You might think that “When can I sign up for Medicare?” would be a simple question. Many people may think that you can sign up for Medicare as soon as you are age 65. Alas, that’s not always the case.
This is because Medicare has a few different rules for eligibility other than simply turning 65.
If you are interested in purchasing a private Medicare Advantage (Medicare Part C) plan or a Medicare Supplement Insurance (Medigap) plan, there are other eligibility requirements and enrollment periods that may affect when you can enroll in a plan.
Some people are automatically enrolled in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance, which is optional) when they turn 65.
You should be automatically enrolled in both if you are already receiving Social Security or Railroad Retirement Board retirement benefits when you turn 65.
If you are not automatically enrolled, you may be able to sign up for Part A and/or Part B during certain Medicare enrollment periods.
Part B of Medicare is voluntary. Depending on the other health insurance coverage you have, you may want to consider enrolling in Part B.
If you do not enroll in Part B when you’re first eligible – and if you do not have creditable coverage – you will typically incur a 10 percent late enrollment penalty for each twelve months you were eligible for Part B but did not enroll.
The Part B late enrollment penalty is added to your Part B monthly premiums for the rest of the time that you remain enrolled in Part B.
Medicare Supplement plans, also called Medigap plans, are sold by private insurance companies.
If you enroll in a Medigap plan during your Medigap Open Enrollment Period, Medicare Supplement Insurance companies cannot charge you higher premiums or deny you a policy based on your health.
Your Medigap Open Enrollment Period lasts for six months and starts as soon as you are at least 65 years old and enrolled in Medicare Part B.
If you do not enroll during the six months when you are first eligible, you may apply at any time of the year.
If it is outside of your six-month Medigap Open Enrollment Period, however, the insurer may ask you health questions and adjust your premiums to reflect any increased risk. They can also deny you a plan completely.
You can enroll in a Medicare Advantage plan during your Initial Enrollment Period. Once that passes, there is one period each year that allows you to review your coverage and make changes as needed.
The Medicare Annual Election Period (AEP) runs from October 15 to December 7 of each calendar year.
During this period, you can:
There may be other special circumstances that allow you to make changes to your Medicare Advantage plan outside of AEP.
If you do not enroll in a Part D plan during your seven-month Medicare Initial Enrollment Period and decide to enroll later on, you will likely have to wait until the next Annual Election Period, which runs from October 15 to December 7 of each calendar year.
If you didn’t sign up for Part D coverage when you first became eligible (and if you didn’t have other creditable drug coverage), then you will likely have to pay a Part D late enrollment penalty.
The penalty can vary based on how long you didn’t have Part D or creditable drug coverage, and your penalty amount could increase each year.
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Charles MacKay is the author of two health care books, including Medicare Made Easy. He has written over 300 academic papers, including many dealing with healthcare. He now lives in Pennsylvania.