Apply for Medicare

Applying for Medicare can feel intimidating, but your Medicare enrollment will be easier than you might think. We walk thousands of people through how to sign-up for Medicare every year, so read on for everything you need to know to apply for Medicare.

The Social Security Administration handles Medicare eligibility and applications for Parts A (hospital insurance) and B (outpatient medical insurance). They offer several easy options so you can choose how to apply for Medicare. If you are aging into Medicare, you may apply as early as 3 months prior to the month of your 65th birthday. You’ll find that getting started early is a plus so that you’ll have your new Medicare card in hand before your effective date.

This is your Medicare Initial Enrollment Period to enroll in Parts A and B. (It is also your enrollment period for Part D. Since prescriptions drugs are not covered by Original Medicare, you purchase Part D separately from an insurance company. You do not enroll in it through Social Security because Part D is voluntary.)

Next, we’ll cover when to apply for Medicare.

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When to Apply for Medicare

Medicare is separate from your application for Social Security income benefits. People age into Medicare at age 65, regardless of whether they are taking retirement income benefits yet. If you are a citizen age 65 or older and need medical insurance, you are entitled to enroll in Medicare. You can also qualify for Medicare early due to certain disabilities, having Amyotrophic Lateral Sclerosis (Lou Gehrig disease), or End-Stage Renal disease (ESRD) and need a transplant or on dialysis.

Don’t expect that Medicare will notify you of when it’s time to sign-up either. This can be especially important for those who live out of the country.

If you are already taking Social Security income benefits or Railroad Retirement Board benefits, you will be automatically enrolled in Medicare Parts A and B at age 65. Your card should arrive 1-2 months before you turn 65. This timeframe also applies to those who qualify early due to disability.

However, you will not automatically receive Part B benefits if you live in Puerto Rico. This means you will need to apply for Part B even if you receive Social Security benefits before age 65.

If you are NOT yet taking retirement benefits, then you will need to submit a Medicare application yourself. The government expects for you to know when to enroll. Let’s look at the timeline for when and how to register for Medicare.

IEP

Your Initial Enrollment Period (IEP) for Medicare Parts A, B and D lasts 7 months. It begins 3 months before your 65th birthday month, and runs for 3 months after your birth month. Enrolling in Medicare during your IEP means that you will have no late penalties. There are also no pre-existing condition waiting periods.

When to register for Medicare

Parts A, B and D depends on whether Medicare will be your primary coverage, or whether you still have employer coverage.

If Medicare will be your primary coverage, you should enroll in Medicare in the 3 months before your birth month. Your Medicare will start on the first of the month in which you turn 65. Enrolling prior to your birthday will ensure your benefits begin on the first of your birthday month.

If you register for Medicare in the 3 months after your 65th birthday, then your start date will be later. People unaware of this could end up with a few months of no health coverage. It’s important to realize that your application date affects your start date.

Also, if you are leaving employer coverage in the middle of your Medicare Initial Enrollment Period, then your IEP trumps any other election period. We’ve seen this a number of times where people assume their Medicare coverage will start immediately after the group coverage ends.

When you file for Medicare can affect the effective date of your coverage so it’s important to know the deadlines ahead of time.

However, if you are in your IEP and your birth month has already passed, this chart demonstrates that you must wait for your coverage.

It’s easy to see why applying for Medicare prior to your 65th birthday month is generally in your best interest. Although, it is ultimately your choice on when to apply.

If you have questions about when to enroll in Medicare, or what enrollment period applies to you, please contact our office. We would be happy to help you navigate the Medicare system.

Applying during the GEP

If you are a senior citizen and you do not have any other health insurance, it is important that you enroll in both parts of Medicare during your Initial Enrollment Period (IEP). If you fail to enroll during your IEP, you will be subject to a Part B late enrollment penalty of 10% for every full 12-month period that you were not enrolled.

Medicare Enrollment and Small Employer Coverage

If you are a senior citizen and have small employer coverage (less than 20 employees), it is important that you enroll in both parts of Medicare during your Initial Enrollment Period (IEP). Medicare will be primary if your employer has less than 20 employees. Since Medicare will be primary, you will want to give your doctors your Medicare card first. Filing for Medicare at age 65 is very important if you work for a small employer!

Applying for Medicare When You Have Large Employer Coverage

Medicare can coordinate with your employer insurance even if you or your spouse are still working. Your group health plan likely has coverage for medical services already built in, so delaying Part B enrollment can save you money until you retire from your job.

When to apply for Medicare varies for each person. What’s worse is that even though these rules exist, there are often workers at Social Security who will get them wrong. This can really affect you, so contact a Medicare insurance broker like Boomer Benefits for help. We have solved Medicare enrollment issues for our clients with plain facts in many conference calls with Social Security.

Lastly, if you are still working at 65, we’ll evaluate the costs of your employer coverage compared to Medicare. If staying at your employer insurance makes more sense, we can help you decide whether to enroll in Parts A or B or both.

Please note, you will qualify for a Special Enrollment Period (SEP) after 65 and will need to submit documentation when you apply for Medicare due to loss of employer coverage. The two documents include CMS form 40B and CMS form L564 which is your proof that you had creditable coverage during employment.

There are several ways to apply for Medicare. The method that is best for you depends on your schedule and preferences. Remember, since Medicare provides individual coverage, you will have your own application to complete.

Apply for medicare online

If you prefer to sign up for Medicare online without having to leave home, Social Security offers a quick online application that can be completed in fewer than ten minutes. You do not have to be receiving income benefits to get Medicare. Just visit the Social Security website, create an account, and follow the links about applying for Medicare.

To apply for both SS retirement benefits and Medicare at the same time, visit this link: https://www.ssa.gov/retire

To apply for just Medicare, visit this link: https://www.ssa.gov/benefits/medicare/

If you run into problems completing the online application, you can consider signing up by phone. Let’s take a look at that next.

Apply by Phone

When you retire, you become eligible for Medicare. You can sign up for Medicare online, over the phone, or in person.

If you want to apply for Medicare online, visit www.socialsecurity.gov. If you prefer to apply by phone, call 1-800-772-1213 (for TTY users, dial 1-800-325-0778).

You may also choose to apply for Medicare in person by visiting your local Social Security office. To find your nearest Social Security office, go to www.socialsecurity.gov/locator/. When you arrive at the office, tell the staff that you’d like to apply for Medicare.

Keep in mind that if you apply for Medicare over the phone or in person, it may take longer to get your benefits. This is because the forms have to be mailed to you and then you have to mail them back. The best way to avoid any delays is to apply for Medicare online.

Applying for Medicare in Person

Some people prefer to apply for Medicare in person at a local Social Security office. This can be a convenient option if you are very close to turning 65 and need to get your application processed quickly.

Visiting the Social Security website will allow you to search for the nearest office in your state. When you meet with a representative, they will give you a printout which shows that you have applied for Medicare Part A & B. This form will give you all the information you need to move forward with your Medicare Supplement application and/or Part D prescription drug plan.

The representative can also answer any questions about your Medicare costs, if you paid the necessary payroll taxes for premium-free Part A, if you are subject to Income Related Monthly Adjustment Amount (IRMAA) due to having a higher income, and your payment options. For example, if you are not receiving Social Security benefits, you can pay a direct quarterly bill or you can pay online monthly.

Questions

What is Medicare?

Medicare is a national health insurance program that offers hospital and medical insurance to those 65 years of age or older.

What are the parts of Medicare?

There are two parts to Medicare- Part A and Part B. Part A covers inpatient hospital stays, hospice care, skilled nursing facility, home health care, and more. Part B covers outpatient services including doctor visits, surgeries, durable medical equipment, and more.

What does Medicare not cover?

While Medicare does offer extensive coverage, it does not cover 100% of the cost for all services. There are also deductibles and coinsurance that participants must pay.

When is open enrollment for Medicare?

Open enrollment for Medicare is based on your birthday. There is a seven-month window that begins 3 months before your 65th birthday month. It is important to register during this time period to avoid penalties.

When will I get my Original Medicare card?

In most cases, you will receive your Medicare card about 3 weeks after you apply. If you are already receiving Social Security benefits when you turn 65, your card should arrive in the mail about 2 months before your birthday.

Do I have to apply for Medicare every year?

No, just one application is necessary. Part A and Part B will automatically renew every year as long as monthly premiums are paid on time. However, Part D drug plan benefits may change from year to year, so it is important to review your coverage annually during the Annual Election Period.

What should I do if I have more questions about Medicare?

If you have any other questions about Medicare, contact your local Medicare office or visit the Medicare website.

Applying for Medicare is just your first step. Medicare does not cover all of your medical costs. There is significant financial exposure to you in the deductibles and coinsurance that you must pay.

After you sign up for Medicare, you’re not done. You’ll still be responsible for some of your own medical costs, including deductibles and coinsurance. Be sure to review your coverage annually during the fall Annual Election Period so you know what to expect.

Apply free with our help

UrMedicare specializes in helping people with their Medicare applications. We know how important it is to have quality health insurance, and we want to make sure that you are getting the coverage that you need. Our service is free, and we will be there for you every step of the way – from applying for Medicare to setting up your Medigap and Part D plans. Contact us today to get started!