Wednesday, June 15, 2022

Are You Automatically Enrolled In Medicare At 65

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How to Enroll in Medicare Part A and Part B | 2021 Instructions Included

With our online application, you can sign up for Medicare Part A and Part B . Because you must pay a premium for Part B coverage, you can turn it down.

If youre eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday.

If you choose not to enroll in Medicare Part B and then decide to do so later, your coverage could be delayed and you may have to pay a higher monthly premium for as long as you have Part B. Your monthly premium will go up 10 percent for each 12-month period you were eligible for Part B, but didnt sign up for it, unless you qualify for a “” .

If you dont enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a general enrollment period from January 1 through March 31. Your coverage begins on July 1 of the year you enroll. Read our publication for more information.

How Did You Automatically Get Enrolled In Medicare

President/CEO at Healthcare Solutions Direct, LLC, a nationwide insurance agency focused primarily on the retiree health market.

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Medicare is a unique type of health insurance because you do not always have to sign up to get it. Once you turn 65, you will become eligible. If you are already collecting social security benefits, you will automatically be enrolled into what is known as Original Medicare. There is nothing you need to do.

The coverage will begin on the first day of the month in which you turn 65 unless you were born on the first of the month. If that is the case, your coverage will begin on the first day of the previous month. You will get alerted to your coverage automatically in the mail by envelope with your Medicare card enclosed. It is mailed out around three months before your 65th birthday.

For many, Original Medicare is far from complete coverage. It is up to you to decide what changes or additions to your healthcare coverage are necessary. If you are still working, it is also up to you to decide whether you would like to continue using the health insurance offered through your employer or not.

With a decade of experience in the healthcare insurance space, I have talked to thousands of Medicare-eligible individuals. In order to make the best decision on what is right for you, you will need a lot of information. This includes an understanding of what each part within Medicare actually covers.

What Part Of Medicare Are You Automatically Enrolled In At 65

Medicare will enroll you in Part B automatically. Your Medicare card will be mailed to you about 3 months before your 65th birthday. If you’re not getting disability benefits and Medicare when you turn 65, you’ll need to call or visit your local Social Security office, or call Social Security at 1-800-772-1213.

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Should You Wait Until 65 To Sign Up For Medicare

If you wait to sign up right before your 65th birthday , you may go for months without coverage.

Initial Enrollment Period

Your Initial Enrollment Period will last for 7 months. This Initial Enrollment Period begins 3 months before the month of your 65th birthday and ends 3 months after your birthday month. If you fail to enroll before your birthday month, your coverage will be delayed by a month or more.

General Enrollment Period

Youll have the option to sign up during the General Enrollment Period which falls between January 1 and March 31 every year if you didnt sign up during the Initial Enrollment Period. But youll potentially be charged a late enrollment penalty. Your premiums for Part B will be permanently increased by 10% for each year that you neglected to sign up for Part B and your monthly premiums for Part A will temporarily increase by 10%. As a rule, most people dont pay premiums for Part A, but then again, most people dont delay signing up for Part A. Your coverage will start on July 1, three months after the General Enrollment Period ends.

You may be able to avoid the late enrollment penalty and having to wait for the General Enrollment Period if you qualify for a Special Enrollment Period.

Special Enrollment Period

Its important to check with your insurer or HR department to make sure that your coverage is sufficient to postpone Medicare enrollment.

Signing Up For Medicare

Your Clients May Not Be Automatically Enrolled in Medicare

Follow the steps below if you need to actively enroll in Medicare.

If you decide to enroll in Medicare during your Initial Enrollment Period, you can sign up for Parts A and/or B by:

  • Visiting your local Social Security office
  • Mailing a signed and dated letter to Social Security that includes your name, Social Security number, and the date you would like to be enrolled in Medicare
  • Or, by applying online at www.ssa.gov

If you are eligible for Railroad Retirement benefits, enroll in Medicare by calling the Railroad Retirement Board or contacting your local RRB field office.

Keep proof of when you tried to enroll in Medicare, to protect yourself from incurring a Part B premium penalty if your application is lost.

  • Take down the names of any representatives you speak to, along with the time and date of the conversation.
  • If you enroll through the mail, use certified mail and request a return receipt.
  • If you enroll at your local Social Security office, ask for a written receipt.
  • If you apply online, print out and save your confirmation page.
Related Answers

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How Do I Apply For Traditional Medicare

If youre not automatically enrolled in Medicare Part A and Part B, you need to sign up. You should enroll during your IEP, or a Special Enrollment Period if you qualify for one. As mentioned above, one example of a Special Enrollment Period might be if you delayed enrollment in Medicare Part A and/or Part B because you had employer coverage.

You typically sign up for Medicare through the Social Security Administration . You can go to the website at ssa.gov. Or, go in person to a Social Security office. You can reach the SSA at 1-800-772-1213 . Representatives are available Monday through Friday, from 7AM to 7PM, in all U.S. time zones.

Medicare Due To Disability

If you are receiving Social Security Disability, you will automatically be enrolled in Medicare Part A and Part B on the 25th month after Social Security benefits begin. This would be considered your initial Medicare eligibility to enroll in PHIP Medicare coverage. Aging in to Medicare later will not be considered an enrollment opportunity under PHIP.

If you are Medicare eligible due to end-stage renal disease or amyotrophic lateral sclerosis you will have the option to stay on your employer-sponsored retiree coverage during the first 30 months of your Medicare eligibility while Medicare is secondary to your employer plan. Upon Medicare becoming primary your medical plan choices may be limited under PHIP.

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Who Gets Automatically Enrolled In Medicare

A few different groups of people receive Medicare benefits automatically. When you are automatically enrolled in Medicare, you will receive your red, white, and blue Medicare card in the mail.

People who have been receiving benefits from Social Security or the Railroad Retirement Board at least four months before they turn 65 will automatically get Part A and Part B. Coverage for these people starts on the first day of the month they turn 65 or the first day of the month before for people whose birthdays are on the first day of the month. If these people live in Puerto Rico, they will only be automatically enrolled in Part A and will need to apply for enrollment in Part B. These people all receive their Medicare card in the mail three months before they turn 65.

People who have a disability and have received disability benefits from Social Security for 24 months or certain disability benefits from the Railroad Retirement Board for 24 months are automatically enrolled in Part A and Part B. They will receive their Medicare cards in the mail three months before their 25th month of receiving disability benefits.

People with Amyotrophic Lateral Sclerosis automatically receive Medicare Part A and Part B the month they first receive their disability benefits. They will receive their Medicare card in the mail this same month.

The Cost Equation: Will Medicare Save You Money

Do I have to Enroll in Medicare at 65?

If your employer requires you to pay a large portion of the premium on your group health insurance, you may find Medicare cheaper and the coverage adequate. So compare your current coverage and out-of-pocket expenses including premiums, deductibles, copays and coinsurance with your costs and benefits under Medicare, which may also pay some expenses not covered by your group plan.

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The Bottom Line: Know Your Options Enroll On Time

Dont delay making Medicare decisions and dealing with Medicare enrollment. Learn about the choices you have can you delay, must you enroll and then understand the implications of both as they relate to your overall health and financial well-being.

Late-enrollment penalties for Medicare Part B and Medicare Part D are permanent and can have a meaningful impact on your finances so think carefully about what you do and when.

Not sure where to start? A good first step for anyone approaching Medicare eligibility is to know when your enrollment dates are. You can quickly find your dates for your Initial Enrollment Period or Special Enrollment Period using our enrollment date calculator.

Medicare Eligibility At 65 And Older

You can apply for Medicare the year you turn 65, but you generally must meet three eligibility requirements to qualify for full Medicare benefits at this age.

The chief requirement is that you must be a U.S. citizen or permanent legal resident who has lived in the U.S. for at least five years.

In addition, you must meet one of the following other requirements:

  • You or your spouse must have worked long enough to also be eligible for Social Security benefits or for railroad retirement benefits. This usually means you have worked for at least 10 years. You must be eligible for these Social Security benefits even if you are not yet receiving them.
  • You or your spouse is either a government employee or retiree who did not pay into Social Security but did pay Medicare payroll taxes while working.

If you pay Medicare payroll taxes for 10 full years, you wont have to pay premiums for Medicare Part A, which covers hospital care.

You dont need the work credits to qualify for Medicare Part B, which covers doctor visits or outpatient services, and Medicare Part D, which covers prescription drugs. Everyone pays premiums for both regardless of work history.

If you are still working at 65, you dont have to sign up for Medicare but there are benefits to signing up while still employed. Similarly, if you have never worked, you can still get Medicare. It may be more expensive depending on your spouses work history.

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What Happens When You’re Automatically Enrolled In Medicare

Most Medicare beneficiaries who are automatically enrolled get their Part A and Part B benefits starting the first day they’re eligible. This is the:

  • First day of the month you turn 65 if you age into the Medicare program
  • First day of your 25th month of collecting disability benefits
  • Month your disability benefits begin if you have ALS

You will receive your red, white, and blue Medicare card in the mail 3 months before your Medicare eligibility month. For those who age into the program, this is 3 months before your 65th birthday. If you qualify due to a disability, your card should arrive during month 22 of your benefits.

The timeline is slightly different for those who are eligible due to ALS, since there isn’t the same waiting period as those who qualify due to a disability. If you have Lou Gehrig’s disease, you will receive your Medicare card the same month that your disability benefits begin.

How Does Auto Enrollment Work

Am I automatically enrolled in Medicare when Im 65?

Who is this for?

Most people are automatically enrolled in Original Medicare when they turn 65 and get Social Security benefits. There are also some other cases where you are automatically enrolled in Medicare. This page explains when you get coverage without having to do anything.

Many people who are turning 65 will be enrolled automatically in both parts of Original Medicare. Whether you are one of them depends on your situation.

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

  • If you are already getting benefits from Social Security or the Railroad Retirement Board
  • If you are younger than 65 and have a disability
  • If you have Lou Gehrigs disease, also called Amyotrophic Lateral Sclerosis, or ALS

You’ll be automatically enrolled in Part A:

  • If you live in Puerto Rico and get benefits from Social Security or the Railroad Retirement Board. You’ll have to apply for Part B.

You’ll be automatically enrolled in Part D prescription drug coverage:

  • If you get Extra Help because you qualify for Medicare and Medicaid

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Delaying Enrollment Could Result In A Permanent Penalty

As described above, you can’t reject premium-free Medicare Part A without also giving up your Social Security benefits. But since your work history is allowing you access to Medicare Part A without any premiums, few people consider rejecting Part A coverage.

The other parts of Medicare, however, do involve premiums that you have to pay in order to keep the coverage in force. That includes Medicare Part B and Part D , as well as supplemental Medigap plans. Medicare Part C, otherwise known as Medicare Advantage, wraps all of the coverage into one plan and includes premiums for Part B as well as the Medicare Advantage plan itself.

So it’s understandable that some Medicare-eligible people, who are healthy and not using much in the way of medical services, might not want to enroll in Part D and/or Part B. Similarly, people who are eligible for Part A but with premiums might want to avoid enrolling in order to save money on premiums. But before deciding to postpone enrollment in any part of Medicare, it’s important to understand the penalties and the enrollment limitations that will apply if you decide to enroll in the future.

There are penalties associated with delaying your Medicare enrollment unless the reason you’re delaying is that you are still working and you’re covered by the employer’s health plan. If that’s the case, you’ll be eligible for a special enrollment period to sign up for Medicare when you eventually retire.

Do You Have To Sign Up For Medicare If You Are Still Working

The most common reason for people not signing up for Medicare when they turn 65 is because they are still working. Because theyre still working, theyre likely covered under their employers health insurance plan and are also unlikely to be collecting Social Security retirement benefits.

Being covered under your employer-provided health insurance plan has no bearing on your Medicare eligibility. Medicare works in conjunction with several other types of health insurance including health insurance provided by employers or unions and wont prevent you from enrolling.

However, if you are not collecting Social Security retirement benefits at least four months before you turn 65, you will not be automatically enrolled in Medicare when you turn 65. In this case, you will have to manually sign up for Medicare when youre ready to enroll.

Many people choose to delay their Social Security retirement benefits until a later age when they can collect the full amount. If you choose to delay your retirement benefits, you must still sign up for Medicare manually once youre eligible in order to avoid any late enrollment penalties .

Some people who are still working sign up for Medicare anyway, because Medicare can work as extra insurance along with an employer group health insurance plan. Some people may decide that Medicare is more affordable than their employers insurance, so they may continue working but disenroll from their group plan and enroll in Medicare instead.

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When Your Coverage Starts

The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month.

If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

Part B : Coverage starts based on the month you sign up:

If you sign up:

1 month after you turn 65

2 months after you sign up

2 or 3 months after you turn 65

3 months after you sign up

What Day Of The Month Does Medicare Coverage Begin

Initial Medicare Enrollment

Your Medicare coverage generally starts on the first day of your birthday month. If your birthday falls on the first day of the month, your Medicare coverage starts the first day of the previous month. If you qualify for Medicare because of a disability or illness, in most cases your IEP is also seven months.

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What Are Cases When Medicare Automatically Starts

Medicare will automatically start when you turn 65 if youve received Social Security Benefits or Railroad Retirement Benefits for at least 4 months prior to your 65th birthday.

Youll automatically be enrolled in both Medicare Part A and Part B at 65 if you get benefit checks. According to the Social Security Administration, more than 30% of seniors claim Social Security benefits early.1 For those seniors, Medicare Part A and Part B will automatically start when they reach the age of 65.

When do You Get Your Medicare Card?

You can expect to receive your Medicare card in the mail three months before your birthday. Your Medicare card will come with a complete enrollment package that includes basic information about your coverage. Your card wont be usable until you turn 65, even though youll receive the card before that time.

What Are Your Costs?

Keep in mind that youll still have to pay the usual costs of Medicare, even though youre automatically enrolled. Once your Medicare is active, the cost of your Part B premium will be deducted from your Social Security or RRB benefits.

What If You Already Enrolled in Medicare?

What about Medicare Supplement ?

What If I Switch to Medicare Advantage?

And if you want to switch to Medicare Advantage , youll have a one-time Initial Enrollment Period for Medicare Advantage that begins 3 months before the month you turn 65 and lasts for 7 months.

What I Have Part A?

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