Medicare Application

Medicare is a federal health insurance program for people age 65 and older and younger people with certain disabilities and medical conditions. As you near 65 years old, applying for Medicare may be at the forefront of your mind. But while applying Medicare may seem complicated at first, it doesn’t have to be.

Woman on her phone while using her computer

Who is eligible?

The first step to applying for Medicare is to determine whether or not you are eligible. Generally speaking, if you are 65 or older, or if you are younger than 65 but have certain disabilities or medical conditions, you are eligible for Medicare.

Part A — Medicare Part A covers inpatient hospital care and other services, like skilled nursing care and hospice care. Most people who are eligible for Medicare Part A will not have to pay a monthly premium. In order to get premium-free Medicare Part A, you must have had Medicare taxes withheld from your paycheck for 10 years (40 quarters).

Part B —  Medicare Part B covers outpatient medical services, like doctor visits, tests and others. The only additional requirement for enrolling in Part B is that you must already be enrolled in Part A. Once you’ve enrolled in Part A, you can choose whether or not to sign up for Part B.

It’s important to note that everyone covered under Part B pays an annual premium. The Medicare Part B standard premium is $135.50 per month in 2019 (and higher for certain beneficiaries with higher incomes). Even though Part B is optional, if you do not sign up when you are first eligible, you could face higher premiums.

Part C — Medicare Advantage plans are an alternative to Part A and Part B coverage. You receive Part A and Part B benefits from a private health insurance plan instead of the federal government. Your plan may also include additional benefits not offered by Original Medicare, like prescription drug coverage, dental coverage and vision coverage.

Medicare Part C is offered through Medicare-approved private insurance companies. Premiums, deductibles, coinsurance and copayments vary by plan. 

Part D — Medicare Part D offers prescription drug coverage to Medicare beneficiaries. You can either get drug coverage through a Medicare Advantage plan (mentioned above) or through a private, standalone Part D Prescription Drug Plan (PDP) that can be used with Original Medicare and certain Medicare Advantage plans that don’t offer prescription drug coverage.

Standalone Part D plans are also offered through Medicare-approved private insurance companies, so the costs and benefits can vary by plan.

When can I enroll in Medicare?

Some people are automatically enrolled in Medicare Part A and Part B and will receive their Medicare card in the mail three months before their 65th birthday or on their 25th month of disability. You may be automatically enrolled for Medicare if:

  • You are already getting benefits from Social Security or the Railroad Retirement Board (RRB) — includes Puerto Rico
  • You are under 65 and have a disability
  • You have ALS (Amyotrophic Lateral Sclerosis or Lou Gehrig’s Disease)
  • You live in Puerto Rico and get benefits from Social Security or the RRB

If you aren’t automatically enrolled in Medicare, you’ll need to sign up for Part A and Part B during your Initial Enrollment Period. This may be because you:

  • Are not receiving Social Security or RRB benefits
  • You qualify for Medicare because you have End-Stage Renal Disease
  • You live in Puerto Rico and want to sign up for Part B

Your Initial Enrollment Period begins three months before your 65th birthday month, includes your birthday month, and extends for three months after for a total of seven months.

How do I sign up?

  • Part A and Part B — If you meet the automatic enrollment requirements, the Social Security Administration will send you paperwork and information a few months before you are eligible for Medicare. If you do not qualify for automatic enrollment, you’ll need to contact Social Security to apply.
  • Part C and Part D — If you are already enrolled in Part A and Part B or will be enrolling in them soon and you want to enroll in Part C and Part D, you’ll need to find an insurance carrier who offers plans in your area.

You can do so by calling TTY Users: 711 to speak with a licensed insurance agent.

Copyright © 2018 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.