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Situation

The shopper is eligible for Medicare for the first time due to turning 65 or due to disability prior to turning 65.

When to Enroll

 Medicare Advantage/PDPs
  • Up to 3 months before the the first day of the month of initial Medicare eligibility, the month of, and up to 3 months after.

  • If the enrollment is completed during the initial 3 months of the enrollment window, the effective date will occur on the first day of the month of initial Medicare eligibility.

  • If the enrollment occurs anytime after the initial 3 months of the enrollment window, the effective date will occur on the first day of the month after the enrollment took place.

  • It is best to complete the enrollment during the first 3 months to avoid a potential lapse in coverage.

 Medigaps
  • Up to 3 months before the the first day of the month of initial Medicare eligibility, the month of, and up to 6 months after.

  • If the enrollment is completed during the initial 3 months of the enrollment window, the effective date will occur on the first day of the month of initial Medicare eligibility.

  • If the enrollment occurs anytime after the initial 3 months of the enrollment window, the effective date will occur on the first day of the month after the enrollment took place.

  • It is best to complete the enrollment during the first 3 months to avoid a potential lapse in coverage.

Enrollment Reasons

Plan

Medicare Code/Reason

Dialer

Code/Reason

Uses

MAPD/PDP

IEP

IEP

May not be used again after the plan goes into effect

Can be used 3months before Medicare A/B effective dates, the month of, and 3 months after.

MA-Only

ICEP

ICEP

May not be used again after the plan goes into effect

If Medicare A/B effective dates are the same, and enrolling into MA-Only plan, then this can be used 3months before effective dates, month of, and 3 months after.

If using ICEP due to delayed Part B effective date, then you can enroll into MAPD or MA plan but can only use this SEP during the 3 months before the Part B effective date, not the month of nor after.

MAPD/MA-Only/PDP

IEP2

IEP2

May not be used again after the plan goes into effect

If the shopper has Medicare already, due to disability, but is turning 65, this can be used 3months before effective dates, month of, and 3 months after.

Medigap

GI

GI

May be used multiple times until the enrollment window expires

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