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When Must I Apply For Medicare

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Why Enrollment Deadlines Matter

Medicare 101

Why do these deadlines matter? As mentioned above, you could be charged late enrollment penalties for enrolling after your initial enrollment period. Enrolling in Medicare on time ensures that you avoid paying the late enrollment fees, some of which last for as long as you have Medicare. Over time, penalty fees for signing up late could make this low-cost health insurance option less cost-effective for you, without any recourse.

Who Needs To Apply For Medicare

You may not need to sign up for Original Medicare, Part A and Part B, but you may have options about the type of Medicare coverage you receive.

To be eligible for Medicare, you must be either a U.S. citizen or a legal permanent resident of at least five continuous years. Generally, if youâre receiving Social Security or Railroad Retirement Board benefits, youâll be automatically enrolled in Medicare when you turn 65. If youâre under 65 and have been receiving disability benefits from Social Security or the RRB for two years, or if you have ALS , you also qualify for automatic enrollment.

If you donât qualify for automatic enrollment in Medicare, you need to apply when you become eligible. For details about whether you need to apply for Medicare, see Do I Need to Apply for Medicare?

How Do I Sign Up For Medicare

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Youll be automatically enrolled in Medicare at age 65 if youre already receiving Social Security. If you arent receiving those benefits, you can enroll in one of three ways:

The online application typically takes less than 10 minutes. The Social Security Administration has suspended face-to-face service in local offices due to the COVID-19 pandemic, so no in-person visits are possible at this time. It’s planning to reopen some offices later in 2022, but most Medicare enrollment is quick and easy online.

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Medicare Part B Enrollment Deadlines

Medicare Part B enrollment deadlines mimic those of Part A enrollment deadlines. Initial enrollment into Part B is automatic for the same people listed above in Part A. You have seven months to enroll in Part B if you dont qualify for automatic enrollment. However, there are a few differences when it comes to Medicare Part B.

First, Part B requires a premium, whereas most people dont have to pay a premium for Medicare Part A. Because of this, you may be tempted to forgo Part B coverage. You should note that if you cancel Part B coverage or decide against enrolling in it, then you may not be able to enroll in Part B until the general enrollment period. This runs from January 1 through March 31 each year.

Medicare Part B penalties are also different from Part A penalties. In essence, you get charged a 10 percent penalty fee for each full year that you lacked Medicare Part B coverage when you could have enrolled. For the following example, well return to Janice to see how much her premium would be if she failed to enroll in Medicare Part B on time.

Unfortunately, Janice will have to pay this late penalty fee indefinitely. Unlike the penalty fee for missing the Medicare Part A enrollment deadline, the penalty for missing the Part B deadline lasts for as long as you have Medicare Part B. As long as Janice keeps Medicare Part B, shell have to pay the higher premium.

When To Apply For Medicare

Peabody Council on Aging Resource Library: DID YOU GET YOUR NEW ...

Approaching Medicare? New to Medicare? Have questions? Youre not alone, approaching Medicare brings lots of questions such as: Do I need additional coverage? If so, when should I apply? Can I be turned down?

Just like planning a road trip it helps to have a plan. Medicare can be confusing. Lets start with the basics.

Stop #1 Enrolling into Medicare

Who is eligible for Medicare? You must be a US citizen or permanent alien resident.

Will I automatically be enrolled into Medicare?

Typically, Medicare starts the first of month that you turn 65. If you are collecting your Social Security benefits and are approaching your 65th birthday, you will automatically be enrolled into Medicare Part A and Medicare Part B.

If you are disabled and collecting Social Security disability benefits, Medicare will begin on your 25th month on SSDI.

If you have ALS, you will automatically be enrolled into Medicare.

What are some situations that I need to apply for Medicare?

  • If you arent collecting your Social Security benefits you need to contact the Social Security Administration 1-800-772-1213 to enroll into Medicare.
  • If you have ESRD and would like Medicare, you need to contract the Social Security Administration at 1-800-772-1213.

Original Medicare Enrollment Timelines:

Stop # 2 Applying for additional insurance

If you are under 65 and disabled, some states have guarantee issued rules for Medigap open enrollment.

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How To Qualify For Automatic Enrollment

Some people dont have to follow any of the above steps and are enrolled in Original Medicare automatically. If any of the following situations apply to you, youll automatically be enrolled in Original Medicare, and youll get your card in the mail:

  • If youre already receiving retirement benefits from Social Security or the Railroad Retirement Board , and youre approaching 65
  • If your employer benefits allow you to delay Medicare past 65, but you decide to draw retirement benefits through Social Security or the RRB
  • If you have a disability that qualifies you for Medicare, even if youre under 65

How To Enroll In Medicare And When You Should Start Your Research Process

Getting older means making more decisions, from planning for your kids futures to mapping out your retirement years. One of the most important decisions that youll make as you prepare to retire or head into your 60s is what to do about health insurance. If youve been working, then you probably have a plan through your employer. Most people do. But once you turn 65, you become eligible for Medicare, a government-backed program designed specifically for seniors. There are also other reasons that you might be eligible for Medicare, which can muddy the waters when youre researching your options for coverage.

Medicare is administered by the Centers for Medicare and Medicaid Services , but technically speaking, youll enroll via Social Security. In this article, well outline eligibility guidelines so that you can sign up with confidence, and as always, if you have any questions about how to sign up, or what plan might be best for your needs, were always available toll free to answer any questions you might have. Well also highlight the importance of enrolling on time to avoid penalties and delays in coverage. Heres what you need to know about eligibility and Medicare.

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Confirm Your Medicare Enrollment

You should also be aware that applying for Medicare for the first time is a two step process, Youll first need to submit an application online then open an email from SSA to confirm your enrollment.

Failure to could result in your application being incomplete and therefore not submitted, Norce says.

To submit an application for Medicare online, go to ssa.gov/benefits/medicare and select the blue button for Apply for Medicare Only about halfway down the page. This will take you to a secure page to begin your application.

Documents Needed If You Sign Up In Person

How to Enroll in Medicare Online (2020 Update)
  • An original or certified copy of your birth certificate or other proof of birth
  • Proof of United States citizenship or legal residency if not born in the U.S.
  • Your Social Security card if you are already receiving benefits
  • A copy of your most recent W-2 form and/or self-employment tax return
  • U.S. military discharge papers if you served before 1968
  • Health insurance information

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Get Started With Medicare

Medicare is health insurance for people 65 or older. Youre first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease , or ALS .

Follow these steps to learn about Medicare, how to sign up, and your coverage options. Learn about it at your own pace.

Sign Up: Within 8 Months After Your Family Member Stops Working

  • If you have Medicare due to a disability or ALS , youll already have Part A .
  • Youll pay a monthly premium for Part B , so you may want to wait to sign up for Part B.

Avoid the penalty & gap in coverageIf you miss this 8-month Special Enrollment Period, youll have to wait to sign up and go months without coverage. You might also pay a monthly penalty until you turn 65. The penalty goes up the longer you wait to sign up. How much is the Part B late enrollment penalty?

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Or Older And Still Working

If you are 65 or older, currently employed, and get health care coverage through your employer, you can wait to sign up for Medicare until you retire or your coverage with your employer expires. You have an 8-month window to sign up for Medicare in this scenario. This is considered a Special Enrollment Period.

Applying For Medicare Online

HICN Claims Reject for Medicare Starting January 2020

Applying for Medicare online is a quick and easy process on the Social Security website, taking approximately ten minutes. After you have applied for Medicare online, you can check the status of your application and/or appeal, request a replacement card, and print a benefit verification letter.

You can easily apply online for Medicare and Social Security retirement benefits or just Medicare.

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Ways To Apply For Disability Benefits:

  • If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

Once your disability benefits start, well mail you a welcome package with your Medicare card.

Sign up for Part B if you live in Puerto Rico or outside the U.S.You get Part A automatically. If you want Part B, you need to sign up for it. If you dont sign up for Part B within 3 months after your Part A starts, you might have to wait to sign up for Part B and pay a monthly late enrollment penalty.

Already Enrolled In Medicare

If you have Medicare, you can get information and services online. Find out how to .

If you are enrolled in Medicare Part A and you want to enroll in Part B, please complete form CMS-40B, Application for Enrollment in Medicare Part B . If you are applying for Medicare Part B due to a loss of employment or group health coverage, you will also need to complete form CMS-L564, Request for Employment Information.

You can use one of the following options to submit your enrollment request under the Special Enrollment Period:

  • Fax or mail your CMS-40B, CMS-L564, and secondary evidence to your local Social Security office .
  • Note: When completing the forms CMS-40B and CMS-L564

    • State I want Part B coverage to begin in the remarks section of the CMS-40B form or online application.
    • If possible, your employer should complete Section B.
    • If your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
      • Income tax form that shows health insurance premiums paid.
      • W-2s reflecting pre-tax medical contributions.
      • Pay stubs that reflect health insurance premium deductions.
      • Health insurance cards with a policy effective date.
      • Explanations of benefits paid by the GHP or LGHP.
      • Statements or receipts that reflect payment of health insurance premiums.

    Some people with limited resources and income may also be able to get .

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    Should I Sign Up For Medical Insurance

    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.

    Medicare Part A Enrollment Deadlines

    Link Medicare to myGov using a Medicare card

    Some people get enrolled in Medicare Part A automatically. If you meet one of the following conditions, you may be enrolled in Medicare Part A three months prior to your 65th birthday or during the 25th month of your disability, depending on circumstance:

    • You currently receive benefits from the Railroad Retirement Board or Social Security
    • You are younger than 65 and have a disability
    • You have been diagnosed with amyotrophic lateral sclerosis
    • You live in Puerto Rico and draw benefits from the Railroad Board or Social Security

    Those who meet the above qualifications wont need to worry about enrollment deadlines.

    If you are enrolled into Medicare Part A automatically due to health conditions or retirement status, you dont have to do anything. But if not, your ability to enroll in Medicare begins three months prior to your 65th birthday and ends three months after the month you turn 65. Essentially, you have a total of seven months to enroll in Medicare when you first become eligible.

    If you dont enroll during your Initial Enrollment Period , then you may be charged a penalty fee if you enroll later. Penalty fees are assessed for as many months as you lacked Medicare coverage this sum can add up over time. Numbers and dates tend to run together for some people. So, lets take a look at an example to give you an idea of the reality of Medicare Part A deadlines.

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    D: Prescription Drug Insurance

    Sign up for a Part D plan itself or with Medicare.

    You can sign up for a Part D plan as early as 3 months before your 65th birthday until the 3 months following the month of your birthday. The time between these dates is called your initial enrollment period.

    If you get Medicare because you have a disability, your initial enrollment period is between the 3 months before to the 3 months after your 25th month of disability.

    If you do not sign up for Part D during your initial enrollment period, you can only join during certain times of the year. Also, you may have to pay a penalty, a higher premium, if you delay your enrollment and you do not have other qualifying health insurance. These premium penalties will last as long as you are on Medicare.

    You can see some of the Part D options for your area using the Medicare Plan Finder at www.medicare.gov.

    Important

    If you decide not to get Part D and then later you change your mind, you may have to pay a penalty. Your premiums will be much higher. For every month you could have been getting Part D, your monthly premium will be 1% more.

    What If I Am Rejected

    If you are rejected for Medicare or Medicaid you can call your local Social Security office to learn more and confirm you provided the correct information.

    If you were denied because you did not provide the correct information then you need to reapply and give the correct document.

    If you were rejected because you were deemed not eligible you may have to wait until you become eligible. If you believe you are eligible, you need to request

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    When To Apply For Medicare Part A And Part B

    The Initial Enrollment Period is usually the first time you can apply for Medicare. There are a few special circumstances that might allow you to enroll earlier . But in general, people apply for Medicare within their seven-month IEP.

    Heres what the Initial Enrollment Period looks like:

    • Three full months before your 65th birthday month
    • The entire month in which you turn 65
    • Three full months after your birthday month

    If you miss your sign-up window for Medicare Part A and Part B during your Initial Enrollment Period, there is also a General Enrollment Period every year from January 1 to March 31. And if you defer your Part B coverage , there is a Special Enrollment Period.

    As a word of caution, if youre signing up for Medicare outside of your IEP, there are some pitfalls that are easily stepped into. You can read more about enrollment periods here.

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