Medicare Enrollment: How and When to Sign Up For Medicare

checkmark Fact checked Reviewed by: Leron Moore - Published: February 18, 2021

 

Your 65th birthday is a pivotal moment in most Americans’ lives. It marks the date when, after decades of working and paying into the Medicare system through taxes, the system finally starts paying you back with government health insurance.

What you should know:

  • 1 Medicare enrollment begins around 65 for most Americans.
  • 2 Most people qualify for premium-free Medicare Part A, which covers hospital care and other services.
  • 3 If you don’t qualify for automatic Medicare enrollment, you’ll need to sign up during your seven-month initial enrollment period.
  • 4 If you don’t sign up during your IEP, you can enroll during the annual open enrollment period which lasts from January 1 through March 31 of each year.

“Enrolling in Medicare is vitally important for all Americans, and it’s just as important to do it in the right way, at the right time,” says Bryan W. Adams, co-founder and CEO of Integrity Marketing Group. Given that healthcare expenses tend to rise as you age, “taking full advantage of the Medicare coverage and benefits you’ve earned can play a crucial role in protecting your health and savings.”

Most people qualify for premium-free Medicare Part A, which covers inpatient hospital care and temporary care at a skilled nursing facility following a hospital stay plus some home health and hospice care, if you or your spouse paid Medicare taxes for at least 10 years.

“If you have both Medicare parts A and B, you should consider a Medicare Advantage plan,” says Leron Moore, Medicare consultant. “Typically, a Medicare Advantage Plan will cover dental, vision, and hearing benefits.”

It pays to be on time with Medicare enrollment. If you sign up too late, you may get a penalty in the form of a higher monthly premium. Every 12 month period you could have had Part B but didn’t, your monthly premium could increase by 10%, unless you qualify for a Special Enrollment Period (SEP) by having creditable coverage, such as group health coverage through your current employer. You’ll have to keep paying this higher premium for as long as you have Medicare.

Here is what you need to know about how and when to sign up for Medicare.

When should I sign up for Medicare?

If you start receiving Social Security or Railroad Retirement Benefits (RRB) at least four months before your 65th birthday, you’ll be automatically enrolled in Medicare Part A and Part B when you turn 65. You should get your Medicare card in the mail three months before your 65th birthday. Your coverage will begin the first day of the month you turn 65 unless your birthday is the first day of the month, in which case coverage begins the month before you turn 65. Your Medicare premiums will be automatically deducted from your Social Security payments.

If you are not receiving Social Security or RRB at least four months before your 65th birthday, you’ll need to sign up for Medicare yourself. You should generally do this during your initial enrollment period (IEP) to avoid paying a penalty premium. Your IEP begins three months before the month you turn 65 and lasts for three months after your birthday month, giving you seven months total to enroll. For example, if your birthday is in September, your IEP will last from June 1 through December 31. Your Part A coverage can apply retroactively for up to six months before enrollment but not beyond the date you first became eligible for Medicare Part A.

“I would recommend enrolling as soon as possible, so you can start receiving benefits as soon as you’re eligible,” Adams says.

If you don’t sign up during your IEP, you can enroll during the annual open enrollment period which lasts from January 1 through March 31 of each year. Just be aware that when you enroll during general enrollment, your coverage doesn’t begin until July 1 of the year you enroll. You may also face higher premiums for Medicare Part B because of your late enrollment.

Enrollment can take place during the annual enrollment period if your IEP ends before AEP.

“Medicare Part B coverage is fully optional,” Adams says. Because you must pay a premium for Medicare Part B, you can turn down that part of your coverage. However, doing so could prove costly down the road.

“By not having Part B, you cannot enroll in a Medicare supplement or Medicare Advantage plan,” says John Norce, president of Medicare assistance firm MedicarePortal. “Thus, you are exposed to all claims that normally would be covered under Part B until your enrollment is active.”

Part B also cannot be backdated or retroactively enrolled “unless there is some crazy mitigating circumstance where the government made a mistake or you received bad information from the government,” Norce says.

Some people can delay Medicare coverage after they turn 65. If you have group health plan coverage through your current employer or your spouse’s employer, you may be able to delay enrollment without paying a late enrollment penalty when you do sign up.

People with certain disabilities or conditions may be able to sign up for Medicare before turning 65. You’ll be automatically enrolled in Medicare Parts A and B after you’ve received Social Security or RRB disability benefits for 24 months and should receive your Medicare card in the mail three months before the 25th month of your disability benefits.

Certain conditions can change Medicare eligibility and enrollment. If you have ALS, you are automatically enrolled in Medicare Part A and Part B starting the month you begin receiving disability benefits. Individuals with End-Stage Renal Disease (ESRD) who qualify for Part A can sign up before turning 65 as well. If you qualify for Part A due to ESRD, you can also get Part B. You’ll need both Parts A and B to cover some dialysis and kidney transplant services. You won’t be subject to the late enrollment period if you are approved for Medicare based on ESRD.

Whether you are automatically enrolled in Medicare Part A and Part B or sign up yourself, you can also decide to get a Medicare Advantage Plan (Part C) and Medicare drug coverage (Part D). You can sign up for Parts C and D during your IEP or the open enrollment period from October 15 to December 7 each year.

How do I sign up for Medicare?

If you aren’t automatically enrolled in Medicare Part A, you can sign up online at SSA.gov or your local Social Security office, if it’s open. The online application process takes 10 minutes and usually does not require any documentation or signatures. You’ll need to submit your date and place of birth, your Permanent Resident Card number if you are not a U.S. citizen, your Medicaid number and start and end dates and the start and end dates for your current health insurance through your or your spouse’s employer.

To enroll in Part B through a SEP, you can apply online or mail a completed Application for Enrollment in Medicare – Part B form (CMS 40B) along with a Request for Employment Information form (CMS L564) and any required proof of employment to your local Social Security office. You can also fax these forms to 1-833-914-2016. These forms are available on the Centers for Medicare & Medicaid Services website, cms.gov.

All Social Security Administration offices are closed due to COVID-19, but the Medicare hotline is still available to answer questions at 1-800-633-4227.

Once you sign up, you’ll have to choose what parts of Medicare coverage you want. “The cost and benefits of the coverage options available to you can vary significantly, so you’ll want to do a little homework ahead of time,” Adams says. “Making a list that includes your doctors and hospitals, prescription drugs and lifestyle and budget can help narrow down your options and find coverage that fits your needs.”

Bryan W. Adams, co-founder and CEO of Integrity Marketing Group

John Norce, president of Medicare assistance firm MedicarePortal