TN 61 (03-23)

HI 00801.133 Enrollment and Coverage Periods

A. Policy — Basic rules

An individual who is not subject to Part A buy-in as discussed in HI 00801.140 may only enroll for Premium-HI during the

following periods:

  • Initial Enrollment Period (IEP): the IEP begins 3 months before the first month of eligibility (generally, the month of attainment of age 65; see HI 00801.131 C. for exceptions) and continues for 7 months. Coverage based on an IEP enrollment begins as provided for in HI 00805.165. The IEP for Premium-HI is generally the same as the IEP for SMI.

  • General Enrollment Period (GEP): the GEP is January through March of each year. Coverage based on a GEP enrollment begins the first day of the month following the month of enrollment.

  • Special Enrollment Period (SEP) – Group Health Plan: this SEP is an enrollment opportunity for individuals whose employer group health plan coverage based on current employment has ended. (See HI 00805.265ff. for a complete discussion of the GHP SEP provisions).

  • Special Enrollment Period (SEP) – Exceptional Conditions: these SEPs are for individuals who are eligible for Medicare on any basis and may enroll (or re-enroll) in Medicare Part B Supplementary Medical Insurance (SMI) and Part A Premium Hospital Insurance (HI) during any months that fall within the duration of the specific exceptional conditions SEPs described in HI 00805.382.

  • Transfer Enrollment Period: This is a special enrollment opportunity for Medicare beneficiaries who are also Health Maintenance Organization (HMO) or Competitive Medical Plan (CMP) enrollees and whose HMO or CMP enrollment is terminated either on a voluntary basis or because of termination of the HMO or CMP contract. (See HI 00801.143 for further discussion.)

B. Policy — Additional considerations

The following provisions which apply to SMI enrollment also apply to Premium-HI enrollment for the Aged:

To Link to this section - Use this URL:
HI 00801.133 - Enrollment and Coverage Periods - 03/10/2023
Batch run: 06/10/2024