Fall Open Enrollment Isnt The Only Window
When you become eligible for Medicare, you have a seven-month initial enrollment period to sign up, which starts three months before your 65th birthday month and ends three months after. If you miss this window, you may face late enrollment penalties for Medicare Part B and Medicare Part D . According to the Social Security Administration, you should sign up for Medicare at age 65 even if youre not planning to retire yet.
If youre switching to a Medicare Advantage plan, you can do so during the Medicare open enrollment period, which runs every year from Oct. 15 to Dec. 7. Any new plans or changes you make during this period are effective starting Jan. 1.
There are also special enrollment periods for certain situations, like a significant change to your financial or medical circumstances. If youre currently on a Medicare Advantage plan and want to switch to Original Medicare, you can do so from Jan. 1 to March 31. If youre over 65 and still covered by an employer group health plan, Medicare allows you to sign up for Medicare Part B without penalty during a special enrollment period: the eight months after your job or coverage ends.
How To Enroll In Medicare
Enrolling in Medicare is easy once you understand how to do so. It’s important to know that how you enroll in Medicare Part A and Part B is different from how you enroll in Medicare Advantage , Part D or Medicare supplement insurance.
See the table below for a quick overview of how to enroll in a Medicare or Medigap plan and read on for how-to steps for both Original Medicare and the three kinds of Medicare and Medigap plans.
Original Medicare Medicare Advantage plan Medicare Prescription Drug plan Medicare Supplement Insurance plan How to Enroll
Enroll in Original Medicare online at the Social Security website or by calling or visiting your local Social Security office.
Enroll directly in the plan e.g., on the plans website or Medicare.gov .
Enroll directly in the plan e.g., on the plans website or Medicare.gov .
Enroll directly in the plan e.g., on the plans website
Original Medicare
How to Enroll
Enroll in Original Medicare online at the Social Security website or by calling or visiting your local Social Security office.
Medicare Advantage plan
How to Enroll
Enroll directly in the plan e.g., on the plans website or Medicare.gov .
Medicare Prescription Drug plan
How to Enroll
Enroll directly in the plan e.g., on the plans website or Medicare.gov .
Medicare Supplement Insurance plan
Enroll directly in the plan e.g., on the plans website
Primary And Secondary Payers
Your Medicare and private insurance benefits are coordinated, which means they work together. Typically, a primary payer will pay insurance claims first and a secondary payer will only kick in for costs not covered by the primary payer. The secondary payer may not pay all of the remaining uncovered costs, and you may be responsible for any additional balance.
In many instances, if you are age 65 and covered by either a retiree plan or a plan with fewer than 20 employees, then Medicare is your primary payer and private insurance is your secondary. If this is your situation, you should enroll in Part A and B, along with D if your private insurance plan doesnt have creditable prescription drug coverage.
If youre covered by a plan with 20 or more employees, Medicare is often the secondary payer. Medicare may pay costs that your employers plan doesnt.
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When To Sign Up For Medicare Part A And Part B
The size of the employer determines whether you may be able to delay Part A and Part B without having to pay a penalty if you enroll later. The employer has fewer than 20 employees. You should sign up for Part A and Part B when youre first eligible. In this case, Medicare pays before your other coverage.
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:
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Which Medicare Advantage Plan Is Best
It depends on your specific situation and needs. If you need guidance about which Medicare Advantage plan works best for you, please call us at TTY: 711 to speak with a licensed sales agent by phone or in person. We understand the challenges involved with choosing the right plan and are happy to help guide you through the process so youre confident in your choice!
Delaying Part B Coverage And Late Enrollment Penalties
You should enroll in Part A when youre first eligible near your 65th birthday, but some people may choose to delay Part B.
If you receive group health insurance at work or through your spouses employer you may be able to delay enrollment in Part B.
But once you stop working or that coverage ends, you must sign up for Part B within eight months. Otherwise, youll face a late enrollment penalty.
If you enroll in Part B after your group health insurance ends, you have options for how to apply.
You can do so online through an application on the Social Security website or by mail.
How to Sign Up for Part B by Mail After Employer Health Insurance Ends
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When To Sign Up For Medicare
In most cases, youre automatically enrolled in Original Medicare, Part A and Part B, if youre already receiving retirement benefits from the Social Security Administration or the Railroad Retirement Board before you turn 65. In this situation, your Medicare coverage will automatically start on the first day of the month that you turn 65. If your birthday falls on the first day of the month, youll be automatically enrolled in Medicare on the first day of the month before you turn 65.
Youll generally also be automatically enrolled in Medicare Part A and Part B if youre receiving disability benefits from Social Security or the Railroad Retirement Board for at least two years if you qualify for Medicare because of disability, youll be automatically enrolled in Medicare in the 25th month of disability benefits. If you get Medicare because you have amyotrophic lateral sclerosis , youll be automatically enrolled in Medicare in the first month that your disability benefits starts you dont need to wait two years in this case.
You can expect to get your Medicare card in the mail about three months before your 65th birthday or the 25th month of disability benefits if youre automatically enrolled.
If none of the above situations applies to you, youll need to manually sign up for Medicare. This includes:
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Who Is Eligible For Medicare
Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease . Medicare has two parts, Part A and Part B . You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
- You are receiving retirement benefits from Social Security or the Railroad Retirement Board.
- You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them.
- You or your spouse had Medicare-covered government employment.
To find out if you are eligible and your expected premium, go the Medicare.gov eligibility tool.
If you did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
- You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months.
- You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
I Turn 65 In A Few Months When Should I Sign Up For Medicare
En español | If you already receive Social Security benefits, Social Security will automatically sign you up for Medicare Part A and Part B though you can decline Part B enrollment if you want to. Otherwise, you need to apply for Medicare. The best time to do that depends entirely on your own situation. Broadly, there are two options:
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Enrolling Your Newborn Baby
You can enrol your newborn baby by using the Newborn Child Declaration. Youll get the declaration from the hospital. Find out how to enrol your baby.
If youve adopted a child or your child was born overseas, youll need to give us extra documents. Read more about what to do:
Is There A Penalty If I Dont Enroll In Medicare At Age 65
There may be, if you do not have group health coverage or creditable drug coverage/Extra Help in place when you become eligible for Medicare.
- Late enrollment penalty for Part A that you have to buy because you do not qualify for premium-free Part A: You pay up to 10% more for your monthly premium for twice the number of years you could have had Part A but didnt sign up.
- Late enrollment penalty for Part B: Your monthly premium may go up 10% for each 12-month period that you could have had Part B but didnt sign up. This late penalty will be in force for as long as you have Part B.
- Late enrollment penalty for Part D: The cost depends on how long you did not have creditable drug coverage. The penalty is calculated by multiplying 1% of the national base beneficiary premium by the number of full, uncovered months you didnt enroll in a Medicare drug plan or Medicare Advantage plan with drug coverage when you could have, and you went without creditable coverage. The final amount is rounded to the nearest $.10 and added to your monthly premium for as long as you have drug coverage through a Medicare health plan.
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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 employerâs 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.
Why Sign Up For Medicare Part D
Medicare Part D is optional you dont have to sign up for it. Part D is the prescription drug coverage part of Medicare. But you dont automatically get Part D, even if youre one of the many who get enrolled in Medicare Part A and Part B automatically.
Original Medicare, Part A and Part B, doesnt include prescription drug coverage, except in certain cases. Part A usually covers medications given as part of your treatment when youre a hospital inpatient. Part B may cover prescription drugs administered to you in an outpatient setting, such as a clinic. But when it comes to medications you take at home, Original Medicare doesnt cover them in most cases.
Theres another reason to think about signing up for Part D: if you dont sign up when youre first eligible for Medicare, you might have to pay a late enrollment penalty if you need medications at a later date and decide to sign up. Learn more about the Part D late enrollment penalty.
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How To Sign Up For Medicare
Some people are automatically enrolled in Original Medicare while others need to sign up on their own. In this guide, we explore the step-by-step process of enrolling in Medicare Part A and Part B as well as Part D drug plans, Medigap policies and Medicare Advantage plans.
On This Page
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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When Do I Get My Medicare Card
In most circumstances, youll get a Medicare I.D. card several weeks after your initial application. However, waiting times can be up to 90 days. If you are automatically enrolled in Medicare because you already get Social Security benefits, you will receive your I.D. card two months before turning 65.
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Do I Need To Notify Social Security When I Turn 65
This means that you may delay enrolling in Medicare Part B without having to wait for a general enrollment period and paying the penalty for late enrollment. There are limits, so we strongly advise you to contact Social Security up to three months before your 65th birthday if you are unsure of your situation.
What Is Medicare Advantage
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Medicare Advantage is also referred to as Medicare Part C or simply Part C.
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You cannot have a Medicare Advantage plan and Medicare Supplement insurance at the same time.
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Its an alternative way to get Medicare coverage through a private insurance company instead of directly through the federal government.
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If the Medicare Advantage plan you choose does not cover prescription drugs you can add a Medicare Part D plan which is specifically for prescription drug coverage.
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You must already be enrolled in Original Medicare to qualify for Medicare Advantage.
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