THE BASICS OF ENROLLING IN MEDICARE
How to get enrolled in Medicare
Some people will get Part A and Part B automatically
If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically get Part A and Part B starting the first day of the month you turn 65. (If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month.)
If you’re under 65 and disabled, you’ll automatically get Part A and Part B after you get disability benefits from Social Security for 24 months or certain disability benefits from the RRB for 24 months.
If you’re automatically enrolled, you’ll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability benefits. If you don’t need Part B, follow the instructions that come with the card, and send the card back. If you keep the card, you keep Part B and will pay Part B premiums. If you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease), you’ll get Part A and Part B automatically the month your disability benefits begin.
Some people have to sign up for Part A and/or Part B
If you’re close to 65, but not getting Social Security or Railroad Retirement Board (RRB) benefits and you want Part A and Part B, you’ll need to sign up. Contact Social Security 3 months before you turn 65. You can also apply for Part A (premium free) and Part B (for which you pay a monthly premium) at http://www.ssa.gov/pgm/medicare.htm
You can also call Social Security for more information on enrolling at 1-800-772-1213. If you worked for a railroad, contact the RRB at 1-877-5772.
When to sign up for Medicare if you are not automatically enrolled
Initial Enrollment Period
You can sign up for Part A and/or Part B during the 7-month period that begins 3 months before the month you turn 65, includes the month you turn 65, and ends 3 months after the month you turn 65. If you sign up for Part A and/or Part B during the first 3 months of your Initial Enrollment Period, in most cases, your coverage starts the first day of your birthday month. However, if your birthday is on the first day of the month, your coverage will start the first day of the prior month.
If you enroll in Part A and/or Part B the month you turn 65 or during the last 3 months of your Initial Enrollment Period, your start date could be delayed.
General Enrollment Period
If you didn’t sign up for Part A and/or Part B (for which you must pay premiums) when you were first eligible, you can sign up between January 1–March 31 each year. Your coverage will begin July 1. You may have to pay a higher Part A and/or Part B premium for late enrollment.
Special Enrollment Period
If you didn’t sign up for Part A and/or Part B when you were first eligible because you’re covered under a group health plan based on current employment (your own, a spouse’s, or a family member’s if you’re disabled), you can sign up for Part A and/or Part B:
- Anytime you’re still covered by the group health plan.
- During the 8-month period that begins the month after the employment ends or the coverage ends, whichever happens first.
Usually, you don’t pay a late enrollment penalty if you sign up during a Special Enrollment Period. This Special Enrollment Period doesn’t apply to people with End- Stage Renal Disease (ESRD). You may also qualify for a Special Enrollment Period if you’re a volunteer serving in a foreign country.
COBRA and retiree health plans aren’t considered coverage based on current employment. You’re not eligible for a Special Enrollment Period when that coverage ends. To avoid paying a higher premium, make sure you sign up for Medicare when you’re first eligible. See here for more information about COBRA.
To learn more details about enrollment periods, visit www.medicare.gov/publications to view the fact sheet “Understanding Medicare Enrollment Periods.” You can also call 1 800 MEDICARE (1 800 633 4227) to find out if a copy can be mailed to you. TTY users should call 1 877 486 2048.
When to enroll in Part B or Delay enrollment in Part B
It’s very important to pay attention to when you need to enroll in Part B and when you should choose to delay enrollment in part B.
Employer or union coverage
If you or your spouse (or family member if you’re disabled) is still working and you have health coverage through that employer or union, contact your employer or union benefits administrator to find out how your coverage works with Medicare. This includes federal or state employment, but not military service. It may be to your advantage to delay Part B enrollment.
You can sign up for Part B without penalty any time you have health coverage based on current employment.
COBRA and retiree health coverage don’t count as current employer coverage. See below for further information on how your other insurance will work with Medicare.
Once the employment ends, the following events come into play:
- You have 8 months to sign up for Part B without a penalty. This period will run whether or not you choose COBRA. If you choose COBRA, don’t wait until your COBRA ends to enroll in Part B. If you don’t enroll in Part B during the 8 months, you may have to pay a penalty. You won’t be able to enroll until the next General Enrollment Period and you’ll have to wait before your coverage begins.
- You may be able to get COBRA coverage, which continues your health insurance through the employer’s plan (in most cases for only 18 months) and probably at a higher cost to you. If you already have COBRA coverage when you enroll in Medicare, your COBRA will probably end. If you become eligible for COBRA coverage after you’re already enrolled in Medicare, you must be allowed to take the COBRA coverage. It will always be secondary to Medicare (unless you have End-Stage Renal Disease (ESRD).
- When you sign up for Part B, your Medigap Open Enrollment Period begins. (See more info below).
Medicare Supplement Insurance (Medigap) policies, sold by private insurance companies, help pay some of the health care costs that Medicare doesn’t cover. You have a one-time 6-month Medigap Open Enrollment Period which starts the first month you’re 65 and enrolled in Part B. This period gives you a guaranteed right to buy any Medigap policy sold in your state regardless of your health status. Once this period starts, it can’t be delayed or replaced. Visit the Medicare Supplement section of our website for more information on this subject.
End-Stage Renal Disease (ESRD)
If you have End-Stage Renal Disease (ESRD) you will need to sign up. Visit your local Social Security office, or call Social Security at 1 800 772 1213 to find out when and how to sign up for Part A and Part B. TTY users should call 1 800 325 0778. For more information, including when your Medicare coverage will end if you’re only eligible for Medicare because of permanent kidney failure, visit www.medicare.gov/publications to view the booklet “Medicare Coverage of Kidney Dialysis and Kidney Transplant Services.” You can also call 1-800-MEDICARE (1 800 633 4227) to find out if a copy can be mailed to you. TTY users should call 1 877 486 2048.
To sign up for Medicare or to get detailed information about signing up, contact Social Security via the web at http://www.ssa.gov/pgm/medicare.htm or call them at 1-800-772-1213.
If you worked for a railroad, contact the RRB at 1-877-5772.