The Medicare Initial Enrollment Period (IEP) is a 7-month window during which you can first sign up for Medicare. It begins 3 months before the month you turn 65, includes your birthday month, and extends 3 months after. For example, if you turn 65 in August, your IEP runs from May 1 through November 30.
IEP Timeline and When Coverage Begins
| When You Enroll | Coverage Start Date |
|---|---|
3 months before your birthday month | The month you turn 65 |
The month you turn 65 | 1 month after you enroll |
1 month after your birthday month | 2 months after you enroll |
2 months after your birthday month | 3 months after you enroll |
3 months after your birthday month | 3 months after you enroll |
Enroll Early for the Smoothest Start
Enrolling in the 3 months before your birthday month ensures your coverage starts on the first day of your birthday month, with no gap. Waiting until your birthday month or after delays your start date.
What Can You Enroll In During Your IEP?
During your IEP, you can enroll in Medicare Part A (hospital insurance), Part B (medical insurance), a Medicare Advantage (Part C) plan, and a Medicare Part D prescription drug plan. Most people enroll in Parts A and B first, then decide between Original Medicare with a Medigap plan and Part D, or a Medicare Advantage plan.
Automatic Enrollment
You may be automatically enrolled in Medicare Parts A and B if you are already receiving Social Security or Railroad Retirement Board benefits when you turn 65. In that case, you will receive your Medicare card in the mail about 3 months before your 65th birthday. You do not need to take any action for Parts A and B, but you will still need to actively enroll in Part D or a Medicare Advantage plan if you want that coverage.
People diagnosed with ALS (amyotrophic lateral sclerosis) are automatically enrolled in Medicare the month their Social Security disability benefits begin, with no waiting period. People with end-stage renal disease (ESRD) must apply for Medicare and are not automatically enrolled.
What Happens If You Miss Your IEP?
If you miss your IEP and do not have other qualifying coverage (such as employer coverage through active employment), you will face late enrollment penalties and a coverage gap. You can enroll during the General Enrollment Period (January 1 through March 31 each year), but coverage will not begin until July 1, and you may owe a Part B late enrollment penalty of 10% for each full 12-month period you were eligible but did not enroll.
IEP for Part D
Your Part D IEP runs concurrently with your Parts A and B IEP. If you do not enroll in a Part D plan or maintain other creditable drug coverage during your IEP, you may owe a Part D late enrollment penalty when you do eventually enroll. The penalty is 1% of the national base premium for each month you lacked coverage, and it is permanent.
Can I delay Medicare enrollment if I have employer coverage?
Yes. If you are actively working and covered by an employer group health plan through your own or your spouse's current employment, you can delay Part B enrollment without penalty. When that coverage ends, you get a Special Enrollment Period to sign up for Medicare.
Does my IEP apply to Medicare Advantage plans?
Yes. You can enroll in a Medicare Advantage plan during your IEP. This is called the Initial Coverage Election Period (ICEP) for Medicare Advantage, and it runs concurrently with your IEP.
What if I turn 65 but am not yet receiving Social Security?
You will need to actively apply for Medicare. You can apply online at ssa.gov, by phone at 1-800-772-1213, or in person at a Social Security office. Apply 3 months before your birthday month to ensure timely coverage.
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