It is recommended that individuals apply for Medicare during the Initial Enrollment Period (IEP), which is the first time they meet the program’s qualifications. This helps them receive their benefits as soon as possible.
Although seniors qualify for government health insurance upon turning 65 years of age, they can enroll before their birthday.
The Initial Enrollment Period lasts for seven months. It starts three months before their birth month. For example, the Medicare enrollment start date for someone born on June 15th would be March 1st.
The end date is the last day of the month that is three months after their birth month. For someone born on June 15th, the last day of the Initial Enrollment Period would be September 30th.
When seniors apply for Medicare, the date they apply determines when their insurance benefits start. If they apply:
- During the three months prior to their birth month, coverage starts on the first day of the month they turn 65.
- During their birth month, coverage starts the following month.
- In the month after their birth month, coverage starts two months later.
- During the last two months of the IEP, coverage starts three months later.
Medicare coverage always starts on the first of the month. Individuals who enroll during their Initial Enrollment Period can switch plans within the first three months.
Late enrollees may need to pay a 10% premium increase if they do not meet certain conditions. However, enrollees eligible for premium-free Medicare Part A will still not have a monthly obligation.
The higher premium penalty lasts for twice the amount of time the enrollee was able to apply for Medicare, but did not enroll. For example, an enrollee would pay the penalty for two years if they did not sign up until a year after they became eligible.
Individuals who qualify for Medicare cannot receive the advanced tax credit on Marketplace insurance plans. Those who continue to benefit from the tax credit will be required to pay back the funds.
Those who do not enroll during the Initial Enrollment Period may qualify for a Special Enrollment Period and avoid late penalties. Special situations that can make individuals eligible for a Special Enrollment Period include the following:
- Losing health insurance from their job or spouse’s job
- Moving back to the country after serving abroad
Seniors can sign up during one of the Open Enrollment Periods if they missed their Initial Enrollment Period and do not qualify for a Special Enrollment Period.
The Medicare Open Enrollment Period – General Enrollment Period – occurs every year from October 15 to December 7. Coverage begins January 1 of the following year.
Medicare enrollees can join or switch Medicare Advantage plans between January 1 and March 31, and coverage starts the following month. Enrollees can also switch Medicare Part C plans or switch to Original Medicare.
The type of Medicare plan enrollees choose will determine how much they will pay for medical care. Likewise, their previous income and the date they applied for coverage influences premium costs. Next, find out more about Medicare costs.