The Medicare Initial Enrollment Period is the first Medicare enrollment period you will receive. Below, we discuss what you need to know about your first opportunity to enroll in Medicare. Also, we review how you can best utilize the timeframe.
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What is the Medicare Initial Enrollment Period?
The Medicare Initial Enrollment Period allows those newly eligible for Medicare to enroll. Many new Medicare beneficiaries miss their Initial Enrollment Period because they are unaware of the timeframe. This ultimately results in late enrollment penalties.
Each Medicare Initial Enrollment Period is unique to the person who is becoming eligible for Medicare. Additionally, it typically only happens once in your lifetime.
If you do not qualify for Medicare before age 65, your Medicare Initial Enrollment Period begins on the first day of the month, three months before you turn 65. It lasts through the month of your 65th birthday and continues until the last day of the month, three months after your 65th birth month. Thus, this enrollment period consists of seven months in which you can actively enroll in Medicare Part A and Part B unless you qualify for automatic enrollment.
In the unique circumstance that your birthday falls on the first day of the month, your Medicare Initial Enrollment Period will begin on the first day of the month four months before your birthday, the month of your birth, and end on the last day of the month two months following your birthday. In this case, your Medicare coverage will begin on the first day of the month before you turn 65.
However, suppose you qualify for Original Medicare before age 65 due to disability. In that case, your Medicare will begin on the first day of the 25th month you receive Social Security benefits. Then, you will receive a second Initial Enrollment Period when you turn 65.
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You can take advantage of your Medicare Initial Enrollment Period as early as three months before you turn 65. Those on disability can enroll in Medicare after receiving Social Security Disability Income (SSDI) for 24 months. Then you can enroll again when you turn 65.
Disability is one of the only scenarios where you will get two Initial Enrollment Periods. The only other scenario is if you retire, return to work, get employer group coverage, and retire again later. When you retire for a second time, you will qualify for a Special Enrollment Period.
Utilizing your Medicare Initial Enrollment Period is essential to avoid penalties or lapses in insurance coverage. When you become eligible for Medicare, the last thing you want is to go without coverage. So, enrolling as soon as you become eligible is critical.
What Happens if I Miss My Initial Enrollment Window for Medicare?
If you miss your Medicare Initial Enrollment Period for any reason, you may still enroll in Original Medicare (Part A and Part B) during the General Enrollment Period. Remember, if you sign up during the annual General Enrollment Period, your Medicare will not start until July 1.
Therefore, you may have a coverage gap. If you do not maintain creditable coverage – meaning at least as good as Medicare – until this start date, you may be responsible for paying the Medicare Part B penalty.
How Do I Qualify for Automatic Enrollment Into Medicare During my Initial Enrollment Period?
If you are collecting Social Security benefits, you automatically qualify for Medicare enrollment. In this case, you should receive your Medicare card about three months before your 65th birthday. On the other hand, if you are not collecting Social Security benefits by the time you age into Medicare at 65, you will need to actively enroll yourself.
If you are under age 65 and have received Social Security or Railroad Retirement Board disability benefits for at least 24 months, you also qualify for automatic Medicare enrollment. In this case, your Medicare card is mailed out about three months before the 25th month of collecting disability benefits.
Automatic Enrollment into Medicare for those Diagnosed With ALS or ESRD
If you are diagnosed with amyotrophic lateral sclerosis, you will automatically enroll in Medicare Part A and Part B starting the month disability benefits begin. You will not need to wait the 24-month waiting period.
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Similarly, if you have an end-stage renal disease (ESRD) diagnosis, you do not need to receive SSDI benefits to qualify for Original Medicare. If you have ESRD, you can enroll in Medicare at any time.
When Does Medicare Coverage Begin If I Enroll During My Medicare Initial Enrollment Period?
If you sign up for Original Medicare during your Medicare Initial Enrollment Period, your effective date can vary. Enrolling during the three months before your 65th birthday means your effective date is the first day of your birthday month. Then, if you sign up during the month of your 65th birthday or in the three months following your birthday, your effective date is the first day of the following month.
For example, if you were born on June 11 and enrolled in Medicare in August (two months after your birthday), your effective date will be September 1.
Medicare Part D Initial Enrollment Period
Your Medicare Part D Initial Enrollment Period is the same as your Medicare Part A and Part B Initial Enrollment Period. Suppose you do not enroll in Medicare Part D prescription drug coverage during your Initial Enrollment Period window. You may incur a Part D late enrollment penalty if you do not have creditable coverage.
Once you enroll in at least Medicare Part A, you become eligible for Medicare Part D.
When Do I Enroll in Medicare Part D if I Missed my Initial Enrollment Period?
If you missed your Initial Enrollment Period, you should know the Annual Enrollment Period occurs each fall. This window begins on October 15 and ends on December 7. During this period, you can enroll in Medicare Advantage or a Medicare Part D prescription drug plan. Coverage will begin on January 1 of the following year.
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How to Use Your Medicare Initial Enrollment Period
At MedicareFAQ, we are here to help walk you through your Medicare Initial Enrollment Period. Our agents understand the importance of avoiding penalties and meeting deadlines for enrollment. Thus, we ensure you enroll on time so you never incur late penalties.
Additionally, our licensed Medicare agents will work one-on-one with you to find the best available supplemental policies and help you enroll in the right plan. Give us a call today or complete our online comparison form to see all your options side-by-side.
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Sources:
MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.
- When Does Medicare Coverage Start, Medicare. Accessed July 2022.
https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start - 5 Things You Need to Know About Medicare Enrollment, CMS. Accessed July 2022.
https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Employers-and-Unions/Top-5-things-you-need-to-know-about-Medicare-Enrollment
