When you’re close to the age for Medicare eligibility, you may wonder when to enroll and when your Medicare coverage starts. You may not know what questions you need to ask, or what requirements you’ll need to meet to begin receiving Medicare benefits. We cover some of these basics in the content below.
Medicare is a national health insurance program in the United States that covers people who are 65 years old and above, younger than 65 with qualifying disabilities and people of any age who have been diagnosed with amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD).
Since eligibility for most begins at age 65, you may already be researching which enrollment period applies to your situation and how that affects when you start receiving coverage. Here’s a guide of when Medicare coverage starts and the factors that influence it.
The Initial Enrollment Period (IEP)
The Initial Enrollment Period is the first opportunity (and often the best time) to enroll in Medicare. This is a seven-month window during which you can sign up for Medicare Parts A, B, C and D. The seven months are aligned with your date of birth:
- The three months prior to your 65th birthday.
- Your birthday month.
- The three months following your 65th birthday.
If you sign up for Medicare during the first three months of your IEP, your Medicare coverage will start on the first day of the month you turn 65. However, if your birthday is on the first day of the month, your coverage will start the first day of the previous month.
If you sign up during your birthday month, your Medicare coverage will begin the first day of the following month.
If you enroll in Medicare one month after your 65th birthday, your Medicare coverage will start two months later.
If you enrolled for Medicare two or three months after your 65th birthday, your Medicare coverage in both cases will begin three months later.
Medicare Coverage When Automatically Enrolled
If you are already receiving Social Security or Railroad Retirement Board benefits before your 65th birthday, you will be automatically enrolled in Medicare Parts A and B when you turn 65. In such a case, your Medicare coverage will begin on the first day of the month you turn 65.
If your birthday is on the first day of the month, the coverage will begin on the first day of the previous month. For instance, if your 65th birthday is on August 1, your Medicare coverage will start on July 1.
Additionally, people who are below age 65 and receive Social Security Disability Insurance (SSDI) payments will attain Medicare eligibility after a two-year waiting period. For those diagnosed with Amyotrophic Lateral Sclerosis (ALS) or with End-Stage Renal Disease (ESRD), they are automatically enrolled in Medicare with no waiting period.
Medicare Coverage for General Enrollment Period (GEP)
If you miss out on the seven-month window of IEP, and you are not automatically enrolled in Medicare, you can sign up during the General Enrollment Period. General Enrollment runs every year, starting from January 1st to March 31st. In this case, your Medicare coverage starts on July 1 of the same year you enroll.
Note that you may only sign up for Medicare Parts A and B during the General Enrollment Period. To enroll in Parts C and/or D, you must wait for the Annual Enrollment Period in October instead.
Special Enrollment Period (SEP)
In some cases, you might be eligible for special enrollment depending on circumstances that affect your current health insurance coverage. For instance, you may have moved (plan options can vary by region) or lost creditable coverage – such as when you or your spouse retire and lose employment coverage benefits. It is important that you verify your Special Enrollment Period eligibility; for more information on SEP qualifying life events, click here. If you qualify for the Special Enrollment Period and use this timeframe to sign up for Medicare, your coverage begins on the first day of the month after you enroll.
Knowing the enrollment period during which you enroll in Medicare directly impacts when your Medicare coverage starts. If you have further questions about the start of your Medicare coverage, determining which enrollment period applies to you, navigating plan options and more, contact one of Medicare Portal’s licensed, experienced Medicare insurance agents today.