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Applying for Medicare

Applying for Medicare? What to Know When Signing Up for the First Time    

One assumption about Medicare enrollment is that you’re automatically enrolled once you reach age 65. However, that’s not always the case. Applying for Medicare is an essential first step towards obtaining the insurance coverage you need when approaching age 65 or if you have a qualifying disability.

In this article:     

Who Can Apply for Medicare?Jump to
Will I be Enrolled in Medicare Automatically?Jump to
When Do I Apply for Medicare?Jump to
How Do I Apply for Medicare?Jump to
Should I Apply for Medicare if I’m Still Working?Jump to
When Will My Medicare Card Arrive?Jump to
Do I Have to Enroll in Medicare Every Year?Jump to

Who Can Apply for Medicare?

Original Medicare, consisting of your hospital insurance (Medicare Part A) and your medical insurance (Medicare Part B), is available under a set number of circumstances.

Who is Eligible for Medicare?

  1. People approaching age 65 or older
  2. People under age 65 with a disability
  3. People with End-Stage Renal Disease (ESRD)

I’m about to turn 65

The most well-known way to become eligible for Medicare Is meeting the age requirement which is currently 65. The earliest you can enroll under normal circumstances is three months before the month of your 65th birthday, known as the start of your Initial Enrollment Period. We’ll get to that later.

I’m under 65 with a disability

You can also become eligible for Medicare before age 65 if you have a disability. A person under age 65 who is entitled to monthly Social Security or Railroad Retirement Board (RRB) benefits due to a disability is automatically eligible to enroll in Medicare Part A after receiving disability benefits for 24 months.

I have ALS

If you have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s disease, then you are entitled to Medicare Part A, the first month you are entitled to Social Security or RRB disability cash benefits.

I have ESRD

If you have End-Stage Renal Disease (ESRD), you are eligible for Medicare Part A if you meet a set of criteria. This list of criteria includes:

  1. Receiving regular dialysis treatment or a kidney transplant
  2. Have filed an application for Medicare
  3. Meets the requirements to receive Social Security or RRB benefits.

Will I be Enrolled in Medicare Automatically?

Some people get Medicare Part A and Part B automatically, and some have to sign up for it. This will depend on if, and when, you apply for retirement or disability benefits through Social Security or the Railroad Retirement Board (RRB).

If receiving Social Security or RRB benefits at least 4 months before being eligible for Medicare:
Your Social Security or RRB application also serves as your Medicare application. This means, you’ll be automatically enrolled in both premium-free Part A and Part B when applying for your retirement or disability benefits. That is, unless you live in Puerto Rico – in which you’ll only be enrolled in premium-free Part A.

When qualifying for automatic enrollment, you have the option to refuse or delay Part B. Depending on your situation, delaying Part B can result in late enrollment penalties.

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When Do I Apply for Medicare?

If you do not apply for your retirement or disability benefits through Social Security or RRB before turning 65, you may have to sign up for Medicare manually. This can only be done during certain enrollment periods.

These periods are triggered by specific life events or windows of time throughout the year. Below are the enrollment periods you should know about when applying for Medicare.

Initial Enrollment Period

Your Initial Enrollment Period lasts for seven months, starting three months before you turn age 65 and ends three months after your 65th birthday month.

The date your coverage starts depends on which of the seven months you sign up for coverage during your IEP. If you qualify for the premium-free Medicare Part A, your coverage begins the month you turn 65. Your Medicare Part B coverage starts based on when you signed up:

If you sign up:Part B coverage starts:
Before your 65th birthday monthThe month you turn 65
During your 65th birthday monthThe next month
The month after your birth month2 months after you sign up
2 or 3 months after turning 653 months after you sign up

Please note that your coverage always starts on the first of the month.

What to do if you miss your Medicare IEP?

Special Enrollment Periods

Many people decide to delay enrollment in Medicare because they are still working past 65 or are covered under a spouse’s insurance plan. In these cases, you’ll want to determine if you’ll qualify for a Special Enrollment Period (SEP) that will allow you to enroll later without penalties.

These SEPs are only available when specific events happen in your life, like if you lose employer-provided insurance coverage.

General Enrollment Period

The Medicare General Enrollment Period (GEP) happens annually from Jan. 1 to March 31. This period allows people who are eligible for Medicare to sign up for Medicare Part B (hospital insurance) if they missed their IEP or don’t qualify for a special enrollment period.
This period often gets confused with the Medicare Advantage Open Enrollment Period, which happens simultaneously. However, the Medicare Advantage OEP is available to those currently enrolled in Medicare Advantage (Medicare Part C) private insurance plan.

If you enroll during the GEP, your Medicare Part B coverage begins July 1. Keep in mind that you may have to pay a Part B late enrollment penalty in addition to your monthly Part B premium once your coverage starts.

How Do I Enroll in Medicare?

When the time comes to enroll in Medicare, you will need to contact the Social Security Administration to get started. There are three ways to enroll in Medicare: online, over the phone and in-person.

Online Medicare Enrollment

The easiest way to enroll in Medicare is online. Go to www.ssa.gov. Once on the Social Security website, go to the Medicare section and Apply Online.

Medicare Enrollment Over the Phone

If you’re not comfortable enrolling online, you also have the option of enrolling over the phone. Call the Social Security Administration’s toll-free phone number at 1-800-772-1213 (TTY 1-800-325-0778)

In-Person

You may also enroll in-person if you don’t wish to do it online or over the phone. Please note that hours and days of operation may vary, and you may be required to have an appointment. Locate your local Social Security Administration office here.

Should I Apply for Medicare if I’m Still Working?

If you’re still working after age 65, there are many factors to consider when deciding to enroll in Medicare or to hold off. How long you’ve worked, where you work and what type of insurance you currently have play a role in your decision.

It’s essential to understand what suits your lifestyle the best, and you may want to consider enrolling in Medicare even if you have a plan through your current employer. Read more about what you should consider before making your decision

When Do I Get My Medicare Card?

It usually takes about three weeks to get your Medicare card after you apply and are accepted. If you are considering adding a Medicare Supplement Insurance plan to your Original Medicare or switching to a Medicare Advantage Plan, then you can apply without your card in hand. You just need to know your Medicare number and your effective dates for Medicare Part A and Part B.

Do I Have to Enroll in Medicare Every Year?

Once you’re enrolled in Medicare, you don’t need to reapply every year. This is the case for anyone enrolled in Original Medicare, Medicare Advantage, Medicare Supplement Insurance or Medicare Prescription Drug Plans. As long as you continue paying your premiums, your Medicare coverage will renew.

Ensurem Trusted Expertise

Education is crucial in finding the right Medicare solution for you. With so many Medicare resources out there, it can be difficult finding a source you can trust. That’s why Ensurem has a Compliance Program dedicated to ensuring our Medicare content meets Centers for Medicare & Medicaid Services (CMS) regulations. So, you can rest assured you’re getting the information you need to make the right coverage decisions.

Learn More Here

Denise Austin, 65, Ensurem Ambassador

Best-Selling Author, Creator of Fit Over 50 Magazine

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