What is the Medicare Initial Enrollment Period?

For many people, Medicare’s Initial Enrollment Period (IEP) is your first chance to enroll in Original Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). For those eligible due to age, this period begins 3 months before you turn 65, goes through your birthday month, and ends 3 months after. For those eligible due to disability, this period begins three months before their 25th month of disability payments, includes the 25th month, and ends 3 months after.

Here’s some information to help you get started with Medicare.

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Am I automatically enrolled in Medicare at 65?

Maybe. If you’re under 65 and start receiving Social Security retirement benefits or Railroad Retirement benefits at least 4 months before you turn 65, you’ll be automatically enrolled in Parts A and B. You should receive a package in the mail 3 months before your 65th birthday with your new Medicare card. There should also be a letter explaining how Medicare works and that you were automatically enrolled in both Parts A and B.1

If you’re under 65 and not receiving Social Security retirement benefits or Railroad Retirement benefits, you’ll need to actively enroll in Medicare. If you need to enroll, use this helpful guide on how to sign up for Medicare in 3 easy steps.

Do I need Medicare if I’m working past 65?

It depends. If you’re still employed when you become eligible for Medicare, you can keep your coverage under your employer’s group health plan. Here are some rules to consider:2

  • If your employer has 20 or more employees, generally you can choose to delay Medicare enrollment, drop your employer coverage for Medicare, or have both Medicare and employer coverage.
  • If your employer has fewer than 20 employees, generally you will need to enroll in Medicare during your Initial Enrollment Period.
  • If you have health coverage through a spouse’s employer, your options will depend on the employer’s rules.

If you choose to delay enrolling in Part B, you may avoid penalties by qualifying for a Special Enrollment Period (SEP). For more details on enrolling in Original Medicare, explore when to sign up for Medicare if you’re still working past 65.

For people eligible due to age, this period begins 3 months before you turn 65, goes through your birthday month, and ends 3 months after. For people eligible due to disability, this period begins three months before their 25th month of disability payments, includes the 25th month, and ends 3 months after.

When will my Medicare coverage start after Initial Enrollment?

The date your Medicare plan coverage starts depends on the month you sign up during your IEP. Coverage always starts on the first of the month.3

If you sign up Before the month of your 65th birthday The month you turn 65 1 month after you turn 65 2–3 months after you turn 65 Medicare coverage will start The month you turn 65 The next month The next month The next month

What if I miss my Medicare initial enrollment period window?

If you miss your 7-month Initial Enrollment Period, you have another chance to sign up for Original Medicare.4

General Enrollment Period (GEP)

If you miss your chance to apply for Original Medicare during your IEP, or you weren’t automatically enrolled, the Medicare General Enrollment Period is your chance to sign up for Medicare Part A and Part B.

Dates: Jan. 1–March 31

During the General Enrollment Period, you can:

  • Sign up for Medicare Part A and Part B

Additional information:

  • Coverage will start on July 1
  • You may have to pay a late enrollment penalty

Special Enrollment Period (SEP)

A Special Enrollment Period sign up for Part A (if you have to buy it) and Part B once your IEP ends, but only if you meet certain requirements.5

When do you qualify for a special enrollment period to sign up for Parts A and B?

If you’re covered under a group health plan based on current employment, you have a SEP to sign up for Part A and/or Part B at any time as long as you or your spouse (or family member if you’re disabled) is working, and you’re covered by a group health plan through the employer or union based on that work.

Additional information:

If you enroll during a Special Enrollment Period, your Medicare coverage typically begins the month after Social Security gets your completed request. Usually, you don’t pay a Part B late enrollment penalty if you sign up during a Special Enrollment Period.

Frequently asked questions

Can I enroll in a Medicare Advantage plan during IEP?

Yes. When you become eligible for Original Medicare (Parts A and B), you also become eligible for a Medicare Advantage plan (Part C).

The enrollment period is called your Initial Coverage Election Period (ICEP). This is your first opportunity to enroll in Medicare Part C. ICEP begins 3 months before your 65th birthday and ends either the last day of your Part B initial enrollment period or the last day of the month before you’re enrolled in Parts A and B (whichever is later).

Can I enroll in a prescription drug plan during IEP?

Yes. IEP is your first chance to sign up for Medicare Part D (prescription drug plan).

There are 2 different ways you can get prescription drug coverage. You can enroll in a standalone Medicare Part D plan or you could get drug coverage as part of a Medicare Advantage plan.

To learn more, check out how to enroll in a Medicare Part D prescription drug plan.

What should I consider before enrolling in Medicare?

If you’re new to Medicare, it’s natural to have questions when shopping Medicare plans. Here are some coverage details to consider:

  • Out-of-pocket costs—premiums, deductibles, copayments and any other payments not covered by Medicare
  • Prescription drug coverage—eligibility requirements, medication coverage and costs, generic vs. brand name, etc.
  • Healthcare needs—any upcoming surgeries or doctor appointments you may have in the coming year
  • Travel plans—Original Medicare typically doesn’t cover services overseas, so if you plan on traveling out of the country, you might consider buying a supplemental insurance plan that will cover you in case of an emergency

To get more information about costs, coverage and eligibility, check out these answers to frequently asked questions about Medicare.

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Sources

  1. “Medicare,” Social Security Administration, last accessed June 8, 2023, https://www.ssa.gov/pubs/EN-05-10043.pdf, PDF.
  2. “Working past 65,” Medicare.gov, last accessed June 8, 2023, https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65.
  3. “When does Medicare coverage start?”, Medicare.gov, last accessed June 8, 2023, https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start
  4. “Joining a plan,” Medicare.gov, last accessed June 8, 2023, https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan.
  5. “Enrolling in Medicare Part A & Part B,” Medicare.gov, last accessed June 8, 2023, https://www.medicare.gov/Pubs/pdf/11036-Enrolling-Medicare-Part-A-Part-B.pdf.