CASE FLASH: MEDICARE ENROLLMENT TIMELINES

Mrs. H became eligible for Medicare when she turned 65 this year. Because her birthday is in February, Mrs. H’s Initial Enrollment Period runs from November to May (the three months before her birth month, her birth month, and the three months following her birth month). Since Mrs. H is not yet receiving Social Security benefits, she was not automatically enrolled into Medicare. She went to her local Social Security office in March to enroll in Original Medicare Parts A and B. However, the representative there informed Mrs. H that her Medicare B coverage would not be effective until July 1. Mrs. H was confused, because she thought that Medicare coverage should begin the month after her birth month.

Mrs. H called the Medicare Rights Center. She spoke to a hotline counselor who confirmed that July 1 was too long to wait, but that Mrs. H. was also incorrect about when her coverage should start. The counselor explained that when your Medicare coverage begins depends on when you enroll during your Initial Enrollment Period. If you enroll the month after your birth month, as Mrs. H was trying to do, your coverage should begin the third month after your birth month. Therefore, Mrs. H’s coverage should begin in May.

The counselor suggested that perhaps the Social Security representative confused Mrs. H’s situation with the timeline of coverage for the General Enrollment Period. He explained that when people do not enroll in Medicare when they are first eligible, they must usually enroll during the General Enrollment Period, which runs from January 1 to March 31 every year. Their coverage would begin on July 1.

The counselor helped Mrs. H find a Medicare publication that explains Medicare enrollment guidelines and start dates for coverage. He encouraged Mrs. H to take the publication with her when she went back to the Social Security office. At the Social Security office, Mrs. H explained that since she was still in her Initial Enrollment Period, she should not have to wait until July 1 for her Medicare coverage to begin. The representative was able to correct Mrs. H’s enrollment record so that her Medicare coverage would become effective May 1.

-Adapted from: “CASE FLASH: DIFFERENT START DATES FOR MEDICARE COVERAGE” MEDICARE WATCH, a biweekly electronic newsletter of the Medicare Rights Center, Vol. 11, No. 9: April 29, 2008.

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