How Do You Sign Up For Medicare Once You Are Eligible?
Updated for January, 2022
You may be among the millions of people currently asking yourself the question: “How do I sign up for Medicare?” The good news is that it is easier than you might think.
Signing up for Medicare is a simple process, but the exact procedure will be guided by your individual decisions regarding receiving Social Security and working beyond age 65. The following are the scenarios to consider:
- Retiring and taking Social Security at age 65
- Retiring at age 65, but not taking Social Security
- Working beyond age 65
Signing up for Medicare is a simple process, but the exact procedure will be guided by your individual decisions regarding receiving Social Security and working beyond age 65.
Retiring and Taking Social Security at 65
If you retire at age 65, you can sign up for Medicare and Social Security at the same time. If you were born in the United States, the easiest way to sign up for Social Security and Medicare is to do so online at the Social Security Administration website. You can also enroll over the phone.
If you are a naturalized citizen, you may have to go to a Social Security office and enroll in person. In either case, you can enroll in Medicare Part A and B at the same time.
Retiring at 65, but not Taking Social Security
If you are retiring at age 65 and want Medicare benefits but will not be receiving Social Security, you will need to sign up for Medicare only. You can do this online, over the phone, or in person at a Social Security office. Again, your citizenship status may limit your choices here.
Working Past Age 65
If you are going to work past age 65 and you receive health insurance from your employer, there is one more factor that affects your need to sign up for Medicare:
- If your employer has less than 20 employees, you may need to enroll in Medicare Part A and Medicare Part B
- If your employer has more than 20 employees, you can choose to stay on their plan, or you may opt to enroll in Part A and B
If you are not if these criteria apply to you, talk to your employer and ask them about your options for coverage.
If you must enroll in Medicare because you work for a small employer, or if you decide that you want to enroll, you can enroll over the phone, online, or in person. If you enroll online, you can do so on the Social Security website.
The Basics of Eligibility
Your eligibility for Medicare falls under the following two categories:
- Citizenship or residence status (eligibility rules)
- Age, health diagnosis, or disability status (entry rules)
Citizenship and Residence Status
To gain Medicare coverage, you must be a US citizen or permanent legal resident. If you are a permanent resident, you must have lived in the country for at least five consecutive years.
Age, Health, or Disability Status
If you meet the citizenship or resident requirement, you can enter the Medicare program when you meet one of the following criteria:
- You turn 65 (this is called aging into Medicare)
- You receive Social Security or Railroad Retirement Board (RRB) disability payments for 24 consecutive months, regardless of your age
- You are diagnosed with ALS (Lou Gehrig’s disease), regardless of your age
- You are diagnosed with ESRD (end-stage renal disease), regardless of your age
If you retire at age 65, you can sign up for Medicare and Social Security at the same time.
When Can You Enroll?
Now that you know everything you need to know about the basics of Medicare coverage and how your decision to receive Social Security or to work beyond age 65 impacts your Medicare timing, it is time to pinpoint specific enrollment windows.
If you gain Medicare coverage due to a diagnosis of ALS or ESRD, you will automatically enter Medicare four months after your official diagnosis (ALS), or four months after you begin dialysis (ESRD).
If you become eligible for Medicare due to a disability, you will automatically enter on the first day of the 25th consecutive month after you begin receiving disability payments.
When you age into Medicare at age 65, you will have a window of time in which to apply. This window, known as the Initial Coverage Election Period (ICEP), lasts a total of seven months, which includes:
- Three months before the month you turn 65
- The exact month you turn 65
- Three months after the month you turn 65
For example, if you turn 65 in September 2020, your enrollment window begins June 1, 2020, then ends December 31, 2020. You can enroll anytime during this seven-month window without incurring any late enrollment penalties.
What If You Work Past Age 65?
If you work past age 65 and your employer has more than 20 employees as discussed earlier, you can choose to delay Part B coverage. When you retire, or your employer coverage ends, you will have a Special Enrollment Period that gives you eight months to enroll in Part B without penalty.
If you miss your enrollment deadline, you will be able to enroll during the General Enrollment Period. The General Enrollment Period runs from January 1 to March 31 of each year. If you sign up during this window, your Medicare coverage will be effective July 1 of that year.
It is important to note that, in this case, you will need to pay a late enrollment penalty in the form of higher Part B premiums for every 12 months that you are late.
What If You Want Something Besides Original Medicare?
If you want to add coverage beyond Part A and B, you will add those plans during the same enrollment windows.
Medicare Advantage has the same enrollment window as Original Medicare. You can enroll in a Medicare Advantage plan during your seven-month ICEP. If you work beyond age 65, you can enroll in Medicare Advantage during a two-month Special Election Period that begins when your employer coverage ends.
Prescription Drug Plans
Prescription drug plans follow the same enrollment windows as Medicare Advantage. As such, you can enroll:
- Anytime during your seven-month Initial Coverage Election Period, Or
- During your two-month Special Election Period (if you keep employer coverage beyond age 65)
To gain Medicare coverage, you must be a US citizen or permanent legal resident.
Medicare Supplement Insurance
Every Medicare-eligible American has the right to enroll in a Medicare Supplement plan (also known as Medigap plans) when they first enter Part B. The Medigap Open Enrollment Period is six months, and it begins when you turn 65 and are enrolled in Part B.
This is the time that you will need to enroll in Medigap. If you want a Medicare Supplement plan after your Open Enrollment Period has expired, your coverage is not guaranteed, which means that you can be declined coverage.
Putting It All Together
Throughout this review, we have answered the question: “How do I sign up for Medicare?” We also covered the basics of eligibility and enrollment, as well as some of the specific benefits of Medicare.
Before making any decisions, you should review all of your options for coverage, including supplemental plans. It would be especially beneficial to compare quotes for various Medicare insurance coverage while chatting with a licensed professional.
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