The Initial Coverage Election Period (ICEP) refers to the period during which people newly eligible for Medicare can enroll in a Medicare Advantage plan. Medicare Advantage plans provide your Original Medicare Part A (hospital insurance) and Part B (medical insurance) coverage through Medicare-approved private insurance companies (except hospice care which continues to be covered under Part A). Medicare Advantage plans are required to offer at least the same level of coverage as Original Medicare; many Medicare Advantage plans include extra benefits, such as prescription drug coverage. Plans that include health and prescription drug coverage are referred to as Medicare Advantage Prescription Drug plans
Initial Coverage Election Period eligibility
You’re eligible for an Initial Coverage Election Period as soon as you are eligible for Original Medicare (Part A and Part B). Generally, you’re eligible for Part A and Part B at one of the following times:
- When you turn 65.
- In your 25th month of receiving disability benefits from the Social Security Administration or the Railroad Retirement Board.
- In the first month you start receiving disability benefits, if you have amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease).
To enroll in a Medicare Advantage plan , you need to:
- Have both Medicare Part A and Part B.
- Be a permanent resident living in the service area of the Medicare Advantage plan you select.
- Not have end-stage renal disease (ESRD). Benefits for the treatment of ESRD are typically provided under Part A and Part B.There are some exceptions. If you have ESRD and you want to enroll in a Medicare Advantage plan, call the plan you’re considering, or call Medicare (contact information at the end of this article) and ask about the exceptions involving ESRD.
You may be interested in signing up with a Special Needs Plan, a special type of Medicare Advantage plan. Depending on the type of Special Needs Plan, you must meet at least one of the following conditions to enroll:
- Have a specific chronic condition the Special Needs Plan is designed for .
- Have both Medicare and Medicaid.
- Live in an institution (for example, a nursing home).
When the Initial Coverage Election Period occurs
The time and length of your ICEP depends on whether or not you delay Part B enrollment.
If you enroll in Part B during the Initial Enrollment Period when you are first eligible for Medicare, then your Initial Coverage Election Period:
- Occurs simultaneously with the Initial Enrollment Period for Part B and Part D.
- Starts three months before the month of your eligibility (e.g., the month of your 65th birthday)
- Ends either the last day of the month before you enroll in Medicare Part B or the last day of your Initial Enrollment Period for Part B, whichever date is later.
Generally, any enrollment during the Initial Coverage Election Period takes effect the first of the month following the month you enrolled in the Medicare Advantage plan; however, the effective date cannot come before you have both Medicare Parts A and B.
- Perhaps you continue to work past the age of 65. You may delay your Medicare Part B enrollment until later on when you retire or lose your employer health coverage. You may enroll in Part B through a Special Enrollment Period upon retirement or losing employer health coverage up to eight months. (It’s usually advisable to sign up for Part B in the months just before retirement so Part B will start in the month following retirement, leaving no gaps in health coverage.) Since you’re not eligible for Medicare Advantage until you have both Part A and Part B, your Initial Coverage Election Period changes if you delay Part B. In this case, your Initial Coverage Election Period starts three months before you enroll in Part B, and ends the last day of the month before your Part B coverage starts.
Keep in mind that if you enroll in Medicare Advantage, you’ll continue to pay your Part B premium, in addition to the premium for your Medicare Advantage plan (if applicable).
Other Medicare Advantage enrollment periods
If you miss your Initial Coverage Election Period, you have other opportunities to enroll in a Medicare Advantage plan. These include:
- The Annual Election Period, also known as the Fall Open Enrollment Period, which takes place from October 15 to December 7 every year. During this time, you can enroll in a Medicare Advantage plan, change Medicare Advantage plans, add or drop a stand-alone Medicare Part D Prescription Drug plan, or disenroll from a Medicare Advantage plan and return to Original Medicare.
- A Special Election Period occurs when you have life changes that affect your health coverage. For example, if you delayed enrollment in Part B because you were working and had employer-sponsored group health coverage, when you retire or lose your group insurance coverage, you have an eight-month Special Election Period in which to enroll in Medicare Part B and select and enroll in a Medicare Advantage plan, with or without Medicare prescription drug coverage. Other examples of circumstances in which you may be eligible for a Special Election Period include, but are not limited to, moving out of the service area of your Medicare Advantage plan or losing Medicaid eligibility.
How to enroll in a Medicare Advantage plan
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