Are you approaching age 65 and wondering how you can sign up for Medicare? This page discusses all you need to learn about enrollment for the different Medicare programs.
Medicare Automatic Enrollment
Enrollment into the Medicare program is automatic in some situations, as we have identified below:
Americans getting retirement benefits
Americans who are receiving Social Security benefits or Railroad Retirement Board retirement benefits are automatically enrolled into Medicare once they turn 65. However, the enrollment is only for Medicare Part A and Part B. For Part B, the beneficiary must have signed up for Medicare Part B alongside their retirement benefits. People living outside America will enjoy automatic enrollment for Medicare Part A but must enroll manually for Medicare Part B.
Americans getting disability benefits
Younger people who enjoy Social Security disability benefits are also enrolled in Original Medicare, Part A, and Part B automatically after 24 months of receiving such benefits. For people with Lou Gehrig’s disease or ALS, Medicare enrollment and coverage become active right from the first month of their disability check. People living with end-stage renal disease (ESRD) and who have undergone a kidney transplant or require regular kidney dialysis are eligible to apply for Medicare.
NB – A beneficiary who is automatically enrolled in Medicare Part B can drop the coverage if they so wish. All you have to do is send the Medicare coverage card back by following the instructions on the card. However, this is only possible if the coverage is not yet effective – if the coverage has started, kindly contact the Social Security office and request to be exempted.
Considering that Medicare enrollment is not a one-off process, beneficiaries may have to sign up for each part of the plan at different points after their eligibility. But not to worry, signing up for different parts of this United States federal government health insurance program is easy.
When can you enroll for Medicare?
For qualified potential beneficiaries who are not automatically enrolled, they are expected to enroll for Medicare before their 65th birthday.
Initial Enrollment Period
People who are new to Medicare can enroll in Parts A, B, and/or D within the Initial Enrollment Period. This enrollment period lasts seven months, starting from three months before their 65th birthday and ending three months after their birthday month.
The Initial Enrollment Period does not cover Medicare Part C – it has a different enrollment period, which is called the Initial Coverage Election Period. Similarly, the Medicare Advantage plan has a different enrollment period. People looking to enroll in a Medicare Advantage plan can only do so within three months before their Medicare Part B enrollment is due to start, until three months after their 65th birthday.
General Enrollment Period
People who failed to enroll during the Initial Enrollment Period get another enrollment window during the General Enrollment Period. This enrollment period starts from January 1 to March 31 every year. However, signing up during the General Enrollment Period may attract a late enrollment penalty.
Special Enrollment Period
Eligible beneficiaries may decide not to enroll in Medicare Part B due to their coverage by a group medical insurance (through a union or company). If such beneficiaries decide to switch from such group coverage to Medicare, they can sign up for Part B without exiting their current coverage.
For such beneficiaries, their Special Enrollment period starts either when their group health coverage ends or when their employment ends.
Enrolling for Medicare Advantage Plan
Enrollment in a Medicare Advantage Plan is usually through a private insurance company. The condition includes an existing Original Medicare, Part A, and Part B coverage. Every Medicare Advantage plan provides the same Medicare Part A and Part B benefits as Original Medicare. However, beneficiaries may get additional benefits like prescription drug coverage with certain private insurers.
When does your Medicare coverage start?
The coverage for each part of Medicare starts on a different date. The Part A coverage becomes active on the first day of the 65th birthday month. On the other hand, the Part B coverage starts on the first day of the 65th birthday month, provided the beneficiary has signed up within three months before their birthday or in their birthday month.
How can you enroll for Medicare?
If you are not automatically enrolled for Medicare, you can do so manually using one of the three mediums below:
- Physical enrollment at a local Social Security office.
- Online application via Social Security website.
- A phone call to Social Security at 1 (800) 772-1213
The easiest and fastest option is the online application; you can be done in about 10 minutes. For physical enrollment at the Social Security closest to you, kindly make an appointment in advance either by calling or the website.
Whichever option you decide to go for, we recommend that you pay attention to the specific enrollment deadlines for the Medicare plans you are joining. This is the best way to ensure that your benefits are properly arranged.
Are there penalties for late enrollment?
Yes, beneficiaries may pay penalties for Parts A, B, and D of Medicare if they fail to sign up at first eligibility. The exact penalty is estimated according to the duration of non-enrollment and non-payment of the Medicare base premium price. The penalties are then added to the monthly premium.
For Part A, the penalty for late enrollment is 10% higher premium, to be paid for 2x the number of years of non-enrollment.
For Part B, the penalty for late enrollment is a 10% higher premium, to be paid for every 12 months of non-enrollment after becoming eligible. This will continue for as long as the plan is active.
For Part D, the penalty for late enrollment is 30% of the base beneficiary premium, to be paid every 63 days of non-enrollment after becoming eligible. This will continue for as long as the plan is active.
Talk to the Experts
Do you qualify for Medicare but are not sure of how or where to start? Or do you want to know how best to approach your Medicare penalties? Feel free to reach out to us via phone or the contact us page. We will be happy to speak to you and help you get started with your Medicare enrollment process.