Original Medicare:
Enrollment Periods

I. Initial Enrollment Period (IEP): for individuals upon first meeting the eligibility requirements for Medicare

Individual have seven months to enroll in Medicare. The IEP begins three months before the person meets the eligibility requirements and ends seven months from that date.

If an individual qualifies for Medicare based on age, and his 65th birthday falls between the 2nd and 31st of a month, he can enroll when the IEP begins, three months before his birth month. Medicare coverage will start on the first day of his birth month. (Note: If an individual’s birthday is on the first of the month, and she enrolls in the first three months of the IEP, Medicare coverage starts the first day of the month prior to her birth month.)

• Ms. Fen became Medicare eligible in May. She enrolled in Medicare in February (the first month of her IEP). Her Medicare is effective May 1.

If an individual enrolls in the fourth month of her IEP, coverage begins the following month.

• Ms. Fen became Medicare eligible in May. She did not enroll in Medicare until June (the fourth month of her IEP). Her Medicare is effective July 1.

If an individual enrolls in the fifth month of his IEP, coverage begins the second month after the month of enrollment.

• Ms. Fen became Medicare eligible in May. She did not enroll in Medicare until July (the fifth month of her IEP). Her Medicare is effective September 1.

If an individual enrolls in the sixth or seventh month of her IEP, coverage begins the third month after the month of enrollment.

• Ms. Fen became Medicare eligible in May. She did not enroll in Medicare until August (the seventh month of her IEP). Her Medicare is effective November 1.

II. General Enrollment Period (GEP): for individuals who miss their IEP or terminated their enrollment and want to re-enroll

Enrollment can occur between January 1 and March 31. Coverage is effective July 1.

III. Special Enrollment Period (SEP): for individuals who receive primary health coverage under an employer group health plan and delay enrollment in Part B because the benefits duplicate their primary coverage

A SEP is available for eight months after an individual terminates participation in an employer group health plan. If an individual is disabled and his plan is involuntarily terminated, the SEP is six months.

• Mrs. Avilla is 72 and has been covered by her husband’s health coverage for a number of years. Her husband recently retired and has signed up with a retirement plan through his former employer. Mrs. Avilla is no longer covered because her husband is no longer actively working. She has eight months from her husband’s retirement to sign up for Medicare Part B. This is a special enrollment period. Because she has been covered through his employer group health plan, she will not have to pay a penalty for late enrollment into Part B.
  
• Mr. Dogett is under 65 and Medicare eligible. He has not signed up for Medicare Part B because he is covered under his wife’s employer plan. Recently, however, his insurance under the employer plan contacted him to state that he does not have primary coverage. His wife’s employer reduced its work force from 115 to 45 workers, and is no longer a “Large Group Health Plan.” It is, therefore, secondary to Medicare and Mr. Dogett needs to sign up for Part B. Mr. Dogett has a six month SEP to sign up for Part B.

See HAP’s Eligibility and Enrollment pages for more information.