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Most individuals become eligible for Medicare when they turn 65, at which point they can enroll in both Part A (Hospital Insurance) and Part B (Medical Insurance). Enrolling on time is crucial to avoid potential coverage gaps or penalties so here are the periods for when you should sign up.
Typically, most people should enroll in Medicare Part A and Part B as soon as they are eligible at age 65. If you are already receiving Social Security benefits at that age, you will be automatically enrolled in Part A.
Delaying enrollment in Part B may be an option if you have coverage through an employer's group health plan. Otherwise, postponing enrollment can lead to higher costs and delayed coverage.
However, certain circumstances may allow for delayed enrollment without penalties, such as having an employer-sponsored health plan.
Typically, Medicare offers three primary enrollment periods that determine when and how you can sign up. There is an initial Enrollment Period (IEP) which is available for individuals approaching their 65th birthday.
You have seven months to sign up-beginning three months before your 65th birthday month and ending three months after and enrolling during this window ensures there are no late fees or delays in coverage.
For instance, if you were born on February 17, 1960, you would need to sign up by May 31, 2025, with coverage beginning the month following enrollment.
Then comes a Special Enrollment Period (SEP). If you or your spouse are covered by an employer group health plan, you may qualify for a Special Enrollment Period, allowing you to sign up later without penalties.
You can enroll while still employed and covered by the group plan, within eight months of leaving your job or losing employer-sponsored health insurance and Within eight months after the group health plan ends, even if employment continues.
Your coverage usually starts the month after enrollment, though in some cases, it may take up to three months to begin.
Finally there is the General Enrollment Period (GEP) which is for if you miss the Initial or Special Enrollment Periods and sees coverage start the month after enrollment is completed.
You can still sign up during the General Enrollment Period, which runs annually from January 1 to March 31. However, this often results in a permanent late enrollment penalty.
What are the exceptions for missing the enrolment period?
While most individuals must enroll during one of the designated enrollment periods, there are certain exceptions that allow for enrollment outside of these periods without penalties. These exceptions are designed to accommodate individuals who may have faced unforeseen circumstances that prevented them from enrolling on time.
Recognizing these exceptions can help eligible individuals secure Medicare coverage without unnecessary delays or penalties.
Some of the specific circumstances that qualify for an exception include situations such as:
- Losing Medicaid coverage.
- Encountering enrollment barriers due to a declared natural disaster.
- Receiving incorrect information about eligibility from an employer or health plan.
- Being recently released from incarceration, after the enrollment period ends.
- Those serving as volunteers abroad.
- Those covered under TRICARE or an employer-sponsored insurance plan.