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The Medicare Initial Coverage Election Period (ICEP) Explained

The Initial Coverage Election Period (ICEP) is when you can enroll in a Medicare Advantage Part C plan for the first time. You first must have Original Medicare Part A and Part B before you can enroll in a Medicare Advantage plan.

David Levine

by David Levine | Published December 14, 2023 | Reviewed by

Medicare is broken up into a several parts, all carrying a letter: Parts A,B,C and D. You can enroll in Medicare’s different parts at different times of the year, depending on your unique personal circumstances. These times when you can apply or sign up for a Medicare plan are called enrollment periods.

One of these enrollment periods is known as the Medicare Initial Coverage Election Period, or ICEP. This period of time is when you are first eligible to enroll in Medicare Advantage (Part C) coverage.

What Is ICEP?

Your Initial Coverage Election Period (ICEP) is the first time that you are allowed to replace your Original Medicare (Medicare Part A and Part B) coverage with a Medicare Advantage (Medicare Part C) plan.

Original Medicare, which includes Part A (hospitalization insurance) and Part B (medical insurance) coverage, is the public option of Medicare. It is administered by the Centers for Medicare & Medicaid Services (CMS), a department of the federal government. 

Part C plans, known as Medicare Advantage, are private insurance plans that are sold by insurance companies. Medicare Advantage plans are required by law to offer the same coverage as Original Medicare. But in addition, Medicare Advantage plans can also offer other benefits, such as prescription drug coverage, routine dental care, hearing care and more, all of which is not typically covered under Original Medicare.

What Is the Difference Between an ICEP and an IEP?

You can first enroll in Original Medicare Parts A and B during your Initial Enrollment Period, or IEP. Your ICEP may overlap with your Medicare Initial Enrollment Period, but your ICEP applies specifically to Medicare Advantage enrollment.

Your Medicare IEP begins three months before the month of your 65th birthday, includes your birthday month and continues for the next three months, for a total of seven months.

You must be enrolled in both Part A and Part B in order to qualify for Part C coverage. If you enroll in both A and B during your Medicare IEP, your ICEP will run at the same time as your IEP. This means that you can sign up for a Medicare Advantage plan right after you enroll in Original Medicare, if you’re still within your Initial Enrollment Period.

How Does the ICEP Enrollment Period Work?

Let’s say for example that your birthday is in April. Your IEP begins three months before April and runs three months after that – January through July. You can choose to enroll in both Part A and Part B during this time. If you do, your ICEP runs concurrently, so you can choose to also enroll in a Medicare Advantage plan.

However, you can choose to enroll only in Part A and not in Part B. Some people may do this because they are still covered under their own or their spouse’s employer-sponsored insurance policy. If you don’t enroll in Part B, you cannot enroll in Medicare Advantage. At a later date, when you and/or your spouse retire and you lose employer-based coverage, or lose coverage for other reasons, you then can enroll in Part B without a penalty. 

When you do, you would be granted a new ICEP to enroll in a Medicare Advantage plan, if you choose to do so. This period runs for the three months before your Part B coverage takes effect. Thus, if you sign up for Part B coverage to begin September 1, your ICEP begins June 1. You could opt to switch out of Original Medicare and into a Medicare Advantage plan during this time. That coverage could begin no earlier than the start of your Plan B coverage (in this case, September 1).

Who Is Eligible for an ICEP?

In order to begin an ICEP and enroll in a Medicare Advantage plan, you must be enrolled in both Medicare Part A and Medicare Part B. You also need to live in service area of the Medicare Advantage plan you want to sign up for.   

If you enroll in Medicare Part B after your IEP, you then become eligible for an ICEP and Medicare Advantage enrollment. This eligibility period lasts three months.

What Are Some Other Medicare Enrollment Periods?

If you choose not to enroll in Medicare Advantage during your ICEP, you may have other opportunities to do so.

The Medicare Annual Enrollment Period (AEP), also known as the fall Medicare Open Enrollment period, occurs every fall, from Oct. 15 to Dec. 7. During this enrollment period, you can sign up for a Medicare Advantage plan, switch from one Medicare Advantage plan to another or disenroll from Medicare Advantage in order to return to Original Medicare

Another type of Medicare enrollment period is a Special Enrollment Period (SEP). A Medicare SEP may be allowed at any other time during year for certain people who experience a qualifying life event, such as:

  • Moving to a new Medicare service area
  • Losing other health care coverage
  • An opportunity to get other coverage
  • Your plan’s Medicare contract changes
  • Other special situations

The Medicare Advantage Open Enrollment Period (OEP) occurs from January 1 to March 31 every year. At this time you can:

  • Disenroll for your Medicare Advantage plan coverage and return to Original Medicare
  • Switch from your current Medicare Advantage plan to a different Medicare Advantage plan

When Can I Apply for Medicare Supplement Insurance?

You may decide that instead of a Medicare Advantage plan, you’d like to stick with Original Medicare. In that case, you may want to consider enrolling in a Medicare Supplement plan, also known as Medigap.

A Medigap plan helps pay for out-of-pocket Medicare costs such as deductibles, copays, coinsurance and more. You typically pay a monthly premium for your Medicare Supplement plan, and in exchange you have more predictable health care spending. Depending on which type of Medigap plan you apply for, you may not face many or any out-of-pocket costs when you use your Medicare coverage. 

A licensed insurance agent can help answer your questions about Medicare Supplement Insurance and help you compare plans available where you live. If you’re eligible, they can even help you apply over the phone. 

Compare Medigap plans in your area.

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