What is the Initial Enrollment Period (IEP)?
There are multiple enrollment periods for Medicare, but your Initial Enrollment Period (IEP) is your first opportunity to enroll in Medicare. In most cases, you need to be at least 65 years old to get Medicare coverage. You will get your first opportunity to enroll in Medicare about three months before you turn 65. This Initial Enrollment Period (IEP) lasts for seven months surrounding your 65th birthday. It will start three months before the month of your birthday, and it will end three months after your birthday month. You’ll have plenty of time to enroll and make adjustments to your coverage before your Initial Enrollment Period closes.
Who is Eligible for Medicare?
How do you become eligible for Medicare? In addition to being 65, there are a few other factors that may effect your eligibility for Medicare:
You must be a United States citizen, or you have been a permanent resident in the US for five years.
You may be eligible if you have been receiving or are eligible to receive Social Security benefits even if you are not 65 or older.
Your contributions to Medicare through payroll deductions during your career will impact your premiums. Contributions are counted quarterly. Once you have hit 40 quarters, your Part A premium falls to $0
You qualify for Medicare at any age if you have ALS or ESRD (end-stage renal disease)
Understanding the parts of Medicare can help you understand what you are looking for in your coverage. You can make changes to your Medicare plan every year, so the plan that you choose now may look vastly different from the coverage you’ll require a few years from now. There are five basic parts of Medicare, including:
- Medicare Part A (hospital care): Offers coverage for inpatient care at hospitals, hospice care, skilled nursing facilities and nursing homes. Most people don’t have to pay a premium for Part A.
- Medicare Part B (medical care): Offers coverage outpatient services, such as doctor visits, medical equipment, lab tests, ambulance services, and preventative services. You will need to pay a premium for Part B coverage.
- Medicare Part C (Medicare Advantage): Includes the same coverage as Parts A and B, and may include additional benefits such as dental, vision, hearing, fitness, prescriptions, and more! For many, Part C coverage offers additional savings with lower premiums, smaller copayments and smaller deductibles.
- Medicare Part D (prescription drug): Helps to pay for your prescription medications.
- Medicare Supplement Insurance (Medigap): Provides supplemental coverage for costs not covered by Original Medicare.
Original Medicare (Parts A and B) doesn’t cover everything, so it’s important to look at all of the options before committing to a plan.
Prepare for Your Initial Enrollment Period (IEP)
Knowing what is coming and what you need to prepare leading up to your IEP will help the process go as smoothly as possible. Mark your calendar for when your Initial Enrollment Period is set to begin and end. If you forget to enroll in Medicare during this time, you will likely need to pay a penalty for late enrollment.
Before your IEP starts, take a look at your healthcare and financial needs. Some elements to take note of include:
· Your physicians: Make a list of your current physicians and any specialists you see. This way, you can make sure all of your doctors are in-network for whatever plan you choose.
· Your medications: Whether you enroll in a prescription drug plan separately, or as part of a Medicare Advantage plan, it’s helpful to make a list of your medications and keep it handy when you are comparing plans.
· Your costs: Comparing the costs of plans in your area can help you determine what plan is right for your financial lifestyle. Some Medicare Advantage plans offer $0 premiums, copays and deductibles, but you must still pay Medicare Part B.
Many individuals choose a Medicare Advantage plan, because not only does it cover everything included in Parts A and B, but most also provide essential services like vision, dental, hearing and prescription drug coverage. A plan like this can help you keep things simple and affordable while getting all the care you need.
Frequently Asked Questions
Medicare starts covering you when you turn 65 and enroll in Parts A and B or once you have been on Social Security disability for 24 months.
You can apply to Medicare beginning 3 months before 65.
Medicare starts at age 65 or at any age if you have received Social Security disability benefits for 24 months (2 years).
If you have End-Stage Renal Disease (ESRD), you may be eligible for Medicare at any age if:
•Your kidneys don’t work
•You have had a kidney transplant or receive regular dialysis
•You have met certain work requirements with Social Security, the Railroad Retirement Board, or as a government employee OR you’re already receiving those benefits OR you’re the spouse/dependent of someone who has met those requirements
If you have ALS, you may be eligible for Medicare immediately after you begin receiving Social Security Disability Insurance benefits, rather than having to wait 24 months.
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Last Updated: November 1, 2022 MULTIPLAN_ETQEZMwebsite_0722_M