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Initial Election Periods

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Election periods can be tricky and overwhelming. The initial enrollment period options can be some of the hardest to navigate. It seems intuitive to select Initial Enrollment Period (IEP) for a client who is signing up for an MA only or MAPD plan for the first time, but did you know there are other enrollment periods that your client may fall into? If not, never fear! We have broken down the various options to help you better understand how to choose the correct enrollment period for you client.

Initial Enrollment Period (IEP) is a 7-month period around the client’s initial eligibility date. More specifically, the 3 months prior to the month the client becomes Medicare eligible, the month they become eligible, and the 3 months after they become eligible. The eligibility date is most often the first day of the client’s 65th birthday month, but it can also be the first day of the month 24 months after becoming disabled. Let’s see an example:

Bob Smith turns 65 on May 15. His eligibility date would be May 1. He would be eligible to sign up for a May 1 effective date between February 1- April 30. During the month of May, he would be eligible for a June 1 effective date. He still has eligibility in June for a July 1 effective, in July for an August 1 effective, and in August for a September 1 effective. Beginning on September 1, Bob is no longer eligible for an IEP; however, he may be covered under an alternative election period, so be sure to contact us to see if we can help!

A special note about IEP:

IEP is tied to Part D enrollment. If your client elects to not sign up for a plan that includes drug coverage, the IEP does not apply to them. Also note, if they don’t maintain creditable drug coverage through another source, they may be subject to a late enrollment penalty. Please contact us with any questions regarding drug coverage.

Initial Coverage Election Period (ICEP) is used when a client has elected to delay their Part B coverage, or they are electing to sign up for an MA only plan. It is also used automatically when an individual enrolls into an MAPD plan during their IEP. The ICEP begins 3 months prior to their Part B start date and ends the later of the last day of the month before entitlement to BOTH Part A and Part B; or the last day of the client’s Part B initial enrollment period. Typically, this Part B initial enrollment period surrounds the client’s 65th birthday which creates the 7-month window noted above under IEP. Let’s see a couple of examples:

Mary Jones delayed her Part B, but now that she is retiring, she will be eligible for Part B on May 1. She will be able to sign up for a plan February 1- April 30 for a May 1 effective date using ICEP. Beginning June 1, she is no longer eligible for an ICEP; however, she may be covered under an alternative election period, so be sure to contact us to see if we can help!

Sandra Brown is turning 65 on May 23. Her eligibility date would be May 1. She would be eligible to sign up for a May 1 effective date between February 1- April 30. During the month of May, she would be eligible for a June 1 effective date. She still has eligibility in June for a July 1 effective, in July for an August 1 effective, and in August for a September 1 effective. Beginning on September 1, Sandra is no longer eligible for an IEP/ICEP; however, she may be covered under an alternative election period, so be sure to contact us to see if we can help!

A special note about ICEP:

When a client enrolls in an MAPD plan, the client has used both their IEP and ICEP.

Initial Enrollment Period 2 (IEP2) is a 7-month period around the client’s 65th birthday when the client has previously been eligible for Part A and Part B. Let’s see an example:

Betty Johnson has a disability and has been Medicare eligible for the last 5 years. She will turn 65 on May 7. Her IEP2 eligibility date would be May 1. She would be eligible to sign up for a May 1 effective date between February 1- and April 30. During the month of May, she would be eligible for a June 1 effective date. She still has eligibility in June for a July 1 effective, in July for an August 1 effective, and in August for a September 1 effective. Beginning on September 1, Mary is no longer eligible for an IEP2; however, she may be covered under an alternative election period, so be sure to contact us to see if we can help!

Whew! That was a lot to take in! The most important takeaway is that if you have a typical T65 signing up for an MAPD plan, you will use IEP. If you have further questions, or you have client specific scenarios you’d like us to help you with, please call us at 855-721-8088 or email us at service@agencyrm.com. We are always happy to help!

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