TN 26 (11-93)

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 following July 1.

  • Special Enrollment Period (SEP): the 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 SEP provisions.)

  • 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:
http://policy.ssa.gov/poms.nsf/lnx/0600801133
HI 00801.133 - Enrollment and Coverage Periods - 04/16/2015
Batch run: 04/16/2015
Rev:04/16/2015