What Happens If You Miss Your Medicare Initial Enrollment Deadline?
Uh oh! Have you missed your Initial Enrollment Period (IEP)? Your IEP is the three months before to three months after your 65th birthday when you can enroll in Medicare. If so, there are more chances to sign up, and there are several important reasons why you’ll want to make sure it’s a top priority.
If you were receiving Social Security benefits when you turned 65, you should have been automatically enrolled in Medicare. If not, you’re responsible for signing up on your own. Missing your chance to sign up for Medicare Parts A (hospital), B (medical), or D (prescription drug) leaves you without coverage. It can also cost you more over time and can affect the timing in which you can enroll in an all-in-one Medicare Advantage plan. Medicare Advantage plans include all of your hospital and medical coverage plus prescription drug coverage and other added benefits, such as dental, vision, transportation and more. You must have Medicare Parts A and B before you can sign up for a Medicare Advantage plan.
You might not always be penalized if you miss your Initial Enrollment Period. It depends on how much time has passed. It also depends on your eligibility for a Special Enrollment Period. This is a period of time when you can enroll in a Medicare plan (without penalty) but only if you meet certain criteria, such as losing employer health coverage.
What are the penalties for enrolling late?
Part A – 10 percent of your normal Part A premium for twice the number of years that you waited to enroll. This means, if you were late two years, you’d have to pay the 10 percent penalty for four years. Most people qualify for premium-free Part A. If you are one of those people, you won’t have to pay a penalty for late enrollment. You’re eligible for premium-free Part A as long as you or your spouse have paid Social Security taxes for at least 10 years.
Part B – 10 percent of the normal Part B premium for every 12-month period you are late. This means that if you are late by two years, you will have to pay your normal Part B premium plus 20 percent. The penalty must be paid for the duration of the time you have Part B coverage.
Part D – One percent of the national base premium for Part D. The penalty is for failing to have creditable prescription drug coverage for 63 days in a row. It must be paid for the duration of the time you have Part D coverage.
When can you sign up for Parts A, B and D if you miss your Initial Enrollment Period?
Open or Annual Enrollment Period (OEP/AEP) — October 15 – December 7
You can join or drop a Part D prescription drug plan during this time. You cannot use this enrollment period to sign up for Medicare Parts A and B for the first time.
General Enrollment Period (GEP) — January 1 – March 31
During General Enrollment, you can sign up for Parts A and B if you’ve missed your Initial Enrollment Period.
Special Enrollment Period (SEP) – Year-round
Only in certain cases can those who are eligible for Medicare qualify for a Special Enrollment Period to enroll in a Medicare plan. Examples include a recent move that made new Medicare options available to you or leaving employer or union coverage. If you qualify for a Special Enrollment Period, you will not face penalties for missing your Initial Enrollment Period. To find out if you’re eligible, talk to your licensed healthcare advisor or visit www.medicare.gov.
What if you want Medicare Advantage?
If you want to enroll in a Medicare Advantage plan, you must use either the General Enrollment Period or a Special Enrollment period to sign up for Parts A and B. After you’ve done that, you can sign up for a Medicare Advantage plan during the next Open/Annual Enrollment Period. If you qualify for a Special Enrollment Period, you can sign up for a Medicare Advantage plan right away.
To learn how to sign up for Medicare, visit our Medicare Learning Center and check out Medicare Timeline Series 3: How to Enroll in Medicare.