When Medicare considers you first eligible for Medicare benefits, it’s important to sign up during the applicable enrollment period to avoid penalties and coverage gaps. For most beneficiaries, the Initial Enrollment Period is often the first time to enroll in Medicare, other than being eligible for a Special Enrollment Period. The Initial Enrollment Period, or IEP, covers the seven month period beginning three months before and ending three months after your 65th birthday. It is important to enroll in Medicare when first eligible, however, should you miss this opportunity, there are other times during the year you are able to apply for Medicare.
What Happens When You Miss the Initial Enrollment Period?
If you missed your Initial Enrollment Period, you’ll want to enroll in Medicare as soon as possible. By virtue of missing your IEP, there are opportunities to apply for Medicare if you qualify for a Special Enrollment Period (SEP). Special Enrollment Periods can occur anytime during the year and many will allow you to enroll in Medicare immediately or within a few months of applying. Special Enrollment Periods can include life events such as moving out of a plan’s service area, entering or leaving a care facility and joining or dropping employer health coverage In fact, many beneficiaries decide to work past 65, therefore delaying their enrollment into Medicare because they want to keep their employer-sponsored health care plan. If you experience such a qualifying event, you’ll have a Special Enrollment Period available to you where you can apply and enroll in Medicare.
What Is the General Enrollment Period?
For those who missed their IEP and do not qualify for an SEP, your only option is to apply during the General Enrollment Period. The General Enrollment Period, or GEP, occurs every year from January 1 – March 31. Note, if approved for Medicare when applying during the GEP, it is important to know that your benefits will not begin until July 1 of the calendar year that you applied.
GEP allows you to enroll in Medicare Parts A and B. Please note that applying for Part A during GEP would be for those that have to pay for it. If you receive premium-free Part A, you can apply anytime for Part A benefits. Once you receive approval for your Medicare Part A and/or B to begin on July 1, you can begin the process of evaluating and enrolling in your additional benefits. These benefits include Medicare Supplement (Medigap), Medicare Advantage and Medicare Part D prescription drug coverage. You can apply for this additional coverage between April 1 and June 30, and these benefits would begin on July 1.
While applying for Medicare during the GEP will get you the benefits you need, having missed your Initial Enrollment Period could leave you in a penalty situation. The penalties associated with Original Medicare (Parts A and B) are as follows:
- The Medicare Late Enrollment Penalty for Part A is 10% of your monthly premium per year and will last a maximum of four years from enrollment.
- Part B is a 10% monthly premium increase for every 12 month period that you’ve gone without coverage since you were first eligible. Unlike the Part A late enrollment penalty, this penalty will last the rest of your life.
The General Enrollment Period is an important safety net for those who have missed their Initial Enrollment Period or do not qualify for a Special Enrollment Period. If you need assistance with the enrollment process, understanding Medicare late enrollment penalties or have additional questions, contact Medicare Portal today. Our team of licensed Medicare insurance agents can assist you with enrollment and evaluating plan choices, and are available to meet with you in person, over the phone or via video call. Contact us today to enroll on time, avoid late enrollment penalties and gaps in coverage.