Original Medicare Eligibility and Enrollment Guide

The Medicare program covers most citizens over the age of 65. It is broken down into four health insurance plans that cover various needs:

Medicare Part A: The hospital insurance plan covers inpatient hospital stays, skilled nursing facilities, home health care in certain situations, and hospice care.

Medicare Part B: The supplementary medical insurance plan

Medicare Part D: Medicare drug coverage helps pay for prescription drugs as well as recommended shots & vaccines. To enjoy the benefits of this drug coverage plan, you need to join a Medicare-approved plan offering drug coverage.

Medicare Advantage (Part C): Medicare Advantage plans offer an all-in-one alternative to the Original Medicare plans. These include Part A, Part B, and usually Part D.

Most of the Medicare Advantage Plans cover extra benefits and costs that Original Medicare doesn’t—like hearing, dental, vision, and more. They usually come as yearly contracts but the amount of “out-of-pocket” costs can depend from plan to plan.

Enrollment Periods and When Coverage Begins

Individuals who wish to enroll themselves in the Original Medicare plans (Plan A & B) need to wait for the allotted enrollment periods:

Initial Enrollment Period (IEP)

The Initial Enrollments Period is a 7-month period. This begins 3 months BEFORE the month of the individual’s 65th birthday and ends 3 months after.

Individuals under the age of 65 entitled to disability-based Medicare can apply 3 months before the 25th month of disability benefit entitlement and before the end of the 28th month.

The IEP for people with ALS depends on their individual situations.

The start of your coverage is determined by when you enroll during the IEP. If you enroll within the first 3 months, your coverage begins in the first month you become eligible for Medicare.

If you enroll after the IEP, your coverage gets delayed.

Please note that in most cases, if you fail to enroll for Part B or Part A during the Initial Enrollment Period, you can pay a late enrollment penalty and enjoy coverage starting the same year.

General Enrollment Period (GEP)

The General Enrollment Period begins from January 1 to March 31 of each year. If you enroll during the general enrollment period, your Part A and Part B coverage begin on July 1 of the same year.