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As a Medicare agent, mastering all the different enrollment periods is crucial to ensure smooth enrollment for your clients. It also helps you stay compliant and that is also very important. Understanding IEP vs ICEP is essential to anyone in Medicare sales. Although these two sound similar, they serve distinct purposes and apply to different parts of Medicare.

IEP (Initial Enrollment Period)

First we will go over The IEP. Most agents know that this is the first window of time when someone is eligible to enroll in Original Medicare; specifically Parts A and B.

• Who is eligible to apply: Individuals turning 65 who worked and paid Medicare taxes for a period of at least 10 years (40 quarters) or their spouse or ex-spouse. Those who are under 65 with a qualifying disability, ESRD or ALS are also eligible to enroll.
• Timing: For those who are turning 65; The IEP spans 7 months: it begins 3 months before their 65th birthday, includes their birth month and ends 3 months after the month they turn 65.
• Timing: Individuals who are under 65 and qualify due to a disability; the IEP begins 3 months before the 25th month of their disability benefit entitlement.

Example: If a client turns 65 in May, their IEP runs from February 1st to August 31st.

What beneficiaries can do during IEP

1. Enroll in Medicare Part A and/or Part B
2. Enroll in a Medicare Part D plan (if they have Part A and/or Part B)
3. If they enroll in both Part A & Part B, they may also opt for either a Medicare Advantage (Part C) plan or a Medicare Supplement (Medigap) plan.

ICEP (Initial Coverage Election Period)

When an individual is first eligible for Medicare, the ICEP can specifically be used to enroll in a Medicare Advantage (Part C) plan.

• Who can use the ICEP: Individuals who are first enrolling in both Medicare Part A and B, and want to join a Medicare Advantage plan.
• Timing: Usually, the ICEP coincides with the IEP. However if an individual delays Part B enrollment (e.g., due to employer coverage), the ICEP does not start until they have both Part A and Part B and ends the last day of the month before their Part B coverage begins.

Example 1 (standard case): Client enrolls in A & B to begin July 1. Their ICEP runs from April 1 to June 30.

Example 2 (delayed Part B): Client took Part A at 65; delayed Part B until they retired at 67. Their ICEP begins when they enroll in Part B and ends the last day of the month before Part B becomes effective.

What beneficiaries can do during ICEP

1. Enroll in a Medicare Advantage (Part C) plan, with or without drug coverage (MAPD or MA-only).

Differences at a Glance

Why Understanding IEP vs ICEP Matters to Agents

Confusing IEP and ICEP could lead to enrollment mistakes, missed opportunities, and compliance issues. Knowing when each applies ensures:

• You recommend the right plans at the right time.
• You help clients avoid penalties for delayed Part D enrollment.
• You position yourself as a knowledgeable and trusted resource.

Watch a YouTube video on Medicare enrollment periods

Important: Always ask clients if they’ve enrolled in both Part A and B before discussing Medicare Advantage options. This small question helps determine whether they’re in their ICEP.

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To answer the question; what is the Medicare GEP; The Medicare GEP is an opportunity for individuals who missed their initial chance to sign up for Medicare Part A and/or Part B to enroll. It runs from January 1 to March 31 each year. This allows eligible individuals to enroll in Medicare coverage, though late penalties may apply.

Who needs the GEP

The GEP is for individuals who did not sign up for Medicare during their IEP (Initial Enrollment Period) and do not qualify for an SEP (Special Enrollment Period).

When does coverage begin

As of 2023, individuals who enroll in Medicare during the GEP will have their coverage begin the month after they enroll. Prior to 2023, coverage did not begin until July 1, which led to significant delays in accessing benefits.

Late enrollment penalties

Individuals who sign up during the GEP may have to pay an LEP (late enrollment penalty). This can increase monthly Medicare costs:

Part A penalty

For those who must pay a premium for Part A, the monthly premium could increase by 10%. This will be in place for twice the number of years they were eligible but didn’t sign up.

Part B Penalty

The monthly Part B premium will increase by 10% for each full 12-month period the beneficiary was eligible but didn’t enroll. This penalty is permanent and remains in place for as long as they have Part B.

Medicare Advantage, Part D and Supplement enrollment

If an individual enrolls in Medicare during the GEP, they can sign up for a Medicare Advantage (Part C) or a Medicare Part D prescription drug plan at this time. Coverage for these plans begins on the month following the enrollment. Although late enrollment in Part D or Medicare Advantage plans that include prescription drug coverage may include a lifelong penalty.

Medicare supplements can be a little more difficult to get after the individual’s Medigap open enrollment has passed. When this is the case, some states require enrollees to undergo underwriting which can lead to denial or higher premiums.

Avoiding the need for the GEP

Beneficiaries can avoid using the GEP (General Enrollment Period) and getting potential LEPs:

Sign up for Medicare during the Initial Enrollment Period, which starts three months before the 65th birthday and ends three months after.

Those who have employer-sponsored coverage should confirm whether they qualify for a Special Enrollment Period (SEP) when that coverage ends. If they do, be sure to enroll before the SEP ends.

The Medicare GEP is an important opportunity for those who miss their initial chance to enroll in Medicare. However, because of potential late penalties and delays in coverage, it’s best to sign up during the Initial Enrollment Period or a Special Enrollment Period when possible. Understanding enrollment deadlines helps ensure that beneficiaries get the healthcare coverage they need and avoid unnecessary costs.

Medicare Supplement Free Look Period

If you are an agent who offers Medicare plans, it is important to understand opportunities to provide clients with the coverage they deserve.  For those enrolled in Medicare, supplement plans offer an additional coverage option.  Because choosing the right supplement plan is an important decision, sometimes a client may change their mind. To safeguard against errors, Medicare offers the free look period.  In this post, we discuss the Medicare supplement free look period, why it’s important, and how beneficiaries can use it.

Learn the difference between Medicare Supplement and Medicare Advantage plans

What is the Medicare Supplement Free Look Period

The Medicare supplement free look period is a time beneficiaries can review their new Medicare supplement plan and, if unsatisfied, make changes without penalty. This period typically lasts for 30 days after the plan’s effective date.

If the client buys a Medicare Supplement policy during their 6-month Medicare Supplement OEP and are unhappy with it, they can change to another Medicare Supplement policy. When the client gets a new (second) Medicare Supplement policy, they have 30 days to decide if they are going to keep it.  This time period is called the 30-day free look period. The client shouldn’t cancel the first Medicare Supplement policy until they are sure they want to keep the second Medicare Supplement policy. Unfortunately, they have to pay both premiums for the month they have both.

Reasons to change a supplement plan

1. Paying for benefits you don’t need.
2. Client needs more benefits.
3. Do not like the insurance company
4. They need a lower cost plan

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Why Does the Free Look Period Matter

Peace of Mind

Because choosing a Medicare supplement plan is overwhelming, sometimes beneficiaries make decisions in haste or without full understanding.  This can lead to dissatisfaction. The free look period offers reassurance to beneficiaries, allowing them to thoroughly evaluate their plan and its benefits at their own pace.

Risk Mitigation

Mistakes in selecting a Medicare supplement plan can be costly, both financially and in terms of coverage gaps. The free look period serves as a safety net, enabling beneficiaries to rectify any errors or misunderstandings without facing financial penalties or being locked into a plan that doesn’t meet their needs.

Consumer Protection

The free look period is designed to protect Medicare beneficiaries from being pressured into purchasing plans that may not be suitable for them. It empowers individuals to make informed decisions about their healthcare coverage without feeling rushed or coerced.

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Making the Most of the Free Look Period

Thoroughly Review the Plan

It is important to go over all aspects of the Medicare supplement plans your client is considering.  Please remember, this not only includes coverage but all costs involved.

Compare Plans

To ensure the client has made the best plan choice, agents should comparing it with other available plans. This can help you identify any discrepancies or better alternatives.

Seek Guidance

Beneficiaries should reach out to a licensed insurance agent for assistance. They provide valuable insights and help navigate the confusing landscape of Medicare coverage.

Document Everything

Important: clients should keep detailed records of their conversations with insurance provider representatives.  They need to include any changes made to their plan or communications regarding the free look period. This documentation serves as evidence in the event there are any disputes or discrepancies.

The free look period is an opportunity for beneficiaries to ensure they have the right coverage for their healthcare needs. Individuals who take advantage of the free look can make informed decisions.  They can also, rectify mistakes, and achieve peace of mind regarding their healthcare coverage. Remember, health is invaluable, and the right Medicare supplement plan can make all the difference in accessing quality healthcare.

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

1. The first and most commonly used is the IEP or initial enrollment period.
2. Second is the AEP or annual enrollment period which can be used for a number of different reasons.
3. 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.

Click here to learn more about the AEP

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.

To learn more about the Medicare Advantage OEP, click here

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.

Find out the rules for SEPs

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Medicare Open Enrollment Period

Because there is some confusion as to what the Medicare Open Enrollment Period actually is, we will take a few minutes to explain it.

Many people confuse the term Medicare open enrollment period or OEP and the term Medicare Annual Enrollment or AEP.  It important to understand the differences between these two enrollment periods.

The Medicare OEP, Open Enrollment Period:

This enrollment period takes place each year from January 1 to March 31.  Anyone who is enrolled in a Medicare Advantage plan (Part C) can use this enrollment period to go over their current MA plan and make changes if they are necessary.

What can enrollees do during this time:

• Change from one MA or MAPD (Part C) plan to a different MA or MAPD plan.
• Drop your MA/MAPD plan and go back to Original Medicare (Parts A & B).
• If you go back to original Medicare, you can Enroll in a Medicare PDP prescription drug plan (Part D).

The new plan starts on the first day of the month following the submission of the member’s application.

Please note; the Medicare Advantage Open Enrollment Period is for Medicare Advantage plan members only.

Beneficiaries on Original Medicare cannot switch to a Medicare Advantage plan at this time. If that is what they want to do,  they must wait for the Medicare Annual Enrollment Period. 

The Medicare AEP,  Annual Enrollment Period:

During this enrollment period, it is wise to review your client’s Medicare coverage and make any changes they decide on.  The AEP runs from October 15th through December 7th each year.

What can beneficiaries do during AEP:

Switch from Original Medicare to Medicare Advantage (or vice versa).

If you’re enrolled in Original Medicare (Part A and Part B) and want to add benefits such as; prescription drug coverage, dental, vision, OTC and more, you may wan to try a Medicare Advantage plan.  On the other hand, if  you’re on a Medicare Advantage plan and want the flexibility of Original Medicare, you can return to it.

1. Change Medicare Advantage Plans: If you’re already enrolled in a Medicare Advantage plan that doesn’t fully meet your needs, you can explore different plan options in your area.
2. Enroll in a prescription drug plan (Part D): If you don’t have credible prescription drug coverage through your current plan or are in Original Medicare, you can join a standalone Medicare Prescription Drug Plan to help manage medication costs.
3. Enrollees can either switch or drop prescription drug plans: Beneficiaries already enrolled in a Part D plan should compare prescription drug plans each year to ensure they have the most suitable coverage for their needs.
4. Review Medicare Supplement Insurance (Medigap) Policies: Although Medicare Supplement plans are not part of the Annual Enrollment Period, it is a good idea to review these plans annually to assess whether they offer the best coverage for your needs.

Why are the Medicare Open Enrollment Period & Annual Enrollment periods important:

The significance of these enrollment periods is that they allow beneficiaries an opportunity to reassess their healthcare needs as their circumstances change.  This gives them a chance to potentially save money on premiums, deductibles, and copayments or purchase additional coverage.

Anyone who fails to take advantage of this window may be stuck in an ineffective or expensive plan for another year.  This can result in less coverage than they need and higher medical costs.

Tips to Help Clients Make Informed Choices:

1. Assess Current Coverage: Review your client’s current plan to identify any gaps in coverage or services they require. Consider their healthcare expenses over the past year and anticipate any potential changes in healthcare needs for the upcoming year.
2. Compare Plans: Use your resources through connecture or sunfire to compare the various plans available in the area. Look for plans that cover your specific medical needs, including prescription drugs, doctors, and hospitals.
3. Check for Plan Changes: Insurance providers can make changes to their plans each year.  This includes adjustments to premiums, drug formularies, and networks. Be sure you understand how these changes impact coverage and costs.
4. Consider Future Needs: While it’s essential to address current healthcare needs, try to anticipate possible medical events or changes that may require different coverage choices in the future.

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Sell Medicare All Year

What Happens After AEP? Learn to sell Medicare all year.

The AEP, or Annual Enrollment Period, is one of the busiest times of the year for Medicare insurance agents and agencies. It can be draining and exciting all at once. Annual Enrollment Period is the period of time when beneficiaries are eligible to sign up for Medicare insurance, and it runs from October 15 to December 7 each year. The new coverage choices that people make during the AEP go into effect on January 1 of the following year. Choices made in the AEP of this year, 2023, will be effective on January 1 2024.   Learn to sell Medicare all year.

As a single agent or broker or as part of an agency, it is important to do three things after making it through another annual enrollment period.

Celebrate Accomplishments

Look at what worked out in favor of the agency/agent this year. Enrollments, for example: How many were successful? Of those, which strategies worked well in getting beneficiaries to enroll in an insurance plan that fit their needs? Being as specific as possible about what worked well and what did not can help make the process more seamless and bring in more revenue in the following year.

Other things to consider are leads: where did the bulk of the leads that resulted in enrollments come from this year? Was it a new channel or was it with previously-known contacts?

Look at Opportunities for Improvement

No matter how well an agent or team did over AEP, there is always room for improvement. Two very common areas that agents report wanting to improve in are time management and carrier options.

Time management can be difficult over such a busy time like the annual enrollment period. If an agent takes meetings all day, things like marketing, returning emails and calls, and paperwork can be neglected and vice versa. One way to streamline the process of enrollment for busy periods is to identify which activities are taking up the majority of the time in the office. Then, agents can redistribute resources to ensure that time is more equitably spent across several activities rather than one.

Having access to multiple carrier options can be vital for closing deals during the annual enrollment period. After all, the purpose of selling Medicare insurance is to connect beneficiaries with the best plan for their individual needs. After AEP is over is an excellent time to determine whether or not the agency or agent wants access to further insurance carrier options next time around.

Regroup for Next Enrollment Period

The lull between enrollment periods can be a great time to regroup for the next round. Many agencies like to consider this as an opportunity to work on weaknesses, begin following up with clients, create new or improved marketing strategies, and re-educate themselves on Medicare Advantage compliance rules.

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Medicare Annual Enrollment 2023

As we get closer to the end of the year, many people start thinking about the Medicare Annual Enrollment 2023.  During this time of the year, you can make changes to your Medicare coverage for the upcoming year.   It is important to note; each year Medicare plans change.  Some plans add benefits to a plan or change the way they cover a medication.  Whether you’re a first-time Medicare beneficiary or have been on Medicare for years, you should check your plan each year to stay informed about the changes that may effect your coverage for the following year.

When is Annual Enrollment 2023:

Medicare Annual Enrollment begins October 15, 2022 and ends on December 7, 2022.  During this time, you’ll be able to make changes to your Medicare coverage for the upcoming year.

What changes can I make during  the Medicare AEP

1. Beneficiaries of  Original Medicare may change to a Medicare Advantage plan.
2. If you are on a Medicare Advantage plan you can change to Original Medicare.
3. You may decide to enroll in a PDP (Part D, prescription drug plan).
4. You can also change from one Medicare Advantage plan to another.
5. Some people switch from one PDP plan to another.
6. Other individuals may choose to drop their Part D coverage altogether.

Things to consider before changing your Medicare coverage:

1. Each year you should review your healthcare coverage. Many people find it invaluable to enlist the expertise of a licensed insurance agent for this.  Because there are so many plan options it can get confusing.  Make sure you understand your current coverage so it will be easier to compare it with the best plan choices for next year.
2. Think about your health care needs especially if they have changed.   If possible, try to consider what you may need in the upcoming year.
3. If you are on a Medicare advantage plan, be sure to check that your health care providers will still be in-network.  Providers and facilities (hospitals, labs, out patient clinics) do make changes during the year and if you skip this step, it could be very costly.
4. Members of PDP plans need to carefully check their plan’s formulary.  Private insurance companies do change these each year and something that is covered this year may not be next year.  It is possible there is a prescription drug plan that is a better fit for you for next year.
5. If possible, it is a good idea to look at the total cost of this year’s plan (plan premium, deductibles, co-pays and co-insurance) to see if you can save money next year. It is important to think about your budget as well as your healthcare needs.

There are many resources to help you learn more about the Medicare Annual Enrollment 2023:

1. Visit the Medicare.gov website: The official Medicare website provides information about all aspects of  Medicare.
2. State Health Insurance Assistance Programs (SHIPs): SHIPs offer free, personalized Medicare counseling and assistance.  These programs can also provide valuable information on programs for those with a limited income.
3. Medicare and You Handbook: The Medicare and You Handbook is a comprehensive guide to Medicare that is updated each year and mailed to all Medicare beneficiaries.
4. Call a local insurance agent.  Make sure the agent is licensed and appointed to sell the most competitive plans in your area.  If you find a reliable and knowledgeable agent, this will help narrow down the choices for you to make an informed decision.

The Medicare Annual Enrollment 2023 is an important time of year for Medicare beneficiaries to review and make changes to their coverage. By staying informed and considering your health care needs, you can make the best decisions for your health and budget.

Please note;  any changes you make during the Medicare Annual Enrollment period will not take effect until January 1, 2024.

There are other enrollment periods that yo may be able to take advantage of during the year.

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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  65^th birthday month.  IEP includes three months before, the month of, and three months after someone’s 65^th 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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Delaying Medicare Part B

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