The Medicare General Enrollment Period (GEP) spans the entire first three months of each year (January 1 – March 31). This is the ideal time for Medicare beneficiary-hopefuls to enroll in Medicare if they have no other enrollment period available.
Why would someone not have an available enrollment period? It’s because they didn’t enroll during their Initial Enrollment Period (IEP) or Special Enrollment Period (SEP), if eligible. Let’s review each enrollment period.
Initial Enrollment Period (IEP)
Initially, a Medicare beneficiary has the opportunity to enroll in Medicare Part A & Part B during their Initial Enrollment Period (IEP) when they turn 65. It’s the three months before a person’s birthday month, the actual birthday month, and the three months after a person’s birthday month…for a total of seven months.
But some Medicare beneficiaries delay Medicare enrollment and stay on a group health insurance plan beyond age 65, based on their own current employment or a spouse’s current employment. Once the IEP passes, it’s no longer available again.
IEP Details: www.medicaremindset.com/iep
Special Enrollment Period (SEP)
The next enrollment period is the Special Enrollment Period (SEP). This takes place literally anytime after the IEP ends and the Medicare beneficiary leaves a group health plan.
The SEP can be used anytime while they have group health insurance based on active employment, or up to eight months after losing group health coverage.
And this can be done without a late enrollment penalty because of continuous health coverage in a group health plan, based on current employment (through yours or your spouse’s active employment).
[Note: COBRA continuation and retiree coverage are NOT considered coverage based on current employment, so Medicare Part B enrollment should be completed within eight months of separation of service from the employer…to avoid a potential late enrollment penalty. Additionally, Medicare coverage due to End-Stage Renal Disease (ESRD) is not an SEP opportunity. Consider accepting ESRD Medicare Part A & Part B when initially eligible to avoid a late enrollment penalty.]
SEP Details: www.medicaremindset.com/sep
General Enrollment Period (GEP)
January 1st through March 31st Each Year
If an individual missed both the IEP and SEP, their enrollment option falls within the General Enrollment Period.
During this time frame, an application for Part B needs to be submitted to a local Social Security office using the Application for Enrollment in Medicare Part B (Form 40B). This form can be found at www.ssa.gov/forms.
The start date for the Part B coverage will be the 1st of the month following the month the application is submitted.
For example…if you submit the application in January, Part B will start February 1st.
Note: While Part B will start the following month, Part A (if you don’t have it already) will be backdated 6 months in the past.
And to add a wrinkle, there could be a late enrollment penalty. If a Medicare beneficiary goes at least 12 months without Medicare Part B, and they didn’t have some sort of creditable health insurance coverage, their Part B premium will be at least 10% higher than normal. This higher premium will be assessed for life. Additionally, the longer one goes without Part B in this example, the higher the late enrollment penalty. So if a Medicare beneficiary is at least 24 months late, the Part B premium will be 20% higher. If 36 months late, a 30% penalty is charged…and so on.
As you can see, the General Enrollment Period (GEP) is not the ideal time to enroll in Medicare, but sometimes it’s the only option. We recommend utilizing the Initial Enrollment Period (IEP) or the Special Enrollment Period (SEP) when they are available.
References Links
www.medicare.gov
www.ssa.gov
www.ssa.gov/forms
Medicare Enrollment Periods
