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By Sue Wonacott
Medicare certified insurance agent 

Enrollment periods for Medicare

Medicare

 


Medicare has several enrollment periods beneficiaries need to be aware of:

Your Initial Eligibility Period (IEP) is a total of 7 months, three months before your birthday month, your birthday month, and three months after your birthday month. For example, if you were born in January, you have the months of October, November, and December, your birthday month of January, and the three months after, February, March and April to sign up initially for Medicare. This is an important time to make your Medicare choices otherwise you can incur penalties. The best time to sign up is the beginning of the first month of your initial eligibility period, in this example , it would be October, and then, in most cases, your coverage will start the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month.

For every year, you wait to sign up for Part B, you may have to pay a late enrollment penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it. For example, Mr. Smith’s initial enrollment period ended September 30. 2011. He waited to sign up for Part B until March 2014 during the general enrollment period. His Part B premium penalty is 20%. Even though Mr. Smith waited a total of 30 months to sign up, this included only 2 full 12-month periods. He’ll have to pay this penalty for as long as he has Part B.

General Enrollment Period

If you didn’t sign up for Part A and/ or Part B (for which you must pay a premium) during your initial enrollment period and you aren’t eligible for a special enrollment period, you can sign up between January-March 31 each year. Your coverage will begin July 1 of that year.

Special Enrollment Period (SEP)

If you move out of the plan’s service area or your employer plan ends or the carrier drops the plan, you may qualify for a Special Enrollment Period. After your employer plan ends, you have an 8-month period of time to sign up for a new plan. If you decide to drop the plan, always check with your plan administrator as usually you cannot get it back. This time period begins the month after your employment ends or the coverage begins, whichever happens first. COBRA (Consolidated Omnibus Budget Reconciliation Act), the insurance often offered to you when you leave a company, and retiree health plans are not considered current employment.

Part D

Part D, prescription drug coverage, has a LEP(late enrollment penalty) also. This is an amount that is added to your Part D premium. You may owe a late enrollment penalty, if at any time, after your initial eligibility period is over; there is a period of 63 or more days in a row when you don’t have Part D or other creditable prescription drug coverage. Creditable prescription drug coverage (for example, from an employer or union) is expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.

The late enrollment penalty is calculated by multiplying 1% of the “national base beneficiary premium” by the number of full, uncovered months that you were eligible but didn’t join a Medicare drug plan and went without other creditable prescription drug coverage. The final amount is rounded to the nearest $.10 and added to your monthly premium.

I do hope these explanations are helping you to unravel the confusion of Medicare. Remember it is like a puzzle (Part A, B, C, D and Supplemental Plans) and when you put the pieces together, they hopefully, make sense and you solve the puzzle.

Again, it is my pleasure to help you with your Medicare concerns and questions. I am a Medicare certified agent with several carriers and am available at Marty Pay (Farmers)Insurance Agency,121 East F Street and may be reached by the office phone 822-3737 or by cell phone 304-4695 or drop me an email at sue.wonacott@sbcglobal.net. I look forward to meeting you and serving you with integrity and compassion for your peace of mind.

 
 

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