How to enroll in Medicare
Step 1: Determine your Medicare eligibility
Enrolling in original Medicare Part A and Part B will vary according to your specific situation. One of the very first steps is to see if you are eligible for Medicare. If you can answer YES to any of the questions below, you may qualify for Medicare Parts A and B. In addition to the list below you must be a US resident for at least 5 years.
Are you currently 65 years of age or older?
Have you been receiving Social Security Disability Benefits for 24 months?
Currently have End Stage Renal Disease or Kidney Disease that requires dialysis or transplant?
Do you have Amyotrophic Lateral Sclerosis or what is commonly referred to as Lou Gehrig’s or ALS?
Assuming you are almost 65 years old and already receive retirement benefits, then you don’t have to do anything to enroll in Medicare. You’ll be automatically be enrolled in Medicare Part A and Part B the month you turn 65. You should receive your Medicare card in the mail three months prior to your birthday. If you want to delay Medicare Part B enrollment, you can follow the instructions that accompany your Medicare card. To opt out you call Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. If you’re a TTY user, call 1-877-486-2048.
If you are almost 65 years old and not yet receiving retirement benefits, you have the option of applying for both retirement and Medicare at the same time. You will not be automatically enrolled in Medicare. Beneficiaries can also choose to enroll in only Medicare even if you’re not yet ready to receive retirement benefits.
You may get Medicare automatically before 65 if you have amyotrophic lateral sclerosis. Medicare enrollment occurs after 24 months of disability benefits. For people with amyotrophic lateral sclerosis, enrollment happens in the first month of disability benefits.
Beneficiaries can also qualify for Medicare before 65. You can qualify if you have end-stage renal disease, need regular kidney dialysis, or have had a kidney transplant.
Step 2: Enroll in Medicare
If you’re almost 65, you can apply for Medicare Part A and/or Part B during your seven month Initial Enrollment Period. This will start three months prior to age 65. It includes the month you turn 65. This period will end three months later.
You can apply for Medicare in the following ways:
- Visiting ssa.gov.
- Calling Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. Social Security representatives are available Monday through Friday, from 7AM to 7PM.
- Visiting a Social Security office in person.
- Contacting the Railroad Retirement Board, if you worked at a railroad. You can call the Railroad Retirement Board at 1-877-772-5772, Monday through Friday, 9AM to 3:30PM. TTY users can call 1-312-751-4701.
If you didn’t sign up for Medicare Part A and Part B during your Initial Enrollment Period, you can sign up during the General Enrollment Period. This enrollment period takes place from January 1 to March 31 every year. You may have to pay a late enrollment penalty for Medicare Part A and/or Part B if you didn’t sign up when you were first eligible.
Assuming you have waited to enroll in Medicare Part A and/or Part B because you had other group coverage, you can always sign up during a Medicare Special Enrollment Period. You won’t have to pay a late penalty if you sign up during a Special Enrollment Period.
Step 3: Decide if you want additional Medicare coverage
Medicare Supplement (Medigap) plans are additional coverage you can purchase to “fill the gaps” in Original Medicare. Medigap plans can help with cost-sharing expenses. Some of these are co-insurance, copayments, and deductibles. These plans can also include benefits not covered by Original Medicare, like foreign travel coverage. Because Medigap is meant to supplement Original Medicare, you must be enrolled in Medicare Part A and Part B to join a Medigap plan.
Once you have enrolled in your Medicare Part A and Part B, you should also decide whether you want to add prescription drug coverage, also known as Medicare Part D. Original Medicare doesn’t include drug benefits, and out-of-pocket costs for medications can be very expensive without insurance.
You can get Medicare prescription drug coverage through a stand-alone Medicare prescription drug plan if you have Original Medicare. If you’re enrolled in Medicare Advantage (a private Medicare health plan), you can get this coverage through a Medicare Advantage Prescription Drug plan.
When researching Medicare Part D options, you should make a list of any drugs you currently use, including the name of each of the drug and dosages. Make sure that any plan you join covers all of the medications you take.
Keep in mind that there’s a Medicare Part D late enrollment penalty if you don’t sign up when you’re first eligible and don’t have creditable prescription drug coverage. If you do not when first eligible you will be assessed a 1% per month penalty for every month that you did not have a drug plan and were eligible to purchase one. Creditable prescription drug coverage is coverage that’s expected to pay, on average, as much as standard Medicare Part D benefits.
By Joe DeAngelis