When you turn 65, you may become eligible for Medicare. Enrolling in Medicare, however, can sometimes be a bit complicated depending on your situation.
The Centers for Medicare and Medicaid Services (CMS) offers five important things to know before you enroll in Medicare:
If you’re eligible for Medicare and need to manually enroll, this guide outlines how you can sign up for Medicare online, in person or over the phone. We’ll also give some additional information about each part of Medicare to help you decide which options you want to apply for and how you can do so.
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Some people are automatically enrolled in Original Medicare, which is made up of Medicare Part A and Part B.
According to the Social Security Administration, most people age 65 or older are eligible for free Medicare hospital insurance (Part A) “if they have worked and paid Medicare taxes long enough” (that is, 10 years or 40 quarters). This is called premium-free Part A.
Enrolling in Medicare medical insurance (Part B) requires paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium.
Other parts of Medicare are run by private insurance companies. They must follow rules set by Medicare but are able to cover costs or services that Original Medicare doesn’t typically cover. The types of private Medicare insurance include:
When you become eligible for Medicare, you need to decide whether to enroll in Part A only or Parts A and B.
If you’re still covered by a group health plan through your employer or your spouse’s employer, you might consider signing up for Part A alone, which is free if you or your spouse worked and paid Medicare taxes for 10 years. To do this, you need records of your or your spouse’s employment and your current group healthcare coverage.
If you have medical insurance coverage under a group health plan, you may not need to apply for Medicare Part B at age 65. Instead, you may qualify for a Special Enrollment Period (SEP) that allows you to sign up for Part B later, without being subject to a late enrollment fee.
There are several specific reasons you might qualify for a Special Enrollment Period, so be sure to check your eligibility if you think you’re qualified.
It’s important to note that if you don’t sign up for Part B when you’re first eligible and don’t qualify for a Special Enrollment Period to enroll later on after your initial enrollment period ends, you will likely have to pay the Part B late enrollment penalty every month for as long as you continue to have Part B if you eventually sign up.
You will typically be automatically enrolled in Medicare at age 65 if you’re already receiving Social Security retirement benefits at least four months before you turn 65. If not, you can sign up for Medicare Part A and/or Part B during your initial enrollment period, which begins three months before your 65th birthday, includes the month you turn 65, and ends three months after your birthday month.
If you miss your Initial Enrollment Period and don’t qualify for Special Enrollment, you can sign up for Medicare Part A and/or Part B during the Medicare General Enrollment Period, which lasts from January 1 through March 31 every year.
Your coverage won’t begin until July 1, however. If you pay a premium for Part A, you could also pay a late enrollment penalty.
If you don't sign up for Medicare Part B during your Initial Enrollment Period, you could potentially have to pay a Part B late enrollment period for the rest of the time that you have Part B coverage.
You can sign up for Medicare online by visiting the Social Security web site and following the instructions based on your personal situation.
If you are within three months of age 65 or older and not ready to start taking Social Security benefits yet, you can use the online retirement application to sign up just for Medicare and wait to apply for your retirement or spouse’s benefits later.
To enroll online, you need to create an online account on the Social Security Administration’s web site. You’ll be asked whether you wish to enroll in Medicare, Social Security or both when you create your account.
Sign-up requires basic information, including:
Social Security says that signing up takes less than 10 minutes. There are no forms to sign. To find out what documents and information you need to apply, go to the Checklist For The Online Medicare, Retirement, and Spouses Application.
You can also get started with your application for Medicare by doing one of the following:
After you are enrolled, CMS will send you a “Welcome to Medicare” packet and your red, white and blue Medicare card in the mail. You will also receive the “Medicare & You” handbook, which includes important information about your coverage.
Medicare Advantage eligibility first requires enrollment in Medicare Part A and Part B. You must also live in the area serviced by the Medicare Advantage plan you’re applying for.
You can sign up for a Medicare Advantage plan during your Initial Enrollment Period. As mentioned above, this is the seven-month period that begins three months before you turn 65, includes your birth month and lasts for three additional months.
As with Medicare Part A and Part B, if you miss your Initial Enrollment Period, you may be able to apply for a Medicare Advantage plan during a Special Enrollment Period, if you qualify.
The other time you can enroll in a Medicare Advantage plan is during the annual Medicare Open Enrollment Period for Medicare Advantage and prescription drug plans, which is also called the Annual Enrollment Period (AEP).
If you already have a Medicare Advantage plan, or if you have other forms of Medicare coverage and want to switch to a Medicare Advantage plan, you can do so during this time of year.
Medicare Advantage plans are sold by private insurance companies.
One way to enroll is to first connect with a licensed insurance agent who will help you review available plan options in your area and assist you with the application process.
Medicare Part D is comprised of plans that provide coverage solely for prescription medications. These plans are sold by private insurance companies.
In order to be eligible for a Medicare Part D plan, you must be enrolled in either Original Medicare or a Medicare Advantage plan that does not include coverage for prescription drugs.
You can enroll in a Medicare Part D plan as soon as you become eligible for Medicare coverage.
If you don’t enroll in Medicare Part D when you first become eligible and you don’t have other creditable prescription drug coverage, you may have to pay a Part D late enrollment penalty.
Like Medicare Advantage plans, Medicare Part D plans are sold by private insurance companies, so it may be helpful to contact a licensed insurance agent who can help you shop for plans in your area.
You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online.
Medicare Supplement Insurance, also known as Medigap, provides coverage for certain out-of-pocket Medicare costs.
These expenses can include things like deductibles, coinsurance, copayments and emergency care received outside of the U.S.
To be eligible for a Medicare Supplement Insurance plan, you must be enrolled in Original Medicare and live in the area that the plan you want services.
Not all states require Medicare Supplement Insurance plans to be available to people under 65, even if they qualify for Original Medicare because of a disability.
Visit MedicareSupplement.com to compare Medicare Supplement plans available where you live.
The earliest time that you can enroll in a Medicare Supplement Insurance policy is during your Medigap Open Enrollment Period.
If you sign up for a Medigap policy outside of your Medigap Open Enrollment Period, insurance companies can charge you higher premiums or deny your application due to your age and health.
You may not have a Medicare Advantage plan and a Medicare Supplement Insurance plan at the same time.
If you have more questions about applying for Medicare, speak with a licensed insurance agent who can help you review the plan options available where you live.
David Levine is an award-winning writer and editor whose work has been featured in the New York Times, New York Daily News, Sports Illustrated, American Heritage, U.S. News & World Report and others.
David has covered health, health insurance and health policy topics – among many others – since 2017. He earned a Bachelor's Degree in English from the University of Rochester and currently lives in Albany, New York.
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