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Medicare Initial Enrollment Period

Fact Checked
Contributing expert: Ron Elledge, Medicare consultant
Reviewed by: Kelly Blackwell, Certified Senior Advisor®
Updated: February 21, 2022


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Ron Elledge
Medicare Consultant and Author
Ron Elledge
Medicare Consultant and Author

Ron Elledge is a seasoned Medicare consultant and author of “Medicare Made Easy.” As a Medicare expert, he regularly consults beneficiaries on Medicare rules, regulations, and strategies.

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Kelly Blackwell
Certified Senior Advisor (CSA)®
Kelly Blackwell
Certified Senior Advisor (CSA)®

Kelly Blackwell is a Certified Senior Advisor (CSA)®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.

Enrolling in Medicare on time is key to getting coverage when you need it and avoiding higher healthcare costs. Read on to understand when your Medicare Initial Enrollment Period (IEP) occurs and how you can avoid costly mistakes.

When Is The Medicare Initial Enrollment Period?

The Medicare Initial Enrollment Period (IEP) is a seven-month period wrapped around your 65th birthday when you become eligible for Medicare. It includes three months before, the month of, and three months after turning 65.

If you qualify for Medicare based on ESRD (end-stage renal disease), ALS (amyotrophic lateral sclerosis), or disability, your Medicare enrollment period can be well before you turn 65. However, in most states, you can’t enroll in a Medicare Supplement Insurance (Medigap) plan until you’re 65 and have Medicare Part B. That makes the IEP an important time for all Medicare recipients.

When Does Medicare Coverage Start?

Your Medicare coverage start date depends on when you sign up. Although you have seven months to sign up for Medicare in your IEP, it pays to sign up during the first three months, before your 65th birthday. Doing so will ensure your Medicare coverage starts the first day of the month you turn 65.

For example, if your date of birth is June 22, and you enroll in March, April, or May, your coverage will begin on June 1. If your date of birth falls on the first day of the month it is handled differently. In that case, your Medicare coverage will begin the first day of the month before turning 65. For example, if your birthday is June 1, you may sign up in February, March, or April and your Medicare will begin May 1. Your IEP will extend two months after your birthday month.

This chart illustrates start dates for Medicare coverage, assuming a birthday of June 22:

Sign-up period Sign-up month When Medicare becomes active Coverage date
Three months before 65 March, April, or May First day of the month you turn 65 June 1
The month you turn 65 June First day of the following month July 1
One month after 65 July First day of the second month after application September 1
Two months after 65 August First day of the third month after application November 1
Three months after 65 September First day of the third month after application December 1

As you can see, coverage start dates are pushed out if you wait to enroll until you are 65 or older. If you sign up in the three months before your birthday, you’ll be covered the same month you turn 65. But if you wait until the end of your IEP, which is three months after you turn 65, your coverage would start six months later than it would have if you’d signed up at the beginning of your IEP.

What Happens if You Miss Your IEP?

If you don’t take advantage of your IEP, you’ll only be eligible to sign up during the General Enrollment Period (GEP). The GEP occurs yearly from January 1 through March 31 with coverage beginning July 1.

Delayed coverage isn’t the only problem with missing your IEP. If you don’t enroll during your IEP, you’ll begin accumulating Late Enrollment Penalties (LEP).

If you aren’t eligible for premium-free Part A, you may be able to buy it. If you don’t buy Part A when you are first eligible, usually when you turn 65, you will have to pay a LEP of an extra 10% of your monthly premium. You’ll pay this for twice the number of years you could have had Part A but didn’t.

The Part B LEP is 10% of the standard Part B premium for every twelve-month period you have been eligible for Medicare and have not signed up unless you have a qualifying Special Enrollment Period (SEP).

Part B special enrollment periods include SEPs for the working aged and working disabled, and an SEP for international volunteers. If you are not covered under any of these circumstances and delay Part B enrollment, you may have delayed Medicare coverage and be assessed late penalties when you do enroll.

What is the Initial Coverage Enrollment Period?

The Initial Coverage Enrollment Period (ICEP) refers to the period when you’re first enrolled in Medicare Parts A and B and can choose a Medicare Advantage Plan instead of Original Medicare. If you enroll in Part B when you turn 65, your ICEP occurs simultaneously with your IEP. . If you delay your Part B enrollment past your IEP, your ICEP for Medicare Advantage ends the last day of the month before both Parts A and B become effective.

When Should You Enroll in Medicare?

The best time to enroll in Medicare is during the first three months of your IEP. However, if you’re still working at that point or otherwise qualify for a SEP, your ideal enrollment period will be different. Before you turn 65 or retire, be sure you know when you’ll need to enroll in Medicare to avoid coverage delays and late enrollment penalties.

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