Medicare is our country's federally backed health insurance program for people aged 65 or older, and certain younger people with disabilities or permanent kidney failure.
Medicare assists with covering health care services. However, it does not cover all medical costs or the expenses of many long-term care. You can choose how you get Medicare coverage for yourself. If you opt for Original Medicare (Part A and Part B) coverage, you can purchase a Medicare Supplement Insurance (Medigap) plan from a private insurance company.
Most people often question how to sign up for Medicare? Signing up for Medicare can be quite complicated. That is probably because it has various parts, and you will have to keep yourself updated with plenty of deadlines and enrollment periods. Moreover, some people are automatically enrolled, while others are not. However, the good thing is that the process is pretty streamlined and easy to navigate through. In this article we will talk about how you can sign up for the various parts of Medicare and when you should start.
Table of Contents
- 1 How to sign up for Medicare?
- 2 How to sign up for Medicare Advantage?
- 3 How to enroll in Medicare Part D?
- 4 Do I have to sign up for Medicare?
- 4.1 When to enroll in Medicare if I am receiving retirement benefits:
- 4.2 When to enroll in Medicare if I am receiving disability benefits:
- 4.3 When to enroll in Medicare if I don’t want Medicare Part B:
- 4.4 When can I enroll in Medicare if I am not receiving retirement benefits?:
- 4.5 When can I enroll in Medicare if I do not qualify for retirement benefits?:
- 5 When should you apply for Medicare?
- 5.1 When Is the Earliest You Can Sign Up?
- 5.2 When Can You Sign Up If You Missed the Initial Enrollment Period?
- 5.3 When Can You Sign Up Outside of the Initial and General Enrollment Periods?
- 5.4 When Should You Apply for Medicare If You Have Employer Health Coverage?
- 5.5 What Other Times Can You Sign Up?
- 6 Medicare Open Enrollment
- 7 Conclusion
How to sign up for Medicare?
Prior to starting the process of signing up for Medicare parts A and B, you need to think of what kind of Medicare coverage you eventually need. The following steps will assist you prepare:
- Find out if you were enrolled automatically in either Part A or Part B of original Medicare.
- Choose if you want Part B coverage or if you would like to defer enrollment.
- Go over the Medicare Advantage plans in your region to see if those coverage options and expenses work better for you than Original Medicare.
- If you choose to stay with Original Medicare, consider your Part D options and if a Medigap plan would be useful to you.
The SSA will give you a list of Medicare applications that may be helpful. It highlights the types of forms you will require for the process, such as proof of military service, tax forms, and W-2s. Once you have gathered all the information you need for applying, you can start the process of signing up. You have several ways to sign up for original Medicare:
Start by opening a My Social Security account at socialsecurity.gov/myaccount, following their instructions. The procedure will require the confirmation of your identity. So you may need your:
- Date and place of birth.
- Email address.
- Medicaid number, if applicable, with start and end dates.
- Permanent Resident Card if you aren’t a U.S. citizen.
- Security number.
- Start and end dates for group health insurance through your (or your spouse’s) employer.
- Start and end dates of employment with the employer providing your group health plan.
- Valid U.S. mailing address.
- W-2 and tax forms.
When you have set up your account, you can begin the Medicare application process. It is unlikely that you will be required to sign anything physically. When you are finished applying online, you will get a confirmation number. Keep it safe and use it to keep track of the status of your application via your My Social Security account. Social Security will let you know if more information is required.
You can call (800) 772-1213 or TTY (800) 325-0778 between 7 a.m. and 7 p.m. from Monday through Friday. Remember that this process takes more time because forms have to be mailed to you. You can then complete them and send them back. At peak times, enrolling for Medicare through phone can take a month or more. If you are an employee at a railroad, you can enroll in Medicare by calling the Railroad Retirement Board at (877) 772-5772 or TTY (312) 751-4701, between 9 a.m. and 3:30 p.m, from Monday to Friday.
Begin by finding the Social Security office nearest to you. (You can do this by entering your ZIP code in the Social Security Office Locator). Keep in mind that every office does not offer appointments, but if yours does, you can make one by calling (800) 772-1213 or TTY (800) 325-0778. As soon as you get an appointment, processing your Medicare application should proceed quickly.
You can send a letter to your local SSA office with your name, your Social Security number, and the date you would like to enroll. They will send you the important information and any additional requests for enrolling.
How to sign up for Medicare Advantage?
Medicare Advantage, or Medicare Part C, is a private bundled health insurance plan. It offers similar coverage as parts A and B. It often gives prescription coverage as well. Some Medicare Advantage plans additionally cover vision, dental, and other healthcare benefits. This plan might put a yearly cap on your out-of-pocket costs. That can be useful in the event that you expect to have any huge healthcare costs.
However, a Medicare Advantage plan will be an extra expense on top of any premiums you pay for other Medicare parts. Numerous Medicare Advantage plans will cover a few or all of your Medicare Part B premium costs. Gauge your healthcare needs with the costs of coverage when choosing what parts of Medicare are best for you.
Assuming you need to sign up for Medicare Advantage, you can do that during your initial enrollment period. You can likewise change your selections during Medicare’s open enrollment period from October 15 till December 7. On the off chance that you join outside these times, you would have to pay a late-enrollment fee, and your coverage will not start until July 1.
You have two ways to sign up for Medicare Part C:
- Shop for Part C plans with Medicare.gov’s plan finder tool.
- With a private company. Insurance companies provide Part C plans, and you can directly sign up with them through their website or by phone.
How to enroll in Medicare Part D?
Enrollment in Medicare Part D is not automatic for any one. In the event that you opt for prescription drug coverage, you will need to choose and buy a Medicare Part D plan. Note that you can only get a Part D plan as an extra (add-on) to original Medicare (parts A and B). If you have Medicare Advantage (Part C), you are not qualified for a Part D plan.
You can sign up with Medicare Part D during your initial enrollment period, a 7-month window around your 65th birthday celebration. On the off chance that you do not sign up during that time, you will have the option to sign up later. However, you may need to suffer a late-enrollment penalty. You may likewise have the option to sign up during the open enrollment period, which is from October 15 through December 7.
You can enroll in Medicare Part D in several ways:
- By phone. You can call 800-633-4227 (or 877-486-2048 for TTY).
- Contact a private insurance company. You can also contact private insurers that provide Part D plans, through their website or by phone, and enroll directly with them.
- Use Medicare.gov’s plan finder tool to compare Part D plans available in your area.
Do I have to sign up for Medicare?
There are a few situations where Medicare enrollment may occur automatically:
When to enroll in Medicare if I am receiving retirement benefits:
In case you are currently getting Railroad Retirement Board or Social Security retirement benefits when you turn 65, you will automatically be signed up for Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) in the event that you enroll in Medicare Part B at the time you sign up for retirement benefits. In the event that you live outside of the 50 United States or D.C. (for instance, if you live in Puerto Rico), you will automatically be signed up for Medicare Part A, but would have to manually sign up for Medicare Part B.
When to enroll in Medicare if I am receiving disability benefits:
In case you are under 65 years old and getting certain disability benefits from Social Security or the Railroad Retirement Board, you will be automatically signed up for Original Medicare, Part A and Part B, following two years of receiving disability benefits. The exception to this is if you have end-stage renal disease (ESRD). If you have ESRD and had a kidney transplant or need regular kidney dialysis, you can apply for Medicare. If you have amyotrophic lateral sclerosis (otherwise called ALS or Lou Gehrig’s disease), you will be automatically selected for Original Medicare around the same time that your disability benefits start
When to enroll in Medicare if I don’t want Medicare Part B:
In case you are automatically enrolled in Medicare Part B, but do not wish to keep it, you have a couple of choices to drop the coverage. In the event that your Medicare coverage has not begun yet and you were sent a red, white, and blue Medicare card, you can follow the directions that accompany your card and send the card back. If you keep the Medicare card, you keep Part B and should pay Part B premiums. On the off chance that you signed up for Medicare through Social Security, you should get in touch with them to drop Part B coverage. If your Medicare coverage has begun and you need to drop Part B, contact Social Security for directions on the most proficient method to submit a signed request. Your coverage will end on the first day of the month after Social Security gets your request.
On the off chance that you have health coverage through your current employment (either through your work or your spouse’s employer), you might choose to defer Medicare Part B enrollment. You ought to talk with your employers’ health benefits administrator so you can understand how your present coverage functions with Medicare and what the results would be if you drop Medicare Part B.
When can I enroll in Medicare if I am not receiving retirement benefits?:
If you are not yet getting retirement benefits and are close to turning 65 years old, you can enroll in Medicare Part A and/or Part B during your initial enrollment period (IEP). If you decide to delay your Social Security retirement benefits or Railroad Retirement Benefits (RRB) past the age of 65, there is an option to sign up in only Medicare and apply for retirement benefits at a later time.
When can I enroll in Medicare if I do not qualify for retirement benefits?:
If you are not qualified for retirement benefits from Social Security or the RRB, you will not be automatically signed up into Original Medicare. Nevertheless, you can still enroll in Medicare Part A and/or Part B during your initial enrollment period (IEP). You might not be able to get premium-free Medicare Part A, and the expense of your monthly Part A premium will be based on how long you worked and paid Medicare taxes. You will still have to pay a Medicare Part B premium.
When should you apply for Medicare?
If you are planning to sign up in Medicare, you will need to know many enrollment deadlines and dates:
- Initial enrollment period. This is a 7-month long time frame around your 65th birthday during which you can enroll in Medicare. It starts 3 months before your birthday, includes your birthday month, and ends 3 months after your birthday. During this time, you can sign up for all parts of Medicare without a penalty.
- Open enrollment period. Medicare’s open enrollment goes on from October 15 to December 7. During this time period, you can change from original Medicare to Part C, or from Part C back to original Medicare. You can also switch Part C plans or add, remove, or change a Part D plan.
- General enrollment period. This enrollment period runs annually from January 1 to March 31. You can sign up for Medicare in this time period if you did not sign up during your initial enrollment period.
- Special enrollment period. If you delayed Medicare enrollment because you were getting private health insurance from an employer, you can later sign up for Medicare during a special enrollment period. You have 8 months from the end of your coverage or the end of your employment during which to sign up without penalty.
Medicare Advantage also has a different open enrollment period that starts from January 1 and ends on March 31 each year. During this time period, you can change from one Part C plan to another or go back to Original Medicare. However, you cannot go from Original Medicare to Part C during this time. Your healthcare requirements may change as you age, so make sure that your Medicare coverage has enough flexibility to change with you.
When Is the Earliest You Can Sign Up?
You are first qualified for Medicare beginning three months before you turn 65. That starts off what is known as your Initial Enrollment Period. (You can concede enrollment penalty-free on the off chance that you have health coverage provided by your employer) The Initial Enrollment Period covers seven months: the three months before your 65th birth month, your 65th birthday month and the three months following your 65th birth month. For instance, suppose your birthday is somewhere in May. The three months before are February, March and April, and the three months following are June, July and August.
Remember that the date you apply for Medicare will influence the starting date of your coverage. To get Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) starting on the first day of the month you turn 65, you should enroll during the three months before your 65th birth month. In the event that you wait before enrolling during your birth month or the following three months, your starting date will be delayed by one, two or three months. In the event that your birthday is on the first day of your birth month, Part A and Part B will begin on the first day of the previous month. In this way, if, say, your birthday is September 1, your advantages will start on August 1.
When Can You Sign Up If You Missed the Initial Enrollment Period?
In the event that you did not join when you were first qualified and you do not have current healthcare coverage anywhere else (likewise with your employer), you will need to wait for the following General Enrollment Period which runs every year from January 1 through to March 31. Your coverage will then start in July of that year, and you might need to pay a late enrollment penalty on your Medicare Part B premium for as long as you have Part B coverage. Your premium will go up by 10% for each 12-month period you were not enrolled.
When Can You Sign Up Outside of the Initial and General Enrollment Periods?
You could meet all requirements for a Special Enrollment Period (SEP) and stay away from the penalty for enrolling late. SEPs are regularly allowed on the off chance that you or your spouse are still working when you turn 65 and you have group health insurance through an employer or union. All things considered, you are permitted to sign up in Part B whenever you have qualified group health coverage and you have turned 65. When you no longer have coverage, you can enroll during the eight-month SEP period that begins in the month after you lose the job or the coverage, whichever comes first.
When Should You Apply for Medicare If You Have Employer Health Coverage?
The vast majority should pursue Medicare Part A when they’re first qualified on the grounds that it will hardly cost you a penny. Be that as it may, a few groups delay signing up for Part B since they would prefer not to pay the month to month premium. The choice generally relies upon the kind of health coverage you already have.
Furthermore, you can put off enrolling for Part B at the age of 65 in the event that you have group health coverage through your or your life partner’s work place and the organization has at least 20 employees. In addition to this, you’ll have the option to enroll with no punishment during the Special Enrollment Period that follows the end of your boss’ insurance. You can likewise decide to sign up for Part B while still having coverage and pay the premium. On the off chance that your workplace has less than 20 employees, you ought to apply for Part A and Part B when you’re qualified.
In addition to this, ensure that you contact your employer’s benefits administration about what pursuing Medicare will mean for your coverage or Health Savings Account (HSA). You can’t add to an HSA in the event that you have Medicare Part A. Moreover, your chairman can assist you with timing the start and end of your coverage through work and your new health insurance so there’s no gap in your coverage. At the point when your group coverage is finishing, you’ll need to finish documentation and submit it to your Social Security office. In the event that you have questions, ask Social Security.
What Other Times Can You Sign Up?
You may likewise become qualified for Medicare for different reasons. In case you are qualified because of a disability, you qualify after you have gotten Social Security disability or certain Railroad Retirement Board disability benefits for two years. On the off chance that you have end-stage renal disease (ESRD), you are qualified in the fourth month of dialysis treatment, potentially earlier. And if you have ALS, you qualify that very month your handicap benefits start.
Medicare Open Enrollment
Your initial Medicare enrollment window takes place when you turn 65 years old or are qualified for Medicare through a disability. However, that is not your only chance to choose your coverage. You can use the Medicare open enrollment window to make changes to your Medicare plan. Each year during open enrollment, you can change your coverage. This includes:
- enrolling in Medicare Advantage
- enrolling in a Medicare Part D plan
- switching back to original Medicare from Medicare Advantage
Open enrollment is an excellent time to evaluate your Medicare coverage and make sure it is still the best option for your requirements. It runs from October 15 through December 7 annually.
The changes you make during open enrollment will start on January 1 of the following year. So, if you used open enrollment to choose a new Medicare Advantage plan on November 12, 2020, your new coverage would start on January 1, 2021.
What can you do during open enrollment?
During the open enrollment period, you can:
- change from a Medicare Advantage plan back to original Medicare
- change from Original Medicare (Part A and Part B) to a Medicare Advantage (Part C) plan
- join, switch, or drop a Part D prescription drug plan
- switch from a Medicare Advantage plan that does not include prescription drug coverage to one that does
- switch from a Medicare Advantage plan that includes prescription drug coverage to one that does not
- switch from one Medicare Advantage plan to another
What can’t you do during open enrollment?
Nevertheless, not all plan changes can be made during this time. The main thing you may not be able to do is purchase a Medigap plan. There are only specific times when you can add a Medigap policy to your plan. The enrollment periods for Medigap are:
- Initial enrollment period. You are qualified to apply for a Medicare plan, and add a Medigap policy during the 3 months before, 3 months after, and month of your 65th birthday.
- Open enrollment period. If you miss initial enrollment, you can sign up for a policy during the Medigap open enrollment period. If you have already turned 65, this period starts when you enroll in Part B. If you are turning 65, this period runs until 6 months after you turn 65 years old and have enrolled in Part B. During this enrollment period, you are guaranteed to be accepted by a Medigap plan and to get a good rate.
You may be able to buy Medigap plans outside of these windows. However, you will not have the same guarantees. Insurance organizations are not required to sell you a Medigap policy, especially if you are under age 65. Moreover, after your enrollment window, Medigap plans can deny your application or charge you a much higher rate.
Enrolling for Medicare is an essential step as you come close to your 65th birthday. It is also one that can be filled with questions — but you do not have to sign up alone. Both the CMS and the SSA can be valuable resources during your enrollment period. They can assist you in making the correct choices given your circumstance.