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UNIVERSITY OF CALIFORNIA, LOS ANGELES BERKELEY DAVIS IRVINE LOS ANGELES UCLA MERCED RIVERSIDE SAN DIEGO SAN FRANCISCO SANTA BARBARA BENEFITS ELIGIBILITY VERIFICATION Welcome to the Department of Medicine

How to fill out period of initial enrollment

Period of Initial Enrollment refers to the specific time frame in which an individual can first enroll in Medicare. Here is a step-by-step guide on how to fill out the period of initial enrollment:

1. Understand your eligibility: Determine if you are eligible for Medicare based on age or certain disabilities. Most people become eligible at the age of 65, but there are some exceptions.
2. Know the enrollment period: The period of initial enrollment lasts for seven months, starting three months before your 65th birthday, includes the month of your birthday, and continues for three months afterward. It's crucial to enroll during this period to avoid late enrollment penalties.
3. Gather required information: Before filling out the enrollment forms, gather necessary information such as your Social Security number, proof of citizenship or legal residency, and any other relevant documents.
4. Choose your coverage: Decide which parts of Medicare you want to enroll in. Part A covers hospital insurance, while Part B covers medical insurance. Additionally, you can opt for a Medicare Advantage Plan (Part C) or a prescription drug plan (Part D).
5. Fill out the application: You can fill out your Initial Enrollment form online at the Social Security Administration's website or by visiting your local Social Security office. Provide accurate information about yourself, your eligibility, and your chosen Medicare coverage options.
6. Review and submit: Before submitting your application, carefully review all the information you provided to ensure its accuracy. If everything looks correct, submit your application as instructed by the Social Security Administration.

Now, let's move on to the second part of the question:

Who needs the period of initial enrollment?

1. Individuals turning 65: Most individuals become eligible for Medicare at the age of 65, so they need to utilize the period of initial enrollment to enroll in Medicare. Failing to do so may result in late enrollment penalties and delayed coverage.
2. Individuals with certain disabilities: Some individuals under the age of 65 may qualify for Medicare due to certain disabilities, such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). They also need to fill out the period of initial enrollment to access Medicare benefits.
3. Individuals without existing creditable coverage: It is essential for individuals who don't have any existing creditable coverage, such as an employer's health plan, to enroll during the period of initial enrollment. This ensures they have Medicare coverage as soon as they become eligible.

By following these steps and understanding who needs the period of initial enrollment, individuals can ensure a smooth Medicare enrollment process and avoid any potential penalties.

For pdfFiller’s FAQs

What is period of initial enrollment?

The period of initial enrollment is the time frame during which individuals can sign up for a health insurance plan.

Who is required to file period of initial enrollment?

Anyone who is eligible for a health insurance plan must file a period of initial enrollment.

How to fill out period of initial enrollment?

Individuals can fill out their period of initial enrollment online, over the phone, or through mail.

What is the purpose of period of initial enrollment?

The purpose of the period of initial enrollment is to ensure that individuals have the opportunity to sign up for a health insurance plan.

What information must be reported on period of initial enrollment?

The period of initial enrollment typically requires personal information, income details, and any dependents who will be covered under the plan.

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