Medicare

Understanding the Medicare Initial Enrollment Period

During your Medicare Initial Enrollment Period, you can enroll in Medicare Parts A, B, C, and D. Learn how the IEP works, what you can do during this period, and what options are available if you miss your Initial Enrollment Period.

Understanding the Medicare Initial Enrollment Period

The Initial Enrollment Period for Medicare is when you become eligible to receive Medicare benefits after turning 65. Medicare is a public health insurance program that helps reduce the cost of healthcare services for individuals over 65 and those with eligible disabilities. For those new to Medicare, learn how the Initial Enrollment Period (IEP) works.

Original Medicare consists of two parts: Part A and Part B. Part A covers hospital-related costs, while Part B handles care such as doctors’ visits, exams, or lab tests. Other Medicare options include:

  • Medicare Advantage, also called Part C
  • Medicare drug coverage, also called Part D
  • Medicare Supplement insurance, also called Medigap insurance

Medicare-approved private insurance companies offer Medicare Advantage plans and often bundle Parts A, B, and D with additional services such as dental or vision. Medigap plans are offered by private insurance companies as a way to supplement your existing Original Medicare coverage.

Is Medicare Enrollment Automatic?

Enrollment in Medicare is typically automatic for those eligible for premium-free Part A, especially for those who receive benefits from the Railroad Retirement Board or through Social Security. If so, a Medicare card will arrive in the mail before your 65th birthday. However, Medicare enrollment is not automatic for Part B in most cases. Ensure you have your Initial Enrollment Period (IEP) on your calendar so you do not miss the enrollment window.

You may also be eligible for automatic Medicare enrollment before your 65th birthday if meet one or more of the following criteria: 

  • You have received Social Security Disability benefits for at least 24 months
  • You have End Stage Renal Disease (ESRD)
  • You have Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s disease)

When Is Your Medicare Initial Enrollment Period?

The Initial Enrollment Period for Medicare begins three months before you turn 65 and ends three months after the month you turn 65. Your IEP lasts for 7 months.

For example, if your 65th birthday is on June 15, your IEP starts on March 1 and lasts until September 30. In cases where birthdays fall on the first day of the month, the IEP starts a month earlier and still runs for 7 months. For example, if your birthday is June 1, your IEP begins on February 1 and lasts until August 31.

If you enroll during your Initial Enrollment Period and are eligible for premium-free Part A, coverage begins the month you turn 65. Coverage would begin the month before you turn 65 if your birthday is on the 1st.

Coverage begins on the first day of the following month if you enroll in Part B or premium-based Part A. For example, if you sign up on May 16, your coverage starts on June 1.

What Can You Do During Your Medicare Sign Up Period?

During your initial Medicare signup period, you can sign up for Original Medicare Parts A and B, enroll in a Medigap plan, or enroll in a Medicare Advantage plan. You can also make changes to your plan during your IEP if you were automatically enrolled in Medicare.

Enroll in Medicare Part A

You can enroll in Medicare Part A during your IEP, though many are automatically enrolled in premium-free Part A. You or your spouse must have paid enough in taxes during your working years to be eligible for premium-free Part A.

Those who are not eligible for automatic enrollment can manually enroll during their IEP. In 2022, the premium for Part A is $274 or $499, depending on how much you have contributed in taxes.

Who it is best for

Enrolling in Medicare Part A is a good choice for anyone eligible for premium-free Part A.

Late enrollment penalty

If you choose not to enroll in Part A during your IEP, you may face a penalty when you enroll later if you are not eligible for premium-free Part A. The penalty for premium-paid Part A is an extra 10% on your monthly premium, which lasts for twice the amount of years you could have signed up for Part A. For example, if delayed enrollment after your IEP for two years, you would pay the extra 10% on your premium for 4 years. However, if you qualify for a Special Enrollment Period which allows you to make changes to your Medicare enrollment outside of your IEP and annual enrollment periods, you may not have to pay a penalty.

How to enroll late if you delayed

If you were eligible for premium-free Part A but were not automatically enrolled, you can enroll any time after you turn 65. Your Part A coverage starts 6 months back from when you sign up or when you apply for benefits from Social Security or the Railroad Retirement Board.

For premium-paid Part A, you will need to wait until the next General Enrollment Period, which runs from January 1 to March 31 each year. Coverage starts the month after you sign up. You may also sign up during a Special Enrollment Period if you are eligible.

Enroll in Medicare Part B

You can also enroll in Medicare Part B during your IEP. The basic premium is $170.10 per month in 2022, but may be higher depending on your income and may change each year.

Who it is best for

Part B is a good choice for eligible adults who no longer have employer-sponsored health coverage. If you have health insurance from your employer, you can delay Part B enrollment until that coverage ends because employer-sponsored healthcare may be more cost-effective and comprehensive.

Late enrollment penalty

You can enroll in Part B after your IEP, but will incur a late enrollment penalty unless you qualify for a Special Enrollment Period. This penalty is a 10% increase to your monthly premium for each year you could have enrolled but did not. Unlike the Part A penalty, this premium increase is permanent.

For example, if you delayed enrollment by 4 years, you may incur a 40% premium increase as a late enrollment penalty.

How to enroll late if you delayed

If you delayed enrolling, you can sign up for Part B during the General Enrollment Period or during a Special Enrollment Period if you are eligible. Your coverage starts the month after you sign up.

Enroll in Medicare Advantage, or Part C

During your IEP, you can choose to enroll in Medicare Advantage rather than Original Medicare. These plans must offer at least as much coverage as Original Medicare and often come with additional benefits, such as health and vision coverage. However, unlike Original Medicare, those with Medicare Advantage are restricted to care within the plan’s network.

Who it is best for

Part C may be a good fit if you are an eligible adult who no longer has employer-sponsored health insurance. It is also a good fit for those seeking a Medicare plan that bundles Part D and additional coverages with Parts A and B.

Late enrollment penalty

There is no late enrollment penalty for Medicare Advantage.

How to enroll late if you delayed

If you did not enroll in a Part C plan when you were first eligible, you can join, switch, or drop a Medicare Advantage plan during the Annual Enrollment Period each year (October 15 to December 7), or during the Medicare Advantage Open Enrollment Period (January 1 to March 31).

Enroll in Medicare Part D

Your IEP allows you to enroll in Medicare Part D as long as you also enroll in either Part A or Part B at the same time.

Who it is best for

Part D provides prescription drug coverage. If you do not have drug coverage through an employer or Medicare Advantage plan, Part D can help you pay for your medications. Even if you do not currently take medications, having active Plan D coverage can help protect you against drug price increases so long as your coverage remains active.

Late enrollment penalty

If you choose not to enroll in Part D during your IEP and forgo any type of drug coverage for more than 63 days, you may be subject to a late penalty. This penalty adds 1% to your premium for each month you could have enrolled but did not, and this remains for as long as you have Part D coverage.

For example, if you delayed enrolling in Part D for 12 months, you may incur a 12% premium increase as a late enrollment penalty for as long as you have Part D coverage.

How to enroll late if you delayed

If you delay enrollment, you can sign up for a Medicare drug plan during the Annual Enrollment Period (October 15 to December 7).

Initial Enrollment Period for Medicare Supplement Insurance, or Medigap

The Initial Enrollment Period for Medigap starts when you enroll in Part B and lasts 6 months. This IEP occurs only once — during this time, you can purchase any Medigap plan offered in your state and pay the same premium as someone who is healthy. After this period, you can apply for Medigap enrollment, but insurers can decline your application based on your medical history and other factors.

What You’ll Need to Enroll in Medicare

To enroll in Medicare, you will need documents that prove your identity. These may include your Social Security number, driver’s license, and passport. You may also need to verify your place of birth and citizenship status and provide information about your spouse, children, and place of employment if applicable.

You can sign up for Original Medicare online by creating an account with the Social Security Administration. You can also call your local Social Security office for more information.

What to Do If You Missed the Initial Enrollment Period for Medicare

If you miss your IEP, you still have options:

  • General Enrollment Period: This period runs from January 1 to March 31 each year. During this period, you can sign up for Part A and Part B if you didn’t sign up during your IEP. 
  • Annual Enrollment Period: This period runs from October 15 to December 7 each year. 
  • Special Enrollment Period: You may be eligible for a Special Enrollment Period, which lets you join, switch, or drop your Medicare coverage outside of the usual enrollment periods. SEPs typically apply if you are moving out of your current plan’s service areas, moving into (or out of) a skilled nursing or rehabilitation facility, or if your employer-sponsored coverage ends.