Apply for Medicare
If you’re new to Medicare and have questions about eligibility or enrollment, you’ve come to the right place. Medicare is a federal program that provides health coverage for older adults and certain disabled individuals. The program is broken into four main parts:
- Part A (hospital insurance)
- Part B (medical insurance)
- Part C (Medicare Advantage plans)
- Part D (prescription drug coverage)
Beneficiaries also have the option of enrolling in a Medicare Supplement (Medigap) plan to fill in any gaps in Original Medicare,Part A and Part B, coverage.
United States citizens and permanent residents who have lived continuously in the country for five or more years are eligible for Original Medicare when they turn 65.
Other individuals may qualify for Medicare before 65 if they have received Social Security or certain Railroad Retirement Board disability benefits for at least two years or if they have certain conditions, such as end-stage renal disease or amyotrophic lateral sclerosis (also known as ALS, or Lou Gehrig’s disease).
When to apply for Medicare
If you’re wondering when you should enroll in Medicare Part A and Part B, the timing of your Initial Enrollment Period will depend on how you qualify for Medicare:
- Turning 65:If you’re eligible for Medicare because of age and are already receiving Social Security or Railroad Retirement Board benefits before you turn 65, you’ll be automatically enrolled in Medicare Part A and Part B on the first day of the month that you turn 65. If you’re not yet receiving retirement benefits, you can manually enroll in Medicare during your Initial Enrollment Period, the seven-month period that starts three months before you turn 65, includes your birthday month, and ends three months later.
- Disability: If you qualify because of disability, you’ll be automatically enrolled in Medicare Part A and Part B in the 25th month of receiving disability benefits from the Social Security Administration or Railroad Retirement Board.
- Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease): If you qualify for Medicare because you have Lou Gehrig’s disease, you’re automatically enrolled the same month that your disability benefits begin.
- End-stage renal disease (ESRD): For individuals who qualify for Medicare because of end-stage renal disease, enrollment works differently and may depend on your specific situation. Contact Medicare for more information at 1-800-633-4227, 24 hours a day, seven days a week (TTY users, call 1-877-486-2048).
If you missed your Initial Enrollment Period, you can also sign up for Medicare Part A and Part B during the General Enrollment Period that takes place from January 1 to March 31 every year. Keep in mind that you may owe a late-enrollment penalty for Medicare Part A and/or Part B if you didn’t sign up when you were first eligible.
You may decide to delay enrollment in Medicare Part A and/or Part B if you were working when you turned 65 and covered through your employer’s group coverage, or you had health coverage through your spouse’s current employer. If you wait to enroll in Medicare Part A and/or Part B for this reason, you’ll get an eight-month Special Enrollment Period to sign up for Medicare that starts the month after you stop working or after the employer-sponsored coverage ends, whichever happens first. You generally won’t owe a late-enrollment penalty if you sign up for Medicare through a Special Enrollment Period. Keep in mind that only individuals with health coverage through current employment may delay Medicare Part A and/or Part B without paying a late-enrollment penalty. COBRA or retiree health coverage doesn’t count as “current” employment and won’t qualify you for a Special Enrollment Period.
When it comes to Medicare plans like Medicare Advantage plans, Medicare Prescription Drug Plans, or Medigap plans, each type of coverage has its own rules regarding eligibility and enrollment. For more about enrollment and election periods for Original Medicare and other types of Medicare coverage, see this article, “When to Apply for Medicare.”
How to apply for Medicare
As mentioned, if you’re already receiving retirement benefits before you turn 65, you’ll be automatically enrolled in Original Medicare, Part A and Part B, on the first day of the month that you turn 65. If your birthday falls on the first day of the month, your Medicare coverage starts on the first day of the month prior to your 65th birthday.
Beneficiaries who are not receiving retirement benefits when they turn 65 will need to manually enroll. You can sign up for Medicare through Social Security or the Railroad Retirement Board during your Initial Enrollment Period, which (as mentioned) starts three months before your 65th birthday and lasts seven months. You have many different options available when it comes to applying for Medicare, including:
- Applying online via the Social Security website. If you’re not yet ready to retire, you can submit an application for Medicare only.
- Applying in person at your local Social Security office.
- Applying over the phone by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday, from 7AM to 7PM.
- If you worked for a railroad, contact the Railroad Retirement Board to enroll in Medicare. Call 1-877-772-5772 (TTY users, dial 1-312-751-4701), Monday through Friday, from 9AM to 3:30PM to reach a Railroad Retirement Board representative.
After applying for Medicare through one of these methods, if there are no issues with your application, you should receive your red, white, and blue Medicare card in the mail. If you’re automatically enrolled in Medicare, your card should arrive three months before your 65th month birthday or the 25th month of disability benefits.
As mentioned, enrollment works differently when it comes to Medicare plans, such as Medigap, Medicare Prescription Drug Plans, and Medicare Advantage plans. Instead of enrolling through Social Security or the Railroad Retirement Board, you can find and compare Medicare insurance plans by contacting the insurance company directly, visiting Medicare.gov, or contacting a licensed insurance broker like eHealth. Keep in mind that costs and benefits may vary from plan to plan, and not every plan may be available where you live. If you need help finding Medicare plan options that may work for your needs, an eHealth licensed insurance agent can help. Contact eHealth to set up an appointment today and get your Medicare questions answered.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.