When you #turn65

The Initial Coverage Election Period (ICEP)

• The ICEP (Initial Enrollment Period) is the period during which an individual newly eligible for Medicare Advantage  may make an initial enrollment request to enroll in an MA plan. This period begins three months immediately before the individual’s first entitlement (Turning 65) to both Medicare Part A and Part B and ends on the later of:
  • 1. The last day of the month preceding entitlement to both Part A and Part B, or;
    2. The last day of the individual’s Part B initial enrollment period.
• The initial enrollment period for Part B is the seven (7) month period that begins 3 months before the month an individual meets the eligibility requirements for Part B, and ends 3 months after the month of eligibility.   See 42 CFR 407.14 for additional information.
• Once an ICEP enrollment request is made and enrollment takes effect, the ICEP election has been used.   ^{Section 30.2} *  ^{Understanding Medicare Enrollment Periods # 11219} *
• Yes, I know this is all very complicated!   Email us or post your specific question below.
• EXAMPLES

It's best to enroll in Medicare A & B 3 months #before you turn 65

Graphic of when you can enroll based on turning age 65  *  Publication 11036  *

Use this Medicare tool to Find out when you’re eligible for Medicare.

The best time to sign up is 3 months before your 65th birthday and coverage will start on the 1st of the month of your birthday.   Be sure to let your prior carrier know at least 30 days in advance that you have new coverage and want to cancel.  Especially if it's Covered CA!  That way you don't have double premiums and duplicate coverage.

THERE is a proposed rule under the Consolidated Appropriations Act, 2021 to starting January 1, 2023 change the effective date to the month after enrollment!  If you're late.  ^{CMS.Gov Fact Sheet *  Proposed Rule *} 

Once you enroll in Parts A & B, you are then eligible to get a Medi Gap Plan and part D Rx or Medicare Advantage (HMO) to fill in the gaps that Medicare doesn't pay.  Please note that prescription drug coverage is effectively mandatory as there is a penalty when you eventually sign up, if you didn't  sign up when you are supposed to.

#Special, Annual & Initial Enrollment Periods CHARTS

For MAPD Medicare Advantage aka Part C & Medicare + Choice & Part D Rx

Medicare Interactive - Rights to Special Enrollment	Understanding Medicare Advantage & Rx Enrollment #Periods Publication # 11219
Official Details & Rules from Medicare Managed Care Manual Chapter 2 Enrollment and #Disenrollment

All Special Election Periods (SEP);

• Special election periods constitute periods outside of the usual times when an individual may elect a plan or change his or her current plan election.
  • Here's the official technical Medicare Marketing Manual or simple
    • plan English, Understanding Medicare C & D enrollment periods Pub # 11219  or see
    • our section on materials & guides below, there are 36 various types of SEPs, including SEPs for dual eligibles, and for individuals whose current plan terminates, who change residence and who meet “exceptional conditions” as CMS may provide, consistent with §1851(e)(4) of the Act and §422.62(b) of the MA regulations.
  • check with us about special enrollment, like when you turn 65 or lose coverage at work.

How the Medicare Advantage Application  #typically asks the "Special" Enrollment Period questions:

1. I am new to Medicare.
2. It's Annual Election Period aka Open Enrollment October 15th through December 7th
3. I am enrolled in a Medicare Advantage plan and want to make a change during the Medicare Advantage Open Enrollment Period (MA OEP).
4. I recently moved outside of the service area for my current plan or I recently moved and this plan is a new option for me. I moved on (insert date) –––––––––––.
5. I recently was released from incarceration. I was released on (insert date) –––––––––––.
6. I recently returned to the United States after living permanently outside of the U.S. I returned to the U.S. on (insert date) –––––––––––.
7. I recently obtained lawful presences status in the United States. I got this status on (insert date) –––––––––––.
8. I recently had a change in my Medicaid Medi Cal  (newly got Medicaid, had a change in level of Medicaid assistance, or lost Medicaid) on (insert date) –––––––––––.
9. I recently had a change in my Extra Help paying for Medicare prescription drug coverage (newly got Extra Help, had a change in the level of Extra Help, or lost Extra Help) on (insert date) –––––––––––.
10. I have both Medicare and Medicaid (or my state helps pay for my Medicare premiums) or I get Extra Help paying for my  Medicare prescription drug coverage, but I haven’t had a change.
11. I am moving into, live in, or recently moved out of a Long-Term Care Facility (for example, a nursing home or long-term care facility). I moved/will move into/out of the facility on (insert date) –––––––––––.
12. I recently left a PACE program on (insert date) –––––––––––.
13. I recently involuntarily lost my creditable prescription drug coverage (coverage as good as Medicare’s). I lost my drug coverage on (insert date) –––––––––––.
14. I am leaving employer or union coverage on (insert date) –––––––––––.
15. I belong to a pharmacy assistance program provided by my state.
16. My plan is ending its contract with Medicare, or Medicare is ending its contract with my plan.
17. I was enrolled in a plan by Medicare (or my state) and I want to choose a different plan.  My enrollment in that plan started on (insert date) –––––––––––.
18. I was enrolled in a Special Needs Plan (SNP) but I have lost the special needs qualifications required to be in the plan. I was disenrolled from the SNP on (insert date) –––––––––––.
19. I was affected by a weather-related emergency or major disaster (as declared by the Federal Emergency Management Agency (FEMA). One of the other statements here applied to me, but I was unable to make my enrollment because of the natural disaster