--- title: "Medicare Initial Enrollment Period at Sutter Health" description: "Turning 65? Your 7-month Medicare enrollment window is your chance to avoid late penalties and choose a plan that fits your needs and future care." url: "https://www.sutterhealth.org/billing-insurance/medicare/iep" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Billing and insurance](https://www.sutterhealth.org/billing-insurance) / 3. [Medicare](https://www.sutterhealth.org/billing-insurance/medicare) / 4. Initial Enrollment Period ![older-couple-surfing](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Images/Billing-and-Insurance/older-couple-surfing1.jpg?h=2100&iar=0&w=3188) # Medicare Initial Enrollment Period  Choose a Medicare plan that gives you access to your Sutter doctors. [Compare Medicare plans](https://www.ehealth.com/Sutterwebsite) ![older-couple-surfing](https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Images/Billing-and-Insurance/older-couple-surfing1.jpg?h=2100&iar=0&w=3188) **Section menu** - [Medicare](https://www.sutterhealth.org/billing-insurance/medicare "Medicare") - [Annual Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/aep "Annual Enrollment Period") - [Medicare basics](https://www.sutterhealth.org/billing-insurance/medicare/medicare-basics "Medicare basics") - [Medicare wellness visits](https://www.sutterhealth.org/billing-insurance/medicare/medicare-wellness-visits "Medicare wellness visits") - [Special Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/sep "Special Enrollment Period") - [Initial Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/iep "Initial Enrollment Period") - [Late enrollment penalties](https://www.sutterhealth.org/billing-insurance/medicare/late-enrollment-penalties "Late enrollment penalties") - [Medicare](https://www.sutterhealth.org/billing-insurance/medicare "Medicare") - [Annual Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/aep "Annual Enrollment Period") - [Medicare basics](https://www.sutterhealth.org/billing-insurance/medicare/medicare-basics "Medicare basics") - [Medicare wellness visits](https://www.sutterhealth.org/billing-insurance/medicare/medicare-wellness-visits "Medicare wellness visits") - [Special Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/sep "Special Enrollment Period") - [Initial Enrollment Period](https://www.sutterhealth.org/billing-insurance/medicare/iep "Initial Enrollment Period") - [Late enrollment penalties](https://www.sutterhealth.org/billing-insurance/medicare/late-enrollment-penalties "Late enrollment penalties") ## Your Medicare Initial Enrollment Period If you're turning 65, your Initial Enrollment Period (IEP) is your first chance to sign up for Medicare. It starts three months before your 65th birthday, includes your birthday month, and ends three months after. That’s a 7-month window to get the coverage you need. If you miss this window, you could face late enrollment penalties that might apply for as long as you have Medicare. These penalties vary by each part — Medicare Part A, Medicare Part B and Medicare Part D all have different rules. Learn more about [Medicare Late Enrollment Penalties](https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties "Medicare Late Enrollment Penalties"). ## Considering retirement? If you’re planning to retire after 65 and have coverage through your employer, you may not need to sign up for Medicare right away. But once your job or health coverage ends (whichever comes first), you have 8 months to enroll. Missing this deadline could lead to [lifetime penalties](https://www.medicare.gov/basics/costs/medicare-costs/avoid-penalties "lifetime penalties"). You may also qualify for Medicare before age 65 if you meet certain criteria like having a disability. Visit [SSA.gov](https://www.ssa.gov/ "SSA.gov") or contact your [local Social Security office](https://www.ssa.gov/locator "local Social Security office") for more info. [View Medicare Fact Sheet (PDF)](https://www.cms.gov/Outreach-and-Education/Find-Your-Provider-Type/Employers-and-Unions/FS4-Medicare-for-people-over-65-nearing-retirment.pdf "View Medicare Fact Sheet (PDF)") ## Get started Watch our Medicare 101 video to learn the basics of Medicare at your own pace. [Watch now](https://bcove.video/4lmEP9b) ## Understand your Medicare options **Original Medicare includes:** - **Part A** - hospital insurance - **Part B** - medical insurance Many people choose additional coverage to help meet their healthcare and prescription drug needs and to avoid Medicare late enrollment penalties. Options may include: - **Original Medicare** plus a **Part D prescription drug plan** and a **Medicare Supplement Insurance plan**, also called Medigap, to help pay some out-of-pocket costs not covered by Original Medicare - A Medicare Advantage plan (Part C), which combines **Medicare Parts A and B** and may include prescription drug coverage and additional benefits not available through Original Medicare¹ These plans are offered through Medicare-approved private insurance companies. ¹Available in Medicare Advantage Prescription Drug Plans. ## Explore Medicare plan options Sutter works with eHealth, a licensed insurance agency, to help you find the right plan for you. [Compare plans](https://www.ehealth.com/Sutterwebsite) This is not an advertisement on behalf of any Medicare plan or plans. For information about Medicare, visit medicare.gov or call 1-800- MEDICARE 24 hours a day, seven days a week. TTY Users should call 1-877-486-2048. eHealth is an insurance agency offering plans from many insurance companies and is not affiliated with the government. Sutter Health co-hosted events are not affiliated with eHealth or the government. For accommodation of persons with special needs at events, call 1-800-478-8837 (TTY 711). Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you’re in your Medicare Initial Enrollment Period. MMR-4521-2026 ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"WebPage","name":"Medicare Initial Enrollment Period at Sutter Health","description":"Turning 65? Your 7-month Medicare enrollment window is your chance to avoid late penalties and choose a plan that fits your needs and future care.","url":"https://www.sutterhealth.org/billing-insurance/medicare/iep","breadcrumb":{"@id":"https://www.sutterhealth.org/billing-insurance/medicare/iep#breadcrumblist"}} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/billing-insurance/medicare/iep#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Billing and insurance","item":"https://www.sutterhealth.org/billing-insurance"},{"@type":"ListItem","position":3,"name":"Medicare","item":"https://www.sutterhealth.org/billing-insurance/medicare"},{"@type":"ListItem","position":4,"name":"Initial Enrollment Period"}]} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Medicare Basics","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/de1a1ead-7c8b-4ebb-902d-c37da3b02f09/48352715-4430-4b2e-ab7c-54d0a354dd3d/1280x720/match/image.jpg","uploadDate":"2021-06-17T23:58:18.644Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6259370150001","description":"Get answers to Medicare FAQs, the benefits of Medicare Advantage, the importance of enrolling when first eligible, how to avoid late enrollment penalties, how to save money and where to go for additional help. \n\n","duration":"PT19M0S","transcript":"[MUSIC PLAYING]\nANNOUNCER: Getting Medicare can be\none of the most daunting steps we take as adults.\nWhether you're newly eligible for Medicare, soon to retire,\nor considering your planning options,\nunderstanding the basics of Medicare\nis a great place to start.\n\nIn the following slides, you'll hear\nus address some of the most commonly asked\nquestions about Medicare.\nLet's start with the basics.\n\nWhat is Medicare?\nMedicare is a federal health insurance program\nfor eligible US citizens and legal residents.\nMedicare is funded in part by taxes you pay while working,\nand Medicare is individual health insurance.\n\nMedicare is available for qualifying individuals.\nFor example, you must be a US citizen or a legal resident.\nLegal residents must live in the US\nfor at least five years in a row, including the five years\njust before applying for Medicare.\nIn addition, to qualify for Medicare,\nyou must be 65 or older, or younger than 65 with\na qualifying disability, or any age with a diagnosis\nof end-stage renal disease or ALS--\nalso known as Lou Gehrig's disease.\n\nSo what does Medicare cover?\nOriginal Medicare is made up of Medicare Parts A\nand B. Medicare Part A is your hospital insurance,\nand helps pay for hospital stays and inpatient care.\nMedicare Part B is your medical insurance,\nand helps pay for doctor's visits and outpatient care.\nLet's talk about Medicare Part A first.\nMedicare Part A, your hospital insurance,\ncovers hospital stays and inpatient care,\nsuch as your hospital room and meals or care in special units,\nto name a few.\n\nMedicare Part A is premium free if you or your spouse\nworked and paid taxes for 10 years or longer.\nYou cannot be denied Part A coverage.\nCoverage is nationwide, including\nany qualified hospital in the US.\nCoverage and costs are per benefit period.\nYou must be admitted as an inpatient.\nYou can't be on observation status, for example.\nAnd part A provides additional 60 lifetime reserve days.\nWhat that means is that, in addition\nto the 90 days of inpatient hospital care\neach benefit period covered by original Medicare,\nyou also have an additional 60 days of coverage that\ncan be used only once in your lifetime.\nYou would still be required to pay your coinsurance\nfor each day used.\nNow, let's move on to Medicare Part B. Medicare Part\nB, your medical insurance, covers doctor visits\nand outpatient care, such as screenings,\npreventive services, mental health care, blood tests,\nand diagnostic tests, as well as other programs and services.\n\nYour monthly Part B premium is adjusted for income.\nYou cannot be denied Part B coverage.\nLike Part A, coverage is nationwide,\nincluding any provider who accepts Medicare.\nIf you are late to enroll in Medicare Part B,\nyou may pay a premium penalty for late enrollment\nthat lasts as long as you're enrolled in Medicare.\nYou'll learn more about Medicare's penalties later\nin this presentation.\nMedicare does not cover everything.\nNow that we've seen what Medicare Parts A and B cover,\nit's important to know what original Medicare does not\ncover.\nAll the costs of your care--\nyou will have out-of-pocket costs.\nThere is no limit to how much you can potentially pay.\nOriginal Medicare also does not cover\nprescription drugs; routine dental, vision, or hearing\ncare; eyeglasses, contacts, or hearing aids;\nlong-term or custodial care, such as help bathing,\neating, or dressing; excess charges for services by doctors\nwho don't accept Medicare assignment;\nor care received outside the US, except for certain\ncircumstances, for example.\n\nSo now that we know that Original Medicare doesn't\ncover everything, let's talk about how\nyou can get more coverage.\nYou have two options for obtaining additional coverage.\nOne option is to add a Medicare supplemental insurance\nplan that helps pay for some of the out-of-pocket costs that\ncome with Original Medicare.\nWith a Medicare supplement plan, you\nwould also need to consider adding a Medicare Part D\nplan, which helps pay for prescription drugs.\nBoth MedSup and Part D plans are offered by private companies,\nand are in addition to Original Medicare.\nMedicare Part D helps with the cost of prescription drug\ncoverage.\nYou must be enrolled in Part A, Part B, or both\nto be eligible to obtain Part D. You may be required\nto use a pharmacy network.\nCoverage and costs vary by plan, and may change each year.\nAnd if you don't enroll when you're first eligible and don't\nhave any coverage, you may pay a late enrollment penalty\nfor life.\nAnother option for obtaining more coverage\nis to enroll in a Medicare Advantage Plan.\nMedicare Advantage Plans are also\nknown as Medicare Part C. These plans combine your Medicare\nParts A and B into one plan, and usually include Medicare Part\nD, prescription drug coverage.\nIn addition to Medicare Advantage,\ncombining your original Medicare Parts A and B and Medicare Part\nD, these plans may offer additional benefits not\nprovided by Original Medicare.\n\nLet's look at Medicare Advantage a little closer.\nMedicare Advantage is a way to get additional Medicare\nbenefits.\n\nAll Medicare Advantage plans cover all the benefits\nof Original Medicare Parts A and B,\nwith the exception of hospice care, which is still covered\nby your Part A. In addition to covering everything\nthat Original Medicare covers, most Medicare Advantage plans\ncover Medicare Part D, prescription drugs.\nMedicare Advantage plans may also offer additional benefits\nand features, such as dental exams, cleanings, and x-rays,\neye exams, glasses, and corrective lenses, hearing\ntests and hearing aids, wellness programs\nand fitness memberships, to name a few of the most\ncommon benefits.\nAdditionally, unlike Original Medicare Parts A and B,\nall Medicare Advantage plans have\nan annual out-of-pocket maximum to help\nprotect against high costs.\nThe following is a quick rundown of Medicare Advantage plans,\nPart C. To be eligible to enroll in Part C,\nyou must already be enrolled in both Medicare Parts A and B,\nand live in the plan's service area.\nYou cannot be denied Medicare Advantage coverage based\non your current financial or health status,\nincluding pre-existing conditions.\nYou may be required to use provider or pharmacy networks.\nYour coverage and costs vary by plan.\nUnlike with Original Medicare, Medicare Advantage plans\nhave an annual limit on how much you pay out\nof pocket for COVID services some plans charge\na monthly plan premium.\nYou will need to continue to pay your Part B\npremium to Medicare.\n\nSo how do you know which coverage option to choose?\nFirst and foremost, you'll want to enroll in Medicare Parts A\nand B once you enroll in Parts A and B,\nyou want to determine whether you\nadd a supplemental insurance plan to your original Medicare\nin addition to adding a standalone Medicare Part D\nplan.\nAlternatively, you can simplify this process\nby choosing an all-in-one Medicare Advantage\nplan that combines your Parts A, B, and D into one plan.\nAs we saw earlier, Medicare Advantage plans\nmay offer additional benefits not provided\nby original Medicare.\nSuch as dental and vision coverage, fitness memberships,\ndiscounts on over-the-counter drugs,\nand assistance in keeping costs down\nby limiting annual out-of-pocket costs for covered services.\nLet's take a closer look at the differences\nbetween a Medicare Supplement plan and a Medicare Advantage\nplan.\nLooking at coverage, Medicare Supplement\nplans help pay for some costs not paid by Original Medicare,\nbut they don't help with prescription drug costs,\nwhile Medicare Advantage plans provide\nall the benefits of Original Medicare and then some,\nwith most Medicare Advantage plans\nincluding prescription drug coverage, and many offering\ndental and vision care, among other benefits.\nBoth plan types may have options for foreign travel coverage.\nIn regards to costs, MedSup plans\nhave monthly planned premiums.\nIf you wanted to have prescription drug coverage,\nyou would need to purchase that separately and pay\nan additional plan premium for that coverage.\nMedicare Advantage plans may charge monthly premiums,\nwith many plans offering low or no monthly costs.\nAnd most Medicare Advantage plans\ninclude prescription drug coverage\nwithout the additional costs.\nAnd unlike Original Medicare or MedSup plans,\nMedicare Advantage plans limit your annual out-of-pocket costs\nfor covered services.\nIt's important to look at your options\nin advance of your initial enrollment period.\nIf you don't enroll in Medicare Parts A and B,\nand choose a plan with drug coverage\nwhen you're first eligible, you may incur lifelong penalties.\n\nLet's talk about when you can enroll.\nMost of us are first eligible to enroll in Medicare\nduring our initial enrollment period.\nThis seven-month window refers to the three months\nbefore your 65th birthday, the month you turn 65,\nand the three months following.\nIf you're already receiving Social Security or Railroad\nRetirement benefits at age 65, or you've\nbeen receiving Social Security benefits for 24 months,\nyou will be automatically enrolled\nin Medicare Parts A and B.\nIf you don't meet that criteria, then you'll\nwant to contact your local Social Security office or visit\nssa.gov to enroll.\nIt can take two to three months or longer\nto receive your Medicare card, so it's\nimportant you enroll yourself early\nin your initial enrollment period\nto avoid gaps in coverage and late enrollment fees\nthat may be imposed by Medicare.\nIf you missed your initial enrollment period,\nyou can also enroll in Medicare during Medicare's\ngeneral enrollment period, which is January\n1 through March 31 each year.\nDuring this time, you can enroll in Medicare Part A and B,\nor both.\nYour coverage will begin on July 1 of that same year.\nOnce you enroll in Medicare Parts A and B,\nyou're eligible to enroll in a Medicare Advantage plan, Part\nC, that includes prescription drug coverage between April 1\nand June 30 of the same year.\nBe mindful that, if you wait to enroll\nin Medicare during Medicare's general enrollment\nperiod and your initial enrollment period window\nhas passed, you may incur late enrollment premium penalties\nfor both Parts B and D that last a lifetime.\nIf you choose to work past 65 and have\nproof of creditable coverage, you\nmay choose to delay your initial enrollment.\nHere's how.\nYour employer will provide you with a notice\nof creditable coverage.\nThis notice will help you determine\nwhether you need to enroll in Part D or not,\nwhen you're first eligible.\nIf you have creditable coverage through your employer\nor other group coverage, you can avoid late enrollment\npenalties.\nIf you work past 65 and don't have\nproof of creditable coverage, you\nmay incur lifelong penalties.\nWe'll discuss that in a little more detail shortly.\nWhen you do retire, you will have an eight-month window\nin which you can enroll in Medicare Parts A and B,\nstarting when your employer coverage ends or when you stop\nworking--\nwhichever comes first.\nOnce you enroll in Part B, that triggers\nyour special enrollment period.\nYou will have only two months from that point\nto enroll in a standalone prescription drug plan\nor to enroll in an all-in-one Medicare Advantage\nplan that includes your Part D prescription drug coverage.\nIf you do not enroll in Part B and in a plan that\nincludes prescription drug coverage\nduring your special enrollment period,\nyou will need to wait until the next general enrollment period.\nWaiting to enroll in Medicare's general enrollment period\ncould result in you having to pay late enrollment penalties,\nbecause you could have had Part B, but did not enroll,\nand you had a gap in prescription drug coverage\nof 63 days in a row or more.\nThese penalties for Parts B and D\nwill apply for you as long as you have Medicare.\n\nAs we've seen, Medicare imposes late enrollment penalties\nfor Parts A, B, and D. Let's begin with Part A.\nIf you do not qualify for premium free Medicare Part A\nor you meet certain conditions that\nallow you to sign up for Part A during a special enrollment\nperiod, then your monthly premium may increase 10%,\nif you sign up late.\nIf you incur that penalty, you'll\nhave to pay the higher premium for twice the number of years\nyou could have had Part A, but did not sign up.\nWith Part B, in most cases, if you don't sign up\nwhen you're first eligible, your monthly premium for Part B\nmay increase 10% for each full 12-month period\nthat you could have had Part B, but didn't sign up for it.\nIn addition, you may have to wait\nuntil the general enrollment period from January 1\nto March 31 to enroll in Part B. If you incur that penalty,\nyou'll have to pay this penalty for as long as you have Part B.\nNow, let's look at Part D. Medicare\nimposes late enrollment penalties\nif you go 63 days or more without creditable coverage.\nThis penalty is 1% per month of the national base beneficiary\npremium times the number of full uncovered months\nthat you did not have Part D or creditable coverage.\nThis penalty is added to your monthly Medicare prescription\ndrug plan premium for as long as you have prescription coverage.\nIt may also continue to increase each year, if the national base\nbeneficiary premium increases.\nYou'll want to note that COBRA insurance is not considered\ncreditable coverage for Medicare Part B,\nand is only considered creditable coverage for part D\nif the plan you're enrolled in is equivalent to or better\nthan Medicare's standard prescription drug coverage.\n\nAvoiding a gap in coverage and enrolling when you're first\neligible is key to avoiding Medicare's late enrollment\npenalties.\nAnother way to avoid Medicare's late enrollment penalties\nis by enrolling in Medicare Parts A and B,\nand choosing an all-in-one Medicare Advantage plan, Part\nC, that includes prescription drug coverage when you're first\neligible.\nYou also have the opportunity to enroll in a Medicare Advantage\nplan each year during Medicare's annual election period.\nIf you're covered by your employer's group health care\ncoverage when you're first eligible for Medicare,\ntalk to your employer about your requirements\nfor enrolling in Medicare Part B. You\nmay choose to delay enrollment, if you have\nproof of creditable coverage.\nThis also applies to Medicare Part D, your prescription drug\ncoverage.\nFor more information on how Medicare's late enrollment\npenalties may apply to you, contact your local broker\nor visit medicare.gov.\n\nMedicare's annual election period takes place October 15\nthrough December 7 every year.\nDuring this period, you can switch from Original Medicare--\nParts A and B--\nto a Medicare Advantage plan--\npart C-- or vice versa.\nYou can also switch from one Medicare Advantage plan\nto another, or you can switch, drop, or join a Medicare\nprescription drug plan.\nOutside of Medicare's annual election period,\nyou have an opportunity to switch plans\nif you have a qualifying life event, such as moving out\nof your service plan area, losing health care coverage,\nor getting financial help with Medicare, for example.\nIn addition to special enrollment periods\nto enroll in Medicare or elect new coverage,\nthere are also opportunities for qualifying beneficiaries\nto get financial assistance.\n\nThere are different forms of financial assistance available.\nExtra Help is a federal program that\nhelps pay for some out-of-pocket costs for Medicare prescription\ndrug coverage, such as premiums, deductibles, and coinsurance.\nThere are options for full or partial Extra Help,\nand eligibility will vary.\nMedicaid, known as MediCal in California,\nis a program that offers free or low-cost health coverage\nfor individuals with limited income and resources.\nMediCal bases your eligibility on your income.\nIt is not based on how much money you have saved\nor if you own your home.\nYou do not have to be on public assistance\nto qualify for MediCal, and you can apply for MediCal coverage\nthrough Covered California any time.\nMedicare savings programs are available from the state\nto help pay your Medicare premiums,\nand may also pay Part A and Part B deductibles,\ncoinsurance, and copayments if you meet certain conditions.\nThere are also programs for all-inclusive care\nfor the elderly, also known as PACE.\nThese programs provide comprehensive home\nand community-based health care services to participants.\n\nFor more information on financial assistance programs,\nadditional resources, and to learn more about Medicare\nand your options, you can visit sutterhealth.org/medicare.\nContact Medicare directly at 1-800-MEDICARE, or visit\nmedicare.gov.\nYou can also reach out to your local Social Security office\nat 1-800-772-1213.\nOr contact MediCal at 1-800-541-5555.\nAlternatively, you can send us an email\nat medicare@sutterhealth.org to have us put you\nin contact with a local licensed insurance agent who can\nwalk you through your options."} ```