If you missed your Initial Enrollment Period (IEP) and need to enroll in Medicare, you likely will have to enroll during either a Special Enrollment Period (SEP) Special Enrollment Periods (SEPs) are periods of time outside normal enrollment periods when you can enroll in Medicare or change your health and/or drug coverage. One example is the Part B SEP, which allows you to enroll in Part B without penalty while you have job-based insurance and for eight months after you lose the insurance or stop working. SEPs triggered by specific circumstances may also allow you to switch or disenroll from Part D and Medicare Advantage Plans. For example, if you moved out of your plan’s service area, you would receive an SEP to switch to another plan. or the General Enrollment Period (GEP) The General Enrollment Period (GEP) is the time period every year from January 1 to March 31 when you can enroll in Medicare Part B for the first time if you missed your Initial Enrollment Period (IEP) and do not qualify for the Part B Special Enrollment Period (SEP). When you enroll during the GEP, coverage begins the first of the month after you enroll, and you may have to pay a Part B late enrollment penalty. .
Part B Special Enrollment Period for losing job-based insurance
- If you are eligible for this Part B SEP, you can enroll in Medicare without penalty at any time while you have job-based insurance and for eight months after you lose your job-based insurance or you (or your spouse) stop working, whichever comes first.
- If you are under 65, are Medicare-eligible due to disability A disability is any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities and interact with the world around them. The Social Security Administration (SSA) determines disability—and eligibility for Social Security Disability Insurance benefits (SSDI)—based on whether you can work and whether your disability is likely to be permanent. (Definition from the World Health Organization) , and have job-based insurance through a family member’s current work One of the qualifications for the Part B Special Enrollment Period is to be currently working. You are considered to be currently working as long as you have employment rights at your company even if you do not work on a regular basis, are on sick leave, are a seasonal worker, or have been temporarily laid-off. You are not considered to be currently working if you receive Social Security Disability Insurance (SSDI), have received disability benefits from your employer for more than six months, or if you receive your employer insurance through COBRA. , you may also be entitled to the SEP if there are at least 100 employees at your family member’s place of work.
- Know the differences in coverage through job-based insurance if you are Medicare-eligible due to age versus disability.
Part B Special Enrollment Periods for exceptional circumstances
- There are also SEPs for less common situations, including;
- You live in an area impacted by an emergency or disaster
- You got certain types of misinformation from your employer
- You were released from incarceration
- Your Medicaid Medicaid is a federal and state program that provides health coverage for certain people with limited income and assets. Â coverage is ending
- You experience other exceptional circumstances
- You must meet certain requirements in order to use one of these SEPs.
General Enrollment Period
- The GEP takes place January 1 through March 31 of each year. During this period you can enroll in Medicare Part B.
- When you enroll during the GEP, coverage begins the first of the month after you enroll. For example, if you enroll in January, your coverage begins February 1.
- Enrolling in Medicare during the GEP means you may have to pay a Part B premium penalty.