The Initial Coverage Election Period, known as ICEP, is a specific timeframe for those newly becoming eligible for Medicare. Understanding this period is important to avoid gaps in health care services.
Defining the Initial Coverage Election Period (ICEP)
The Initial Coverage Election Period (ICEP) is the specific timeframe when a person first becomes eligible to enroll in a Medicare Advantage Plan, also known as Medicare Part C. This period is tied directly to the beneficiary’s first eligibility for both Medicare Part A and Part B. For a person to use their ICEP, they must be entitled to Part A and enrolled in Part B. ICEP provides an initial opportunity to select a coordinated care plan or prescription drug coverage without waiting for other enrollment periods.
Determining Your ICEP Timeline
The ICEP is a seven-month window whose start and end points are determined by the date a person first becomes eligible for both Medicare Part A and Part B. For most people aging into the program, this eligibility occurs in the month of their 65th birthday. The ICEP begins three months immediately before the month of eligibility, includes the month of eligibility, and extends for three months afterward.
For instance, if a person’s 65th birthday is in June, their ICEP runs from March 1st through September 30th, a full seven months. A different scenario applies to those qualifying for Medicare before age 65 due to a disability. For these individuals, eligibility begins with the 25th month of receiving Social Security Disability Insurance (SSDI) benefits.
If a person receives their 25th month of SSDI in May, their ICEP would span from February 1st through August 31st. The exact date of enrollment within this window impacts when the coverage begins. Enrolling in the first three months means coverage starts on the first day of the eligibility month, but enrolling later can delay the start date.
Enrollment Actions During ICEP
The central action during the Initial Coverage Election Period is securing a Medicare Advantage plan. These plans are offered by private insurance companies approved by Medicare.
Many Medicare Advantage plans integrate prescription drug coverage, meaning a person can secure both their medical and drug benefits through a single plan selection during ICEP. If a beneficiary opts for a Medicare Advantage plan that does not include drug coverage, they must enroll in a standalone Medicare Prescription Drug Plan (Part D) during this same period.
This period allows a beneficiary to choose a specific type of coordinated care, such as a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). Making an election during ICEP is the first opportunity to obtain Part C and/or Part D coverage, ensuring the beneficiary avoids any potential late enrollment penalties. Once the election is made and the coverage takes effect, the one-time ICEP is considered used.
The Difference Between ICEP and IEP
Confusion often arises because the Initial Coverage Election Period (ICEP) shares a similar structure and timing with the Initial Enrollment Period (IEP). The key distinction lies in the type of Medicare coverage each period addresses.
The IEP is the one-time, seven-month window specifically for enrolling in Original Medicare, which consists of Part A (Hospital Insurance) and Part B (Medical Insurance).
The ICEP, in contrast, is dedicated to enrolling in a Medicare Advantage Plan (Part C) or a Medicare Prescription Drug Plan (Part D). While the timing of both periods often overlaps for those turning 65, they cover separate components of the Medicare system.
The IEP facilitates the entry into the federal health insurance program, while the ICEP allows the beneficiary to select a private coverage option.