicare or they may choose to delay enrollment in Part B if they have other credible coverage such as from their own or a spouse’s employment.
Medicare AEP (Annual Enrollment Period)
The AEP starts each year on October 15 and runs until December 7. AEP is an opportunity for anyone on Medicare to make changes to their Part C or Part D coverage. Please note: changes made during this enrollment period will go into effect January 1 of the following year.
Medicare GEP (General Enrollment Period)
If a beneficiary neglects to enroll during their IEP and does not have other credible coverage, they may need to use the GEP to enroll in Medicare. The GEP starts January 1 and runs through March 31 each year. During the GEP, coverage begins the first day of the month after you enroll. Beneficiaries who enroll during the GEP may have to pay a late enrollment penalty depending how long they have gone without credible coverage.
Other Enrollment Periods
There are still more enrollment periods available. There are the Medicare Advantage Open Enrollment Period as well as the Medicare Supplement Open Enrollment Period. Each if these enrollment periods apply to the specified type of coverage. Although some individuals qualify for one of the many SEPs (Special Enrollment Periods).
Medicare Supplement Open Enrollment Period
The Medicare Supplement Open Enrollment Period starts the day their Medicare Part B is effective and runs for 6 months. This enrollment period gives beneficiaries guaranteed issue right to enroll in any Medigap plan available to them. Several supplement carriers let beneficiaries apply for a plan up to 6 months before their Part B start date. The supplement will not start until the day Part B benefits are in place. If the beneficiary misses their Medicare supplement open enrollment period, they can apply for a Medicare supplement plan any time of year. Keep in mind, they may have to go through underwriting and can be denied coverage.
Medicare Advantage Open Enrollment Period
When a beneficiary first enrolls in Medicare Part A and Part B during their IEP, they are eligible to enroll in a Medicare Advantage plan. If they do not choose to enroll at that time, they have to wait until the AEP (Annual Enrollment Period) unless they have an SEP available to them.
There is a specific Medicare Advantage Open Enrollment Period available to those who are already enrolled in a Medicare Advantage change their coverage. This enrollment period runs from January 1 through March 31 each year.
Special Enrollment Periods for Medicare
The most difficult to understand enrollment period may be the Special Enrollment Period. This enrollment period can apply to several different circumstances and does not apply to all Medicare beneficiaries. SEPs may require the beneficiary to provide proof of eligibility.
The most common reason for enrolling during an SEP is loss of employer coverage due to the fact that many benficiares choose not to enroll in Medicare PArt B because they have employer coverage.