TN 56 (10-22)

HI 00805.015 Initial Enrollment Period

A. Policy - First opportunity to enroll

The IEP is the first opportunity an individual has to enroll in SMI. The IEP is based on the first month of eligibility for HI for those who are eligible for SMI based only on HI entitlement, as noted in HI 00805.005 A.1. and B.

The IEP may also be based on the month in which the individual meets the requirements related to attaining age 65 and having the required residence/ citizen/alien status, as noted in HI 00805.005 A.2.

B. Policy - 7 month period

Except for people whose first month of eligibility occurred before 3/66 (see HI 00805.700 A.), an individual's IEP consists of 7 months.

The IEP begins on the first day of the third month before the first month of eligibility (as defined in HI 00805.005 C.) and ends on the last day of the third month following the first month of eligibility.

EXAMPLE: An individual's first month of eligibility is 7/92. The IEP begins 4/1/92 and ends 10/31/92.

C. Policy - more than one IEP

An individual under age 65 may have more than one IEP if the individual establishes entitlement to HI based on disability or ESRD more than once.

EXAMPLE: A disabled person has a period of DIB entitlement terminated, along with HI and SMI. If HI is reestablished based on a second period of DIB entitlement, or based on ESRD, the beneficiary has a new IEP beginning 3 months before the new date of entitlement to HI.

NOTE: No matter how often, or under what circumstances, entitlement occurred prior to age 65, every eligible beneficiary has a new IEP at age 65.

An individual age 65 or over has only one IEP, except where the aged individual develops ESRD after age 65 and may have a second IEP based on ESRD. (See HI 00805.085 and HI 00801.258 C.)

NOTE: No months prior to a new IEP are countable for premium surcharge purposes. If the beneficiary had paid a surcharge during the earlier period of SMI entitlement, that has no effect on the premiums due for the new enrollment.

D. Reference

  • IEP extends into a GEP and ends before the end of the GEP, HI 00805.030.

  • IEP for foreign residents who are eligible for HI and foreign residents who are ineligible for HI, HI 00805.007.

  • Effect of birth on first day of month, HI 00805.153.

  • Additional IEP information, HI 00805.165.

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HI 00805.015 - Initial Enrollment Period - 10/31/2022
Batch run: 10/31/2022