When Is My Medicare Initial Enrollment Period
For most people, enrolling in Medicare Part A is automatic. However, there are several instances where you may have to manually enroll in Medicare Part A and/or Part B during your Initial Enrollment Period , the seven-month period that begins three months before you turn 65, includes the month of your 65th birthday, and ends three months later.
Some situations where you would enroll in Medicare during your initial enrollment include:
Signing Up For A Medicare Part D Plan
Medicare Part D drug coverage is optional and available to anyone with Medicare Part A and Part B.
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In both cases, you must already be enrolled in Original Medicare.
You can explore and compare available Part D plans on the Medicare website.
You can also call your local State Health Insurance Assistance Program for free help.
Once you find a plan that meets your needs, there are a few ways to sign up.
Four Ways to Sign Up for a Part D Drug Plan
To sign up for a Medicare Part D plan, you will need your Medicare number and the date your Part A and Part B coverage started. You can find this information on your Medicare card or on MyMedicare.gov.
Other Information You Need to Provide
- Your primary mailing address
- Whether you had or have other drug coverage
- How you want to pay your premiums
Coverage usually begins the first day of the month after enrollment.
If you switch plans during the open enrollment period , your new coverage will start Jan. 1.
When Can You Sign Up Outside Of The Initial And General Enrollment Periods
You could qualify for a Special Enrollment Period and avoid the penalty for enrolling late. SEPs are typically granted if you or your spouse are still working when you turn 65 and you have group health insurance through an employer or union.
In that case, youre allowed to enroll in Part B at any time you have qualified group health coverage and youve turned 65. Once you no longer have coverage, you can enroll during the eight-month SEP period that starts the month after you lose the job or the coverage, whichever comes first.
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You Automatically Get Medicare When You Turn 65
- Well mail you a welcome package with your Medicare card 3 months before your Medicare coverage starts.
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 of turning 65, you might have to wait to sign up and pay a monthly late enrollment penalty.
When To Apply For Medicare Late Enrollment Penalties
Fact checked Reviewed by: Leron Moore, Medicare consultant –
If you do not sign up for a Medicare health insurance and drug plan when you become eligible to do so, you may have to pay late enrollment penalties for Medicare Parts A , B , and D , unless you have other health and drug coverage that meets Medicare standards. Read on to learn more about when to enroll in Medicare to avoid penalties.
What you should know
- 1Consider signing up for Medicare during your initial enrollment period to avoid late enrollment penalties.
- 2You may be able to delay Medicare enrollment if your current health insurance and drug coverage is sufficient, according to Medicare rules.
- 3Find out if you are eligible for a special enrollment period and sign up for Medicare before that period ends.
- 4It is to your benefit to understand and avoid late enrollment penalties because they can add on to your monthly premiums for as long as you have Medicare.
The key to avoiding late enrollment penalties is to make sure that you do not have a gap in coverage for your health insurance and prescription drugs. Medicare considers group insurance that you have through your employer or union to be sufficient coverage in lieu of health insurance you can get through Medicare. Once that coverage ends, you can enroll in Medicare without late penalty fees.
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A Funny Thing Happened As I Set Out To Write This Post
Weve done some posts recently about issues of concern to people turning 65. Some readers wonder whether they really need to sign up for Medicare during their Initial Enrollment Period you know, the one that gets underway three months before the month in which you turn 65 and ends three months after the month of your 65th birthday. I remember writing recently that Medicare enrollment is entirely voluntary whether youre 65 or 95. Yet I pointed out that for most people aged 65 it was advisable to enroll in Medicare during initial enrollment.
As I said then, enrolling in Medicare when youre first eligible means you wont be stuck with late enrollment penalties if you enroll in Medicare later. True, people who work past 65 generally qualify for Special Enrollment Periods when they stop working, and can avoid many of the late penalties generally associated with enrolling in Medicare after initial enrollmentbut many people learn the hard way about those Medicare late-enrollment penalties.
In the interest of fairness and balance, I thought it would be a good idea to write another post identifying a few instances in which it might be advisable for a 65-year-old not to enroll in Medicare. Well get to that funny thing that happened in a moment, but first here are the best reasons I could come up with for not enrolling in Medicare during initial enrollment.
Signing Up For A Medicare Advantage Plan
If you prefer to get your health coverage through a Medicare Advantage plan, you must first enroll in Original Medicare Part A and Part B and then switch to a separate Medicare Advantage plan.
All Medicare Advantage plans must offer the same Medicare Part A and Part B benefits as Original Medicare, but some plans include other benefits, such as prescription drug coverage, dental and vision.
Medicare Advantage Plans do not all offer the same benefits.
Use the Medicare Plan Finder or call your local SHIP representative to compare plans in your area.
Four Ways to Sign Up for a Medicare Advantage Plan
To join a Medicare Advantage plan, you will need your Medicare number and the date your Part A and Part B coverage began.
Free Medicare Help
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How Do I Sign Up For Medicare
If you already get Social Security benefits, well automatically enroll you in Medicare Hospital Insurance and Medical Insurance . Well mail you all the information you need a few months before you become eligible.Note: Residents of Puerto Rico or foreign countries wont automatically receive Part B. They must elect this benefit.If you dont get Social Security benefits and are not ready to apply for them yet, you should sign up for Medicare three months before your 65th birthday.The easiest way to apply for Medicare is by using our online application.If you dont wish to apply online, make an appointment by calling us at 1-800-772-1213 , 8:00 am 7:00 pm, Monday through Friday.Important Information about Medical Insurance CoverageBecause you must pay a premium for Part B coverage, you can turn it down. However, if you decide to sign up for Part B later, your coverage can be delayed and you may have to pay a late enrollment penalty for as long as you have Part B coverage. 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 special enrollment period.More Information
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Applying For Medicare Online
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.
Once you apply for Part B, give us a call so we can help you choose a supplement plan to cover what Medicare doesnt.
If youre not comfortable applying for Medicare online, you can do so over the phone.
Where Do I Go To Sign Up For Medicare
You can sign up for Medicare Part A and/or Part B in person at a Social Security office near you.
You can also enroll online at www.ssa.gov., or you can call Social Security at 1-800-772-1213 .
The Social Security Administration website features a Medicare section that allows you to perform a variety of tasks, including:
- Request a new Medicare cardNew Medicare cards were recently issued to all beneficiaries. You may request a replacement card if yours has been lost or stolen.
- Update your personal informationIf you moved to a new address or changed your name or telephone number, you may update your information online.
- Apply for MedicareYou may enroll in Medicare Part B online or sign up for Medicare Part A .
- Manage your benefitsUse the online portal to check on your applications and appeals, report your wages, check your earnings, set up direct deposit for your benefits payments and more.
The official U.S. government website for Medicare is Medicare.gov. Here you can do a number of things, including:
- Learn about your Medicare coverage options and when you can enroll
- Find out how to get prescription drug coverage
- Find ways to get help paying for Medicare
- File claims and appeals and check claim statuses
- Learn about your rights as a Medicare beneficiary
You may also create an account at MyMedicare.gov to monitor a claim status, view records and expenses and more.
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Medigap Open Enrollment Period
Your Medigap Open Enrollment Period is the six-month window that begins the first day of the month you turn 65 and are enrolled in Part B. For example, if you turn 65 and are enrolled in Part B in January, you can buy a Medigap policy between January and June. This enrollment window cant be changed or repeated.
During this open enrollment period, you can buy any Medigap policy sold in your state, even if you have health problems.
But after your open enrollment period, you may not be able to buy a Medigap policy depending on your health status and may be subject to a health review.
Your new coverage begins on the first day of the month after you sign up.
How Do I Sign Up For Medicare Part B If I Already Have Part A
If you are already enrolled in Medicare Part A and you would like to enroll in Part B under the Special Enrollment Period , you can apply online at Apply for Medicare Part B Online during a Special Enrollment Period. You can upload your application and documents that verify your group health plan coverage through your employer.
You can also fax or mail your completed CMS-40B, Application for Enrollment in Medicare Part B and the CMS-L564, Request for Employment Information enrollment forms and evidence of employment to your local Social Security office. If you have questions, please contact Social Security at 1-800-772-1213 .
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 your employer is unable to complete Section B, please complete that portion as best as you can on behalf of your employer without your employer’s signature.
- Also submit one of the following forms of secondary evidence:
- Income tax returns that show 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.
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I Want To Sign Up For Only Part A Or Both Part A & Part B
Once youre eligible to sign up for Medicare , you have 2 options:
Once you sign up , youll get a welcome package with your Medicare card.
When Do I Need To Sign Up For Medicare Part A
As stated above, if youre collecting Social Security benefits, youll automatically get Part A and Part B. If youre not automatically enrolled, the best time to enroll in Part A is during your Initial Enrollment Period.
As long as you worked a minimum of ten years, Part A will be premium-free. Even if youre still working, it makes sense to join Part A to help keep your out-of-pocket medical costs to a minimum.
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Make Your Decisions Independently
Collecting Social Security is by no means a prerequisite to getting Medicare. In fact, its often advisable to sign up for Medicare as soon as youre eligible but wait on Social Security to avoid a reduction in benefits, or boost them as much as possible.
The only downside to signing up for Medicare alone is having to make your premium payments directly, as opposed to having them deducted from your Social Security benefits, but its a small price to pay for the upside of a higher lifetime income stream.
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.
Medicare Advantage Open Enrollment Period
Medicare Advantage Open Enrollment happens every year from Jan. 1 to March 31. If youre enrolled in a Medicare Advantage plan and want to make changes, you can do one of these:
- Switch to a different Medicare Advantage plan with or without drug coverage
- Go back to Original Medicare and, if needed, also join a Medicare prescription drug plan
Your new coverage begins on the first day of the month following the month you make a change and will be in effect for the rest of the year.
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When Is My Initial Enrollment Period For Medicare Part D:
You can enroll in a stand-alone Medicare prescription drug plan during your Initial Enrollment Period for Part D. You are eligible for prescription drug coverage if:
- You live in a service area covered by the health plan, and
- You have Medicare Part A AND/OR Medicare Part B.
Generally, your Initial Enrollment Period for Part D will occur at the same time as your Initial Enrollment Period for Medicare Part B .
Once you are eligible for Medicare Part D, you must either enroll in a Medicare prescription drug plan, Medicare Advantage Prescription Drug plan, or have creditable prescription drug coverage. Some people may choose to delay Medicare Part D enrollment if they already have creditable prescription drug coverage through an employer group plan.
However, if you do not sign up for prescription drug coverage when you are first eligible for Part D, you may have to pay a late-enrollment penalty for signing up later if you go without creditable prescription drug coverage for 63 or more consecutive days.
Original Medicare And Medicare Advantage
Original Medicare, a government program, consists of the combination of Part A hospital insurance with Part B medical insurance.
However, if you sign up for Medicare Part A only, then you do not qualify for other helpful benefits through Medicare health plans, which require having Original Medicare.
A central choice that Medicare beneficiaries make lies between getting health insurance through the government Medicare program, or through a private plan that provides equal or greater coverage than the government program.
Without both Medicare Part A and Part B, a person cannot get any benefits from Part C: Medicare Advantage plans, or the added protection of Medigap.
Medicare Advantage plans can offer more benefits than Original Medicare while possibly costing less. These Part C can even build in the prescription coverage of Part D.
Comparison shopping will help subscribers compare Original Medicare to Medicare Advantage.
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