Don’t miss your Medicare enrollment deadlines. Here we discuss how and when you should sign up for a range of Medicare health insurance options.
You can enroll in Original Medicare (Medicare Part A and Part B) in one of several different ways:
- Enroll online on the Social Security website
- Call the Social Security Security office at 1-800-772-1213 (TTY: 1-800-0778) and speak to a representative during its regular hours of operation
- Visit your local Social Security office in person
If you worked for a railroad, you can enroll in Medicare by contacting the Railroad Retirement Board at 1-877-772-5772 (TTY: 1-312-751-4701) or in person at a local office.
You May Be Automatically Enrolled
Each year, some people are automatically enrolled in Original Medicare without having to sign up. Below is a list of the different situations in which you will be automatically enrolled in Medicare.
- If you have been receiving Social Security retirement benefits or retirement benefits from the Railroad Retirement Board for at least four months when you turn 65, you will be automatically enrolled in Medicare Part A and Part B. However, if you live outside of the 50 states or D.C. (such as Guam or Puerto Rico, for example), you will need to manually sign up for Medicare Part B. You will only be automatically enrolled in Medicare Part A.
- If you are receiving disability benefits from Social Security or the Railroad Retirement Board, you will be automatically enrolled in Medicare Part A and Part B after receiving benefits for 24 months.
- If you have amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), you will be automatically enrolled in Medicare as soon as your disability benefits begin.
You May Need to Sign Up
If you do not fall into any of the categories above, you will need to sign up for Medicare when you first become eligible. If you fail to do so and miss your initial enrollment period without an approved special circumstance, you could end up paying a late enrollment penalty for the rest of your time on Medicare.
Some situations in which you would need to sign up for one or both parts of Original Medicare include:
- You aren’t receiving retirement benefits from Social Security or the Railroad Retirement Board when you turn 65 — usually because you’re still working.
- You qualify for Medicare because of end-stage renal disease (ESRD). You can enroll in Medicare as early as the first month you receive dialysis, but you will need to sign up for both Medicare Part A and Part B on your own. You are not required to have Medicare if you have ESRD.
- If you opt out of Medicare Part B when you are first eligible because you still have group health coverage based on you or your spouse’s current employment, you will need to manually enroll when your current coverage ends.
When to Enroll in Medicare
Anyone not automatically enrolled in Medicare Part A and Part B should sign up during their initial enrollment period (IEP) to avoid paying a lifetime late enrollment penalty.
Your IEP is a seven-month period that includes the three months before you turn 65, the month of your birthday, and the three months after. The date your coverage will start depends on which month you sign up.
Any time after your IEP, you can sign up for Medicare during the yearly general enrollment period (GEP). This period runs from January 1 to March 31 of every year, but your coverage will not begin until July 1. Keep in mind you may have to pay a lifetime late penalty for each year (full 12 month period) after your IEP you wait to sign up for Medicare.
Late Enrollment and Special Enrollment Periods
It is possible that you can delay signing up for Medicare after your IEP without paying a late penalty if certain circumstances qualify you for a special enrollment period.
You may qualify for a special enrollment period if:
- You delayed your enrollment for Medicare Part B because you had health insurance based on your or your spouse’s current employment. When you or your spouse leave the job, you will be allowed to sign up for Medicare without penalty for eight months after your coverage ends.
*Keep in mind that Marketplace coverage, veterans benefits, COBRA insurance and TRICARE do not qualify as health coverage based on current employment. If you have any of these types of insurance, you should sign up for Medicare during your initial enrollment period to avoid a penalty.
Beyond Original Medicare
If you want coverage beyond Original Medicare (such as through Medicare Advantage, Medicare Part D or Medicare Supplement Insurance), you need to sign up for these options as well.
Medicare Advantage plans are an alternative to Original Medicare that offer all of Medicare’s benefits, as well as some additional benefits, through a private health insurance plan.
You can sign up for a Medicare Advantage plan at the same time as your initial enrollment period. If you sign up for your Medicare Advantage plan at this time, you can drop your plan at any point in the next 12 months and switch back to Original Medicare without penalty.
You can also enroll or disenroll in a Medicare Advantage plan during the annual election period (AEP). This period runs from Oct. 15 to Dec. 7 of each year.
Medicare Part D
You should sign up for Medicare Part D (prescription drug coverage) when you are first eligible for Medicare during your initial enrollment period. You can also qualify for a special enrollment period if you have a qualifying circumstance.
Medicare Supplement Insurance
Medicare Supplement Insurance (also known as Medigap), is insurance purchased from private insurance companies that helps cover some Medicare out-of-pocket costs, such as copayments, coinsurance and deductibles.
You should sign up for Medigap during your Medigap open enrollment period. This six-month period begins when you are 65 and enrolled in Medicare Part B. It is different from your Medicare initial enrollment period.
If you sign up for Medigap during this time, insurance companies cannot deny you coverage or charge you more for your premiums because of your health history. You can also switch your plan without penalty during this time.
Once this period has passed, insurers can use medical underwriting to determine whether or not to accept your application and how much to charge you. For your own protection, you should sign up for Medigap during your Medigap open enrollment period.
*Note: There are some special circumstances that would allow you to purchase a Medigap policy with guaranteed-issue rights.
Have more questions about Medigap? Learn more about enrolling Medicare Supplement Insurance with this helpful guide.