If you are turning 65, it’s important to know what you need to do to enroll in Medicare. For some people, enrollment is automatic while for others you may need to pro-actively reach out to Social Security to enroll.
Do I need to enroll in Medicare myself?
Whether you need to enroll in Medicare yourself depends on your situation and whether you are already receiving Social Security benefits.
- If you are turning 65 and have already been receiving Social Security or Railroad Retirement Board (RRB) benefits for at least 4 months prior to your 65th birthday, you will automatically be enrolled in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You should receive your red, white, and blue Medicare card in the mail 3 months before the month of your 65th birthday, and coverage will start the month of your birthday. Keep in mind if your birthday lands on the 1st of the month, coverage begins on the 1st of the month prior to your birth month.
- If you are under 65 and receiving disability benefits, you will be eligible for Medicare after receiving 24 months of disability benefits. You will automatically be enrolled in Medicare Part A and B and will receive your red, white, and blue Medicare card in the mail 3 months before your 25th month of disability. If you are eligible because you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease) you will automatically get Part A and Part B the month your disability benefits begin.
- If you are turning 65 and not already receiving benefits from Social Security or RRB for at least 4 months before your 65th birthday, you will not get Medicare automatically. you’ll need to proactively sign up with Social Security in order to get Medicare Part A and Part B.
- If you are under the age of 65, you will most likely be enrolled automatically unless you are eligible because you have ESRD (‘End-Stage Renal Disease’ or kidney failure). If this is the case, enrolling in Medicare is your choice. If you decide to enroll coverage typically starts the first day of the fourth month of your dialysis treatments.
When do I need to enroll?
If you need to proactively enroll in Medicare, you should do this during your Initial Enrollment Period which is the 7-month period that begins 3 months before the month of your 65th birthday.
It is important that you keep track of when your Initial Enrollment Period occurs. If you miss your Initial Enrollment Period you may incur Late Enrollment Penalties that could last for as long as you have Medicare when you subsequently enroll.
If you are working past 65, you may choose to delay your enrollment if you are eligible to delay penalty-free.
How do I sign up for Medicare?
If you need to pro-actively sign up for Medicare, you can sign up using one of these options:
- Apply online at Social Security. If you started your online application and have your re-entry number, you can go back to Social Security to finish your application.
- Visit your local Social Security office. Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
- If you worked for a railroad, call the RRB at 1-877-772-5772.
- If you already have Part A and want to sign up for Part B, complete an Application for Enrollment in Part B (CMS-40B). Get this form and instructions in Spanish.
What if I want to sign up for Part C (Medicare Advantage), Part D (Prescription Drug), or Medigap?
If you want to sign up for a Medicare Advantage (also known as Part C) plan, you can do so during your Initial Enrollment Period. However, you must already be enrolled in Part A and B before the private insurance carriers will accept you into a Medicare Advantage plan.
You can search for Medicare Advantage plans using Ascend’s guided tool.
If you prefer to stay on Original Medicare, you can also enroll in a standalone Part D prescription drug plan (PDP) during your Initial Enrollment Period. If you decide you would like a Medigap (also known as Medicare Supplement) policy, you may also sign up during your ‘Medicare Supplement Open Enrollment Period’, which is the 6-month period after you are enrolled in Part B. During this period, private insurance carriers who provide Medigap (i) must sell you a policy without medical questions, (ii) cannot deny you coverage, and (iii) cannot charge you an additional premium for coverage because of your medical history. This is called a ‘guaranteed issue’.
It’s important to sign up for Medicare when you are first eligible to avoid any penalties. Make sure you understand your obligations and whether you need to pro-actively enroll.