Medicare Coverage Start Times after Signing Up

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If you sign up for Medicare during your IEP, the onset of coverage is a bit complicated and needs explanation. The IEP — your first chance of signing up for Medicare — always lasts seven months. But when your coverage actually begins depends on which month you enroll, as you find out.

When you sign up during the first three months of your IEP

The middle month of your IEP — the fourth of the seven — is almost always the month in which you turn 65. If you sign up for Parts A and B during any of the first three months of your IEP, your coverage begins as soon as possible — normally on the first day of the month in which you turn 65, regardless of how far into the month your birthday falls.

But if your 65th birthday happens to fall on the first day of the month, your initial enrollment period is pushed forward, so that your coverage starts on the first day of the previous month. Hardly any ordinary Medicare beneficiary has ever heard of this little-known regulation, but if you were a first-of-the-month baby, you should be aware of it. Here are a couple of examples of IEP enrollments:

  • Betsy turned 65 on April 29, so her seven-month initial enrollment period began on January 1 and ended on July 31. Because she enrolled during the first three months of her IEP (January through March), her coverage began on April 1.

  • Dan’s birthday fell on September 1. Therefore, instead of his seven-month IEP’s running from June 1 to December 31, it actually ran from May 1 to November 30. So the first three months of his IEP were May, June, and July. If he enrolled during these three months, his coverage would begin on August 1 — a whole month ahead of his real birthday.

When you sign up during IEP months four through seven

If you don’t enroll during the first three months of your IEP, your coverage will be delayed. (Why? Quite simply, Medicare wants you to sign up as soon as possible.) Here’s how those delays work according to which month you enroll:

  • The fourth month: Coverage begins the first day of the fifth month.

  • The fifth month: Coverage begins the first day of the seventh month (a two-month delay).

  • The sixth month: Coverage begins the first day of the ninth month (a three-month delay)

  • The seventh month: Coverage begins the first day of the tenth month (a three-month delay)

For example, Raymundo turns 65 on June 20, so his seven-month IEP starts March 1 and ends September 30. If he signs up during March, April, or May, his coverage starts June 1. If he enrolls in later months, he faces the following delays:

  • June (month of birthday): Coverage begins July 1.

  • July (5th IEP month): Coverage begins September 1 (two-month wait).

  • August (6th IEP month): Coverage begins November 1 (three-month wait).

  • September (7th IEP month): Coverage begins December 1 (three-month wait).

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