When Do You Have to Sign Up for Medicare?

• by Christian Worstell
• December 8, 2021

In most cases, individuals are eligible to receive Medicare when they turn 65 years old. However, some individuals may qualify for Medicare sooner if they have certain disabilities and End Stage Renal Disease.

No matter your situation, knowing when to sign up for Medicare is important, as failing to sign up on time could leave you with late enrollment penalties.

Below, we outline important dates and open enrollment periods to help ensure you are signed up for Medicare when you need to be.

When do I sign up for Original Medicare?

Depending on your circumstances, you will either be automatically enrolled or need to sign up manually for Original Medicare.

You’ll be enrolled in Part A and Part B automatically if:

• You’re already receiving Social Security or Railroad Retirement Benefits when you turn 65. You’ll be automatically enrolled in Part A and B, receive your Medicare card three months before your 65th birthday, and your coverage will start the first day of your birthday month.
  
  
• You’ve been receiving benefits from either Social Security or the Railroad Retirement Board (RRB) for a qualifying disability for at least 24 months. You’ll be automatically enrolled in Part A and B at the beginning of the 25th month.
  
  
• You have Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig’s disease). You will receive Medicare Part A and B automatically when your Social Security disability benefits begin.

You’ll need to sign up if:

• You’re turning 65 and not already receiving Social Security or railroad retirement benefits. If you worked for a railroad, contact the Railroad Retirement Board to sign up. Otherwise, you should contact the Social Security Administration three months before your 65th birthday.
  
  
• If you have End Stage Renal Disease (ESRD) and want Medicare, you will also need to sign up. Contact Social Security to find out how and when.

If you are manually signing up for Medicare, there is a 7-month Initial Enrollment Period (IEP) surrounding your birthday month during which you’ll have the opportunity to enroll. It begins three months before your 65th birthday, includes your birthday month, and ends three months following that.

Special Enrollment Period (SEP)

If you’re 65 or older, still working, and covered under a group health plan from your current employer (or your spouse is, and you are both covered under their insurance) — you may qualify for a Special Enrollment Period (SEP).

If so, you can sign up for Medicare Part B without having to wait for the GEP or pay a penalty for late enrollment. You can sign up while you are working, or you can wait until your group coverage ends.

If you wait until losing your group coverage, there is an 8-month enrollment window, following your retirement or coverage ending (whichever happens first).

There may be other circumstances that qualify your for special enrollment to sign up for or change your Medicare coverage.

General Enrollment Period (GEP)

If you didn’t sign up for Part A and/or B during your IEP, and you don’t qualify for special enrollment — you can sign up each year between January 1st and March 31.

However, your coverage won’t start until July 1st, and you may have to pay a higher premium if you wait too long.

For more information on restrictions and qualifications, contact the Centers for Medicare & Medicaid Services (CMS).

Enrolling in Medicare Part C and D

If you decide you want to enroll in Medicare Advantage (Part C) or a Medicare Prescription Drug Plan (Part D), you can do so when you first enroll in Original Medicare (Part A and Part B), or during certain times each year. 

Medicare Advantage is an alternative to Original Medicare coverage that allows you to receive the same benefits as Original Medicare through a private health insurance plan. Your Medicare Advantage plan may include additional benefits, like drug coverage, dental coverage, vision coverage and more.

Standalone Part D Prescription Drug Plans can be purchased and used alongside Original Medicare to help pay for the costs of your medications.

You can sign up for Medicare Advantage plan or a prescription drug plan during your IEP, SEP or GEP.

There is an annual Open Enrollment Period from October 15 - December 7 in which you can sign up for, or make changes to, your Medicare Advantage (Part C) or Prescription Drug Plan (Part D) coverage.

If you elect to change, your new coverage will begin on January 1 the following year.

Call a licensed insurance agent

There are a lot of Medicare enrollment dates to keep up with.

Call to speak with a licensed insurance agent who can help you review your eligibility and your Medicare Advantage plan enrollment options.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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