If you already receive Social Security benefits when you reach 65, you'll automatically get enrolled in Medicare. If you haven't started Social Security yet, but you're approaching your 65th birthday, now's the time to apply for Medicare.
You can apply online or over the phone, although you'll need to pay attention to specific enrollment deadlines and plan details to make sure you've gotten your benefits set up correctly. The following guidelines will help you figure out exactly when and how you should apply for Medicare regardless of the details of your specific situation.
If you qualify for Medicare and don't know where to start, eHealth Medicare, an independent insurance broker and partner of The Balance, has licensed insurance agents at <833-970-1256 TTY 711> who can help connect you with Medicare Advantage, Medicare Supplement Insurance, and Prescription Drug Part D plans.
What Do the Different Parts Cover?
Medicare Part A covers hospital stays, while Part B covers physician fees. Medicare Part C, called Medicare Advantage, offers options for extra coverage that may include vision, dental, and wellness care. Medicare Advantage plans cover at a minimum all that Medicare Part A and Part B cover. You can only apply for this if you're already enrolled in both Part A and Part B. Medicare Part D covers prescription medications.
When Should You Apply for Medicare?
In most cases, you should apply for Medicare when you turn 65. The initial enrollment period starts three months before the month you turn 65, includes your birth month, and extends three months past the month you turn 65, giving you a seven-month window. Your Part B coverage will likely be delayed if you enroll the month you turn 65 (or the three months following), so it is best practice to apply early to avoid a gap in your coverage.
Medicare imposes a hefty late enrollment penalty if you enroll in Part B or D after IEP, so make sure you enroll during your enrollment window. Medicare does not charge a late enrollment penalty for enrolling in a Medicare Advantage plan or Medicare Supplement plan after IEP. Here's how enrollment works depending on whether or not you already receive Social Security benefits.
If you already receive Social Security benefits:
If you already receive Social Security benefits or benefits from the Railroad Retirement system, then you will be automatically enrolled in Medicare (both part A and part B) starting the first day of the month you turn 65. You'll get your Medicare card in the mail about three months before your 65th birthday. It will get sent to the address on your Social Security records.
You will automatically receive a package which contains important information about the decisions you need to make. For example, although eligible, you do not have to enroll in Part B if you're covered under a non-Medicare insurance plan by your employer or a union. If you were supposed to but didn't sign up for Part B, you'll be subject to a 10% premium hike for each 12-month period that you skipped out on Part B coverage. Take the time to learn about Medicare Part B to determine if you should sign up.
You should also check out the Medicare Enrollment Booklet which contains clear, concise information about both Medicare Part A and B, and can help you decide if you should remain enrolled in Medicare Part B.
If you are not yet receiving Social Security benefits:
If you are not yet receiving Social Security benefits or benefits from the Railroad Retirement system, you are eligible to sign up for Medicare three months before the month you turn 65, but your enrollment will not happen automatically. You must call or apply online. It is to your benefit to sign up for Medicare Part A as soon as you are eligible, even if you still have coverage through a group health plan.
Although eligible, you may not have to enroll in Part B, which requires you to pay a monthly premium. Spend the time to learn about Medicare Part B to determine if you should sign up. If you don’t sign up initially, it may cost you more to sign up later.
How to Apply for Medicare
You can apply online or sign up by calling Social Security at 1-800-772-1213. If you're still working at 65, here's how it works.
If you are still working, age 65 or older, and covered by group health insurance:
When you turn 65, you should enroll in Medicare Part A even if you have health insurance from an employer. If you aren't sure, check with your benefits department. Your group health plan usually becomes secondary at this point, with Medicare paying first, then your group plan paying second. At 65, unless your benefits department specifically tells you otherwise, you should apply for Medicare Part A even if you are still working. If you have not applied for Medicare yet, do so as soon as possible.
For those who did not sign up at 65, Medicare has an open enrollment period each year from January 1 to March 31. If you apply for Medicare during this time, your benefits take effect July 1.
Once you are over 65, you'll have a Special Enrollment Period provided to allow you to add Medicare Part B whenever your group health plan benefits subside or go away. This situation may occur if you terminate employment after you reach 65. There is usually no late enrollment penalty if you sign up during the Special Enrollment Period.
If you have Medicare Part A, and now need to start Part B:
At 65, you may have signed up for Part A, but not Part B. This occurs most often with someone who is still working and has access to a group health plan. Once you retire, you'll need to add Part B within eight months of the earliest of either the end of your employment or end of your group health coverage. This enrollment option falls under one of the Special Enrollment Period offerings.
Medicare.gov. "Get Started With Medicare." Accessed Jan. 24, 2020.
Social Security Administration. "How to Apply Online for Just Medicare." Accessed Jan. 24, 2020.
Medicare.gov. "What Part A Covers." Accessed Jan. 24, 2020.
Medicare.gov. "What Part B Covers." Accessed Jan. 24, 2020.
U.S. Department of Health and Human Services. "What Is Medicare Part C?" Accessed Jan. 24, 2020.
Medicare.gov. "Understanding Medicare Advantage & Prescription Drug Plan Enrollment Periods," Page 1. Accessed Jan. 24, 2020.
Medicare.gov. "Part B Late Enrollment Penalty." Accessed Jan. 24, 2020.
Medicare.gov. "Your Medicare Card." Accessed Jan. 24, 2020.
Medicare.gov. "Enrolling in Medicare Part A & Part B," Pages 12-13. Accessed Jan. 24, 2020.
U.S. Railroad Retirement Board. "Medicare for Railroad Workers and Their Families." Accessed Jan. 24, 2020.
Medicare.gov. "Part B Costs." Accessed Jan. 24, 2020.
Medicare.gov. "Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 65," Page 2. Accessed Jan. 24, 2020.
Medicare.gov. "How Medicare Works With Other Insurance." Accessed Jan. 24, 2020.
Medicare.gov. "Part A & Part B Sign Up Periods." Accessed Jan. 24, 2020.