he Medicare health plan industry is a haven of acronyms! PCP, EOC, MOOP, ESRD, EOB …the list goes on and on. This is just another reason a Qualified Medicare Advisor is such a great resource! They can help explain all of these terms in a manner that is easy to understand.
Let’s tackle some basic information on the election periods associated with Medicare Health Plans:
IEP stands for Initial Election Period and defines the period of time when you first become eligible for Medicare. Someone turning 65 is a good example of an IEP. When you enter into your IEP, you have a 7-month window to select a Medicare Advantage or Part D plan, three months prior, the month of, and three months after Medicare effective dates.
Bonus: IEP2 is when a person on disability becomes eligible for Medicare, then turns 65 years later and receives a 2nd IEP!
ICEP stands for Initial Coverage Election Period and is largely exercised when someone delays their Part B enrollment, despite being eligible, due to having Part D equivalent coverage through work or Veterans benefits for instance. The ICEP alone allows for enrollment into an MA Only plan, but often the trigger to picking up the Part B (such as the voluntary or involuntary loss of group coverage) qualifies you for an SEP, known as Special Election Period… so let’s go there next.
Special Election Periods are unique circumstances that qualify a Medicare beneficiary to select a plan outside the designated enrollment windows set by CMS (Center for Medicare and Medicaid Services… Sorry, more letters!).
Examples include permanent moves, loss of group or medicaid coverage, Med Supp trial period, etc. Each has its own window for enrollment. Another reason to have a Plan Advisors agent. They know each one!
Annual Election Period (AEP) runs October 15th to December 7th. This is similar to the enrollment window that employees get each year to select or renew their group health coverage. During this AEP time frame all 50+ Million Americans on Medicare can choose or renew their Medicare plan, without risk or penalty. All AEP elections are for a January 1st effective date.
Years ago this window existed and now it’s back! OEP allows for a plan change in January through March 31st, for the first of the following month. It allows anyone who failed to select a plan in AEP or made a selection and decided to make one more change, to do so within this window. Once April 1st arrives, all selections are final until the following AEP, unless the Medicare beneficiary has an SEP of course.