Medicare has specific enrollment periods when you can sign up. Each has a particular purpose. Most people sign up during their Initial Enrollment Period, but it’s good to know about all the time periods and what they’re for.
Medicare Initial Enrollment Period (IEP)
This is when you’re first eligible to enroll in Medicare. Your IEP is 7 months long and happens around your 65th birthday or the 25th month of receiving Social Security disability benefits. It’s important to take action during your IEP. You’ll have some decisions to make, even if you have other insurance. If you are about to run 65 your enrollment period will begin 3 months prior to your birth month, your birth month, and the 3 months after your birth month.
Medicare General Enrollment Period (GEP)
The General Enrollment Period (GEP) is like a make-up time. It’s when you can enroll in Medicare if you didn’t sign up during your Initial Enrollment Period. The GEP is January 1 – March 31 every year. You may have to pay a penalty for late enrollment, and coverage always takes effect on July 1 when you enroll during GEP.
Medicare Special Enrollment Period (SEP)
A Medicare Special Enrollment Period (SEP) allows you to enroll in Medicare or change your Medicare coverage outside of standard enrollment periods without penalty. There are different SEPs that apply in specific circumstances, and each has its own rules about timing. Below is a list of some of the most common SEPs, their rules and timing.
- Special Enrollment Period for the working aged
If you (or your spouse) are still working when you turn 65 and have group coverage through an employer or union, you can delay Part A and/or Part B and enroll with a Special Enrollment Period when your health coverage or that employment ends. You may not have to pay a late enrollment penalty for not enrolling when you were first eligible.
The health coverage must be based on current employment (either through your work or your spouse’s employer). You can either enroll in Part A and/or Part B while you’re still covered through the group plan or with the eight-month Special Enrollment Period that starts the month that your insurance or the employment that it’s based on ends, whichever happens first. This Special Enrollment period occurs regardless of whether you decide to get COBRA coverage.
Keep in mind that COBRA and retiree health insurance don’t count as coverage based on current employment and won’t qualify you for an SEP when it ends. You also won’t get a Special Enrollment Period if your group coverage or employment ends during your Initial Enrollment Period. In that case, you’d join Part A and/or Part B during your Initial Enrollment Period.
- Special Enrollment Period for international volunteers
- Individuals volunteering in a foreign country may be able to enroll in Part A and/or Part B with a Special Enrollment Period when they return to the United States. To qualify for a Special Enrollment Period, you must:
- Have volunteered for at least 12 months outside of the United States.
- Have volunteered for a tax-exempt program.
- Have had other health coverage for the duration that you served overseas.
- Special Enrollment Period for disabled TRICARE beneficiaries
- TRICARE is health insurance for retired and active-duty service members and their families. If you’re a retired service member, you must enroll in Part B to stay eligible for TRICARE benefits. However, TRICARE beneficiaries who qualify for Medicare based on disability, Lou Gehrig’s disease(ALS) or end stage renal disease (ESRD) may qualify for a Special Enrollment Period if they didn’t sign up for Part B during their Initial Enrollment Period. This 12-month SEP starts on:
- The last day of the person’s Initial Enrollment Period, or
- The month that the person is notified of Part A enrollment.
- This Special Enrollment Period can only be used one time during the TRICARE beneficiary’s lifetime.
- Special Enrollment Period if you were living overseas
There are other situations where you can enroll in Medicare outside of normal enrollment periods without a Special Enrollment Period. This includes if you were living in a foreign country when you turned 65 and were first eligible for Medicare. Since you need to be living in the United States to have Part B, you can sign up in the first month after you return back to the country. This only applies if you were overseas and not receiving Social Security benefits when you turned 65. Otherwise, you may have to pay a Part B penalty when you move back to the United States. For more information on Part B enrollment for U.S. citizens living abroad, contact Medicare at 1-800-MEDICARE (1-800-633-4227). If you’re a TTY user, call 1-877-486-2048. Customer service representatives can be reached 24 hours a day, seven days a week.
Do you have questions about your potential Special Enrollment Period? If you’re already enrolled in Original Medicare, Part A and Part B, you may wish to look at adding a Medicare Part D Prescription Drug Plan or a Medicare Supplement policy. Whatever you’re looking for, HealthEnroller.com can help.
Medicare Supplement Open Enrollment
Medicare supplement insurance may be added to Original Medicare at any time after you are enrolled in both Part A and Part B, but you have “guaranteed issue rights” only at certain times. Guaranteed issue means that you will not be required to undergo underwriting to be accepted by the Medicare Supplement plan. If you join at other times you may have to undergo health underwriting, which may result in you having to pay more for your coverage or you could be denied coverage altogether.