Initial Coverage Election Period (ICEP) and delayed Part B enrollment

The Initial Coverage Election Period (ICEP) is a one-time event that defines the opportunity to enroll in the Medicare Advantage plan. It is defined quite clearly; as long as you enroll in both Medicare Part A and Part B at the same time. But what if you plan to delay Part B enrollment? Then the time frame for ICEP is not as simple. Read below.

Initial Enrollment Period (IEP)

IEP is a 7-month period that begins 3 months before you turn 65, or 3 months before your 25th month of disability. It is used to enroll in Medicare Parts A, B and D, and includes the 3 months before, the month of, and the 3 months after the triggering event, such as turning 65.

Initial Coverage Election Period (ICEP)

ICEP refers to the period when individuals newly eligible for Medicare can enroll in the Medicare Advantage plan. They can enroll in the Medicare Advantage plan with prescription drug coverage (MAPD) or without it (MA). Like the IEP, the ICEP begins 3 months before the month of entitlement to Medicare. However, unlike the IEP, the ICEP ends either the last day of the month before you are enrolled in both Parts A and B, OR the last day of the IEP – whichever is later. Consider two different scenarios.

Signing up for both Part A and Part B during IEP

In this example, an individual named Jim has a birthday in May 2011. His IEP is from February 1 to August 31. He enrolls in both Medicare Part A and B effective May 1. His ICEP is the same as IEP; from February 1 to August 31. This is a period when he is eligible to enroll in the Medicare Advantage plan (with effective date May 1 or later).

Signing up for Part A and delaying Part B

In this example, Mary’s birthday is also in May 2011. Rather than enroll in both Medicare Parts A and B, she just enrolls in Part A. She continues to work and is covered by her employer group health plan. Ultimately, she retires the next year, gets 8-months Special Enrollment Period (SEP) to enroll in Part B, and enrolls in Part B effective April 1, 2012.

Her ICEP to enroll in the Medicare Advantage plan is from January 1 through March 31, 2012. It is quite confusing that ICEP is over before the effective date for Part B. If Mary missed ICEP (by not being familiar with the rules), her next opportunity to enroll in Medicare Advantage will be at Annual Enrollment Period (AEP) that runs from October 15 through December 7.  The effective date of her Medicare Advantage plan will be January 1, 2013 – 9 month delay.

The examples above clearly demonstrate the importance of understanding the Initial Coverage Election Period in order do not miss the Medicare Advantage enrollment window.

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