You’re Eligible for Medicare. Now What?

medicare initial enrollment period

If you’re turning 65 this year, you’ll soon be joining the 44 million Americans in the Medicare system. Learning about the initial enrollment period for medicare can be time consuming, so we created our own guide for MySeniorHealthplan readers. Medicare is the health insurance program in the U.S. that gives seniors and the disabled, access to the medical coverage and support they need to lead healthy active lifestyles.

Navigating Medicare with what you’re supposed to do and when can be a difficult and confusing experience. Here’s a brief breakdown of what Medicare is and what you need to know about your Medicare Initial Enrollment Period (IEP).

What are the different Parts of Medicare?

Before diving into your Medicare Initial Enrollment Period (IEP) and what that means for you, let’s look at the different parts of Medicare:

  • Medicare Part A covers hospital stays and is provided by the federal government.
  • Medicare Part B covers outpatient and routine medical expenses, is provided by the federal government and includes a monthly premium.
  • Medicare Part C, also referred to as Medicare Advantage, is an alternate form of Medicare coverage that combines several parts into one package, provided by private insurance carriers.
  • Medicare Part D covers prescription drugs, is provided by the federal government and includes a monthly premium.

What is IEP?

Your IEP is the time period when you can sign up for Medicare for the first time. In most cases, your IEP will start three months before you turn 65. What if you started using your Social Security benefits before that date? Not to worry, you’ve already been automatically enrolled in Medicare Part A and B.

If you haven’t been enrolled in a Medicare plan through Social Security, your IEP is your window to sign up for Parts A, B and D (with or without a Med Supp). Or you can sign up for a Medicare Advantage Plan, if you prefer.

Initial Enrollment Period for Medicare: Is it really confusing?

We know this can be very confusing, but don’t worry! You have plenty of time. The IEP window is seven months in total, meaning there’s no need to rush to make your Medicare plan selections. Your IEP encompasses the three months before your birth month, your birth month itself, and the three months after your birth month. So if you turn 65 on July 4th, you’re eligible to enroll in Medicare between April 1st and October 31st. Our agents can help you (or a loved one) find the right plan during this window, to ensure you find the coverage you need. 

Enrolling in Part A during your IEP is free if you paid Medicare taxes long enough before retirement. Part B and D plans always have a monthly premium, depending on the level of coverage you choose. And Medicare Advantage Plans also have out-of-pocket costs.

What if I miss my Medicare Initial Enrollment Period?

If you miss out on enrolling during the seven-month enrollment period, you risk paying penalties if you secure coverage. There are, however, a few other times each year when you can add Medicare coverage:

  • Open Enrollment Period (OEP) when provided, is from January 1st to March 31st. During this time, beneficiaries enrolled in a Medicare Advantage Plan can change their plan or return to Original Medicare.
  • Annual Enrollment Period (AEP) takes place annually from October 15th to December 7th. You can change your Medicare plan, whether you’re currently enrolled in Original Medicare or a Medicare Advantage Plan or not. And you can make changes to your Part D coverage as needed. 
  • Special Enrollment Periods (SEPs) kick in if you lose coverage through a spouse or employer, if you relocate to an area where your plan isn’t accepted, or in the case of a natural disaster. A SEP will be declared if the inciting incident prevented you from enrolling in Medicare during OEP or AEP.

How do I enroll in Medicare?

Finding the plan that suits your needs and navigating the enrollment system can be overwhelming. If you have questions about how to enroll, or if you missed your IEP, one of our qualified Medicare representatives can assist you. Click here to get in touch with us today!


image credit: shutterstock/Drazen Zigic

Pete Blasi