TN 109 (07-24)

HI 00805.025 General Enrollment Period (GEP)

A. Definition of GEP

A GEP is the first calendar quarter of each year (January through March).

B. Policy

1. GEP enrollment

The person who fails to enroll during the IEP, or refuses automatic (deemed) enrollment, may enroll only during the GEP.

The person whose SMI has ended because of non-payment of premiums or voluntary withdrawal from SMI, may reenroll only during the GEP.

EXCEPTION: For a person who becomes eligible for SMI and does not lose that eligibility, the only time enrollment after the IEP need not occur in a GEP is where the individual meets the requirements for an SEP, as described in HI 00805.265. If an individual is eligible for an SEP, they may enroll under that SEP, even if they were terminated due to premium non-payment.

2. Extension of GEP

When the GEP ends on a day which is a non-workday (e.g., Saturday, Sunday, legal holiday, etc.), an eligible individual may enroll on the first regular workday after the end of the GEP.

3. When SMI will begin

SMI entitlement based on a GEP enrollment will begin the first of the month after the month of enrollment.

Prior to January 1, 2023, SMI entitlement based on a GEP enrollment always begins July 1 of the year during which the GEP enrollment took place.

4. Inquiry late in GEP

Individuals who inquire by telephone about enrollment shortly before a GEP expires should be told to make their request for SMI enrollment on a letter or postcard and immediately mail it to the FO, if they are unable to visit the FO before the end of the GEP.

5. Deemed filing rules when Medicare is initially established

If the application establishing entitlement to HI is filed after the IEP, but during the GEP, the individual is deemed to have filed the enrollment request on the first day of the current GEP.

If the application establishing entitlement to HI is filed after the IEP, but not during a GEP or SEP, the individual is deemed to have filed the enrollment request on the first day of the next GEP.

Note: 

The GEP deemed filing rules that apply when Medicare is initially established does not apply for individuals who previously refused or terminated SMI in the past and file on a postentitlement basis.

Refer to HI 00805.040 for additional informational on Automatic (Deemed) Enrollment -Aged and Disabled Individuals

C. References

HI 00805.040 Automatic (Deemed) Enrollment - Aged and Disabled Individuals

SM 03040.055 General Enrollment Period (GEP) Processing Via MCS and POS/T2R


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0600805025
HI 00805.025 - General Enrollment Period (GEP) - 07/03/2024
Batch run: 07/03/2024
Rev:07/03/2024