When You Can Enroll in Medicare Insurance Plans
Medicare has various parts, some of which you might receive automatically and others you may opt into. Find out when you can enroll in each one.
Enrolling in Original Medicare, Part A and Part B
U.S. citizens and legal permanent residents (residing in the U.S. for five continuous years) who are within three months of their 65th birthday may enroll in Medicare Part A. If you already receive Social Security benefits or the Railroad Retirement benefits, then you will be automatically enrolled in Medicare Part A the first day of the month in which you turn 65 years old. Your Medicare card will be mailed to you about three months before your 65th birthday. You are also eligible to enroll for Medicare Part B the month in which you turn 65, although because you pay a monthly premium for this coverage, you have the option to opt out of it when you receive your "Welcome to Medicare" packet (which arrives with your Medicare card).
If you don't receive Social Security or Railroad Retirement pension or disability benefits, then you are eligible to enroll in Original Medicare, Part A and Part B, up to three months before the month of your 65th birthday. This is called the Initial Enrollment Period (IEP), and it lasts for a total of seven months: the three months before your birth month, your birth month, and the three months following it.
To enroll during this period, you can apply online via the Social Security Administration (SSA), visit your local SSA office, or contact the SSA by phone at 1-800-772-1213, and TTY users can call 1-800-325-0778. Social Security representatives are available Monday through Friday, from 7AM to 7PM.
If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772, TTY users call 1-312-751-4701, Monday through Friday from 9AM to 3:30 PM.
If you did not sign up for Medicare Part A and Part B when you were first eligible, and you are not eligible for a Special Election Period, then you can enroll during the General Enrollment Period, which runs from January 1 through March 31 each year.
Your coverage begins on July 1, and you will be subject to a higher premium for both Part A and Part B. For Part A, your premium amount may increase by 10%. You'll have to pay this increased amount for twice the number of years you could have had Part A and did not join.
Like the Part A premium, your Part B premium may also increase by 10% for each year that you could have had Part B, but did not take it. Unlike Part A, you must continue paying this increased amount for as long as you remain enrolled in Part B.
Individuals under the age of 65 are eligible to enroll in Medicare Part A and Part B if they meet one of the following conditions:
- You have a qualifying disability such as blindness or a qualifying medical condition.
- You received disability payments from Social Security or the Railroad Retirement Board for the past 24 months.
- You are a disabled widow or widower between age 50 and age 65 but have not applied for disability benefits because you're already getting another kind of Social Security benefit.
- You have permanent kidney failure and you receive dialysis and/or have received a kidney transplant, and you (or your spouse or parent if you are a dependent) meet certain work conditions.
Enrolling in Medicare Supplement (Medigap)
Anyone who has Original Medicare, Part A and Part B, may enroll in a Medigap program at any time during the year. However, the optimal time in which to enroll in a Medigap plan is during the Open Enrollment Period (OEP). Your individual Medigap Open Enrollment Period is six months long and begins on the first day of the month in which you are at least 65 years old and enrolled in Medicare Part B.
During this period you have a guaranteed issue right to buy a Medigap policy. This means the insurance company may not subject you to medical underwriting (a review of your medical history and the potential risk level it represents to the insurance company). However, outside of this Open Enrollment Period, your enrollment application to a Medigap plan would be subject to medical underwriting. In this scenario, you may be denied coverage or you may be charged more if you have health problems.
Enrolling in Medicare Advantage (Medicare Part C)
A Medicare Advantage plan provides your Original Medicare (Part A and Part B) coverage through a private insurance company, sometimes along with other benefits. You can sign up for a Medicare Advantage plan right after you're enrolled in both Part A and Part B. Or, you can join during the Annual Election Period (AEP), which lasts from October 15 through December 7 each year. These plans are sold by private insurance companies that have contracted with the Medicare program.
Beneficiaries may decide that they prefer Original Medicare, Part A and Part B, to this private plan coverage. They have from January 1 through February 14 of each year to disenroll from their Medicare Advantage plan and return to Part A and Part B. This is called the Medicare Advantage Disenrollment Period. A Medicare Advantage beneficiary, however, cannot switch from his or her existing Medicare Advantage plan to a different Part C plan during this period; they can only return to Original Medicare.
Medicare Advantage plans allow for Special Enrollment Periods (SEP) for qualifying individuals. Some of the conditions that can qualify you for a Special Enrollment Period are (this is not an all-inclusive list):
- Your 65th birthday.
- Any time you move to a new coverage area.
- If you suffer from certain chronic medical conditions.
- You are enrolled in the Extra Help from the government or qualify for this program.
- You are enrolled in Medicaid.
During a Special Election Period, an individual may enroll or disenroll from a Medicare Advantage plan.
Enrolling in Medicare Part D (prescription drug coverage)
Like Medicare Advantage, beneficiaries can join a drug plan during the Annual Election Period that runs from October 15 through December 7. Individuals who were eligible for Medicare Part A or enrolled in Part B as of the effective date of coverage could have enrolled in a Part D plan or switched Part D plans during this time.
Individuals could have also enrolled in a Part D plan if they had qualified for a Special Election Period (SEP). Part D has identical qualifications for a Special Election Period as those listed above in the Medicare Advantage section of this page.
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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.