When To Enroll In Medicare If I Am Receiving Disability Benefits
If you are under 65 and receiving certain disability benefits from Social Security or the Railroad Retirement Board, you will be automatically enrolled in Original Medicare, Part A and Part B, after 24 months of disability benefits. The exception to this is if you have end-stage renal disease . 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 , you will automatically be enrolled in Original Medicare in the same month that your disability benefits start
Common Questions About Applying For Medicare
What is Medicare?
Medicare is a national health insurance program that offers hospital and medical insurance through two different parts. Medicare Part A provides inpatient hospital coverage, hospice care, skilled nursing facility, home health care, and more. Part B provides outpatient services including doctor visits, surgeries, durable medical equipment, and more. Medicare does not cover 100% of the cost for these services.
When is open enrollment for Medicare?
Your open enrollment for Medicare itself is based on your birthday. Its a seven-month Medicare enrollment period window that begins 3 months before your 65th birthday month. Register for Medicare within this window to avoid penalties. Be sure not to confuse this enrollment period with the Annual Election Period in the fall.
When will I get my Original Medicare card?
In other words how long does it take to get your Medicare card after applying? In most cases, you will receive your Medicare card about 3 weeks after you apply. If you are already receiving Social Security benefits when you turn 65, your card will just show up in your mailbox about 2 months before you turn 65. When you receive it, be sure that you do not forget to enroll in Part D if you need drug coverage before your Initial Enrollment Period ends.
Do you have to apply for Medicare every year?
Medicare General Enrollment Period
If you dont sign up for Medicare Part A and/or Part B when youre eligible, you can apply for Medicare for the first time using the General Enrollment Period from Jan. 1 through March 31 every year. Coverage begins July 1.
This enrollment period is only available to people who didnt sign up during their Initial Enrollment Period and who arent eligible for a Special Enrollment Period.
Note: You may have to pay a higher premium for Part A and/or Part B due to late enrollment.
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Applying For Medicare When You Have Large Employer Coverage
Medicare can coordinate with your employer insurance even if you or your spouse are still working. If you or your spouse are actively working at an employer with 20+ employees and you are covered by that insurance, Medicare will be secondary to the employer coverage.
In that case, you can choose whether to enroll in Medicare Part B or delay your enrollment into Part B until later. Your group health plan likely has coverage for medical services already built in, so delaying Part B enrollment can save you money until you retire from your job.
When to apply for Medicare varies for each person. Whats worse is that even though these rules exist, there are often workers at Social Security who will get them wrong. This can really affect you, so contact a Medicare insurance broker like Boomer Benefits for help. We have solved Medicare enrollment issues for our clients with plain facts in many conference calls with Social Security.
Lastly, if you are still working at 65, well evaluate the costs of your employer coverage compared to Medicare. If staying at your employer insurance makes more sense, we can help you decide whether to enroll in Parts A or B or both.
Please note, you will qualify for a Special Enrollment Period after 65 and will need to submit documentation when you apply for Medicare due to loss of employer coverage. The two documents include CMS form 40B and CMS form L564 which is your proof that you had creditable coverage during employment.
Who Does Not Have To Apply For Medicare
If you already receive Social Security benefits or Railroad retirement benefits before turning age 65, youll be automatically enrolled in Medicare Parts A and B. You dont need to do anything or apply online.
Your red white and blue Medicare card will be mailed to you approximately 60-90 days before your effective date. Your Medicare card will have your name, Medicare Beneficiary Identifier number and coverage effective dates for Part A and Part B.
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When To Apply For Medicare
Medicare is separate from your application for Social Security income benefits. People age into Medicare at age 65, regardless of whether they are taking retirement income benefits yet. If you are a citizen age 65 or older and need medical insurance, you are entitled to enroll in Medicare. You can also qualify for Medicare early due to certain disabilities, having Amyotrophic Lateral Sclerosis , or End-Stage Renal disease and need a transplant or on dialysis.
Dont expect that Medicare will notify you of when its time to sign-up either. This can be especially important for those who live out of the country.
If you are already taking Social Security income benefits or Railroad Retirement Board benefits, you will be automatically enrolled in Medicare Parts A and B at age 65. Your card should arrive 1-2 months before you turn 65. This timeframe also applies to those who qualify early due to disability. However, you will not automatically receive Part B benefits if you live in Puerto Rico. This means you will need to apply for Part B even if you receive Social Security benefits before age 65.
If you are NOT yet taking retirement benefits, then you will need to submit a Medicare application yourself. The government expects for you to know when to enroll. Lets look at the timeline for when and how to register for Medicare.
Should I Take Medicare Part B
You should take Medicare Part A when you are eligible. However, some people may not want to apply for Medicare Part B when they become eligible.
You can delay enrollment in Medicare Part B without penalty if you fit one of the following categories.
Employer group health plans may cover items normally not covered by Medicare Part B. If so, and you meet one of the categories above or below, then you may not need to enroll in Medicare Part B and pay the monthly premium.
If you are:
- a spouse of an active worker
- a disabled, active worker
- a disabled spouse of an active worker
and choose coverage under the employer group health plan, you can refuse Medicare Part B during the automatic or initial enrollment period. You wait to sign up for Medicare Part B during the special enrollment period, an eight month period that begins the month the group health coverage ends or the month employment ends, whichever comes first.
You will not be enrolling late, so you will not have any penalty.
If you choose coverage under the employer group health plan and are still working, Medicare will be the “secondary payer,” which means the employer plan pays first.
If the employer group health plan does not pay all the patient’s expenses, Medicare may pay the entire balance, a portion, or nothing. An employer group health plan must be primary or nothing.
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It Pays To Enroll On Time
If you miss your initial enrollment window to sign up for Medicare, you can do so later on. But know this: For each 12-month period youre eligible for coverage but dont apply, youll risk a 10% surcharge on your Part B premiums.
If youre still working during your initial enrollment period and have group health coverage, youll get a special enrollment period to sign up for Medicare later on, and you wont have to worry about that penalty. But otherwise, enrolling on time can not only save you money, but ensure that you have coverage when you need it.
Maurie Backman has been writing professionally for well over a decade, and her coverage area runs the gamut from healthcare to personal finance to career advice. Much of her writing these days revolves around retirement and its various components and challenges, including healthcare, Medicare, Social Security, and money management.
Sign Up For A Mymedicaregov Account
After you sign up for Medicare, you can create a MyMedicare.gov account to manage your coverage.
With your MyMedicare.gov account, you can:
- Get details about the plans youre enrolled in and what they cover.
- Update your personal information.
Creating an account on MyMedicare.gov is quick and easy.
How to Sign Up for MyMedicare.gov
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Do I Need To Apply For Medicare
Many people are enrolled in Medicare automatically once they turn 65. If you are already getting Social Security benefits or benefits from the Railroad Retirement Board, in most cases youll be automatically enrolled in Original Medicare . Look for your Welcome to Medicare package in the mail about three months before your 65th birthday. Your package will include your Medicare card. It also contains information about Part B coverage, Medicare Part D Prescription Drug Plans, and Medicare Supplemental Insurance plans.
If you are under age 65 but get disability benefits from Social Security, you may also be automatically enrolled in Medicare Part A and Part B after you receive disability benefits for 24 months in a row. Youll receive a Welcome to Medicare package with your Medicare Card and instructions about your coverage about 3 months before your 25th month of disability benefits.
If you are 65 and not receiving Social Security or Railroad Retirement Board benefits, perhaps because youve continued to work and have health insurance through a union or your employer, youll need to sign up for your Medicare benefits. Usually Medicare will not mail you any information if youre not getting Social Security benefits, so youll need to take steps to apply on your own during your Initial Enrollment Period to avoid potential penalties.
Determine Whether You Need To Sign Up For Medicare
Some people are automatically enrolled in Medicare Part A hospital insurance and Medicare Part B medical insurance.
You are automatically enrolled in Medicare Part A and Part B if:
If you already collect Social Security retirement benefits, you are automatically enrolled in Medicare Part A and Part B. No further action is required.
Your coverage will begin the first day of the month you turn 65.
Even if you are automatically enrolled, you may also decide to:
- Sign up for a Medicare Part D drug plan.
- Buy a Medigap supplement insurance policy.
- Switch to a Medicare Advantage plan.
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How Do I Enroll In Medicare
Administration at 1-800-772-1213 to enroll in Medicare or to ask questions about whether you are eligible. You can also visit their web site at www.socialsecurity.gov.
The Medicare.gov Web site also has a tool to help you determine if you are eligibile for Medicare and when you can enroll. It is called the Medicare Eligibility Tool.
How Do I Apply For Medicare Extra Help
Medicare Extra Help is a program to help Medicare members with limited incomes pay the costs of Medicare Part D. Youll need to be enrolled in both original Medicare and Part D to apply.
You can apply for the Extra Help program using your My Social Security account. The Extra Help application can be completed online.
Youll need to provide some recent information about your income, such as:
- pay stubs
- Social Security or Railroad Retirement benefits statements
- investment account statements
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Be Aware Of Other Enrollment Periods
Most people sign up for Medicare during the seven-month initial enrollment period around their 65th birthday.
But what if you missed your initial enrollment period and want to make changes or add additional coverage?
There are specific times each year when you can do this.
Alternate Medicare Enrollment Periods
Do I Need An Application Form For Signing Up For Medicare Advantage
If youd like, you may be able enroll in Medicare Advantage as an alternative way to get your Original Medicare, Part A and Part B, benefits. Medicare Advantage plans are offered by private health insurance companies that contract with Medicare to deliver your Medicare Part A and Part B benefits with the exception of hospice care, which is still covered under Part A. Many Medicare Advantage plans include benefits beyond Part A and Part B coverage as well for example, some plans offer prescription drug coverage, routine vision care, and/or wellness programs.
There are several types of Medicare Advantage plans, although not every type of plan may be available where you live. Examples of plan types include Health Maintenance Organization plans, Preferred Provider Organization plans, Private Fee-for-Service plans, Special Needs Plans , and Medical Savings Account plans.
To qualify for a Medicare Advantage plan, you need to be enrolled in Medicare Part A and Part B live within the plans service area and, in many cases, not have end-stage renal disease . You can generally sign up for Medicare Advantage only during certain election periods.
You can compare Medicare Advantage plans available where you live just click Find Plans or Compare Plans on this page. Note that you need to continue paying your Medicare Part B premium, along with any premium the plan may charge.
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Documents You Need To Apply For Medicare
To begin the application process, youll need to ensure you have the following documentation to prove identity:
- A copy of your birth certificate
- Your drivers license or state I.D. card
- Proof of U.S. citizenship or proof of legal residency
You may need additional documents as well. Make sure to have on hand:
- Your Social Security card
- W-2 forms if still active in employment
- Military discharge documents if you previously served in the U.S. military before 1968
- Information about current health insurance types and coverage dates
If you are already enrolled in Part A and have chosen to delay enrollment in Part B, you will need to complete additional forms .
What Does Medicare Cover
Medicare helps pay for certain health care services and durable medical equipment. To have full Medicare coverage, Medicare beneficiaries must have Part A and Part B .
The following is a partial list of Medicare-covered services. The covered services listed below may require payment of deductibles and Co-Payments.
If you have questions about covered services, call Medicare at 1-800-633-4227.
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When Will You Get Your Medicare Card
Your Medicare card will arrive in your Welcome to Medicare packet. Once youve submitted your application, the packet will arrive about two weeks after youve been approved.12
If youre already receiving benefits from Social Security or the Railroad Retirement Board, expect the packet to arrive about three months before you turn 65.
Applying For Medicare As Your Primary Coverage
If Medicare will be your primary coverage, you should enroll in Medicare in the 3 months before your birth month. Your Medicare will start on the first of the month in which you turn 65. Enrolling prior to your birthday will ensure your benefits begin on the first of your birthday month.
If you register for Medicare in the 3 months after your 65th birthday, then your start date will be later. People unaware of this could end up with a few months of no health coverage. Its important to realize that your application date affects your start date.
Also, if you are leaving employer coverage in the middle of your Medicare Initial Enrollment Period, then your IEP trumps any other election period. Weve seen this a number of times where people assume their Medicare coverage will start immediately after the group coverage ends.
However, if you are in your IEP and your birth month has already passed, this chart demonstrates that you must wait for your coverage.
Its easy to see why applying for Medicare prior to your 65th birthday month is generally in your best interest. Although, it is ultimately your choice on when to apply.
Applying During the General Enrollment Period
Medicare Enrollment and Small Employer Coverage
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When Do I Have To Sign Up For Medicare
If youre collecting Social Security, youll automatically be enrolled in both Part A and Part B. If youre not receiving Social Security, then youll want to sign up manually during your Initial Enrollment Period.
Three months before your 65th birthday, your Initial Enrollment Period window will start. Your IEP is a once-in-a-lifetime enrollment window that you dont want to miss.
If you do happen to miss it, youll have another opportunity to enroll during another enrollment period. However, you could get a penalty for not signing up when you first become eligible. The only way around the penalty is if you have creditable coverage.
